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炎症关联:揭示阿尔茨海默病和精神分裂症的共同途径及有前景的治疗方法

The Inflammatory Nexus: Unraveling Shared Pathways and Promising Treatments in Alzheimer's Disease and Schizophrenia.

作者信息

Russo Aurelio Pio, Pastorello Ylenia, Dénes Lóránd, Brînzaniuc Klara, Krupinski Jerzy, Slevin Mark

机构信息

Department of Anatomy and Embryology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureş, Romania.

Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureş, Romania.

出版信息

Int J Mol Sci. 2025 Jun 27;26(13):6237. doi: 10.3390/ijms26136237.

Abstract

Alzheimer's disease (AD) and schizophrenia are traditionally considered distinct clinical entities, yet growing evidence highlights substantial overlap in their molecular and neuroinflammatory pathogenesis. This review explores current insights into the shared and divergent mechanisms underlying these disorders, with emphasis on neuroinflammation, autophagy dysfunction, blood-brain barrier (BBB) disruption, and cognitive impairment. We examine key signaling pathways, particularly spleen tyrosine kinase (SYK), the mechanistic (or mammalian) target of rapamycin (mTOR), and the S100 calcium-binding protein B (S100B)/receptor for advanced glycation end-products (RAGE) axis, that link glial activation, excitatory/inhibitory neurotransmitter imbalances, and impaired proteostasis across both disorders. Specific biomarkers such as S100B, matrix metalloproteinase 9 (MMP9), and soluble RAGE show promise for stratifying disease subtypes and predicting treatment response. Moreover, psychiatric symptoms frequently precede cognitive decline in both AD and schizophrenia, suggesting that mood and behavioral disturbances may serve as early diagnostic indicators. The roles of autophagic failure, cellular senescence, and impaired glymphatic clearance are also explored as contributors to chronic inflammation and neurodegeneration. Current treatments, including cholinesterase inhibitors and antipsychotics, primarily offer symptomatic relief, while emerging therapeutic approaches target upstream molecular drivers, such as mTOR inhibition and RAGE antagonism. Finally, we discuss the future potential of personalized medicine guided by genetic, neuroimaging, and biomarker profiles to optimize diagnosis and treatment strategies in both AD and schizophrenia. A greater understanding of the pathophysiological convergence between these disorders may pave the way for cross-diagnostic interventions and improved clinical outcomes.

摘要

阿尔茨海默病(AD)和精神分裂症传统上被认为是不同的临床实体,但越来越多的证据表明它们在分子和神经炎症发病机制上有大量重叠。本综述探讨了对这些疾病潜在的共同和不同机制的当前见解,重点关注神经炎症、自噬功能障碍、血脑屏障(BBB)破坏和认知障碍。我们研究了关键信号通路,特别是脾酪氨酸激酶(SYK)、雷帕霉素的机制性(或哺乳动物)靶点(mTOR)以及S100钙结合蛋白B(S100B)/晚期糖基化终产物受体(RAGE)轴,这些通路将两种疾病中的神经胶质激活、兴奋性/抑制性神经递质失衡和蛋白稳态受损联系起来。诸如S100B、基质金属蛋白酶9(MMP9)和可溶性RAGE等特定生物标志物有望用于对疾病亚型进行分层并预测治疗反应。此外,在AD和精神分裂症中,精神症状通常先于认知衰退出现,这表明情绪和行为障碍可能作为早期诊断指标。自噬功能衰竭、细胞衰老和淋巴系统清除受损的作用也被探讨为慢性炎症和神经退行性变的促成因素。目前的治疗方法,包括胆碱酯酶抑制剂和抗精神病药物,主要提供症状缓解,而新兴的治疗方法则针对上游分子驱动因素,如mTOR抑制和RAGE拮抗。最后,我们讨论了由基因、神经影像学和生物标志物谱指导的个性化医学在优化AD和精神分裂症的诊断和治疗策略方面的未来潜力。对这些疾病之间病理生理趋同的更深入理解可能为交叉诊断干预和改善临床结果铺平道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/964f/12250212/671381d291b1/ijms-26-06237-g001.jpg

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