阿尔茨海默病神经炎症中的适应性免疫。

Adaptive immunity in the neuroinflammation of Alzheimer's disease.

作者信息

Liu Hanchen, Chen Yun, Zhang Jing, Chen Xiaochun

机构信息

Department of Neurology, Fujian Medical University Union Hospital, Fujian Key Laboratory of Molecular Neurology and Institute of Neuroscience, Fujian Medical University, Fuzhou, Fujian 350001, China.

出版信息

Chin Med J (Engl). 2025 Sep 5;138(17):2116-2129. doi: 10.1097/CM9.0000000000003695. Epub 2025 Aug 5.

Abstract

Alzheimer's disease (AD) is the most common cause of dementia and is a growing public health challenge. Neuroinflammation has been proposed as a prominent pathological feature of AD and has traditionally been attributed to the innate immune system. However, emerging evidence highlights the involvement of adaptive immunity, particularly T and B lymphocytes, in the neuroinflammatory processes of AD. It remains unclear how adaptive immune responses, originally intended to protect the body, contribute to chronic inflammation and neuronal dysfunction in AD. Here, we review the roles of adaptive immunity, cellular composition, and niches and their contribution to AD development and progression. Notably, we synthesize the crosstalk between adaptive immunity and the innate immune system of the central nervous system (CNS), which is mainly mediated by glial cells and myeloid cells, and their interrelationships with amyloid-β (Aβ)/Tau pathology. We hypothesized that the alterations observed in innate immunity in AD mirror age-related immune alterations, whereas the dysregulation of adaptive immunity contributes more accurately to disease-specific immune responses. Targeting adaptive immunity in the context of neuroinflammation may provide new insights into potential therapeutic strategies designed to modulate immune responses, thereby facilitating the diagnosis, intervention, and treatment of AD.

摘要

阿尔茨海默病(AD)是痴呆最常见的病因,且对公共卫生构成日益严峻的挑战。神经炎症被认为是AD的一个突出病理特征,传统上一直归因于固有免疫系统。然而,新出现的证据凸显了适应性免疫,尤其是T淋巴细胞和B淋巴细胞,在AD神经炎症过程中的参与。目前尚不清楚原本旨在保护身体的适应性免疫反应如何导致AD中的慢性炎症和神经元功能障碍。在此,我们综述适应性免疫、细胞组成和微环境的作用及其对AD发生和进展的影响。值得注意的是,我们综合了适应性免疫与中枢神经系统(CNS)固有免疫系统之间的相互作用,这主要由胶质细胞和髓样细胞介导,以及它们与淀粉样β蛋白(Aβ)/tau病理的相互关系。我们推测,AD中固有免疫的改变反映了与年龄相关的免疫改变,而适应性免疫的失调更准确地促成了疾病特异性免疫反应。在神经炎症背景下靶向适应性免疫可能为旨在调节免疫反应的潜在治疗策略提供新见解,从而促进AD的诊断、干预和治疗。

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