Götz M E, Künig G, Riederer P, Youdim M B
Department of Psychiatry, University of Würzburg, Germany.
Pharmacol Ther. 1994;63(1):37-122. doi: 10.1016/0163-7258(94)90055-8.
It is not yet established whether oxidative stress is a major cause of cell death or simply a consequence of an unknown pathogenetic factor. Concerning chronic diseases, as Parkinson's and Alzheimer's disease are assumed to be, it is possible that a gradual impairment of cellular defense mechanisms leads to cell damage because of toxic substances being increasingly formed during normal cellular metabolism. This point of view brings into consideration the possibility that, besides exogenous factors, the pathogenetic process of neurodegeration is triggered by endogenous mechanisms, either by an endogenous toxin or by inherited metabolic disorders, which become progressively more evident with aging. In the following review, we focus on the oxidative stress theory of neurodegeneration, on excitotoxin-induced cell damage and on impairment of mitochondrial function as three major noxae being the most likely causes of cell death either independently or in connection with each other. First, having discussed clinical, pathophysiological, pathological and biochemical features of movement and cognitive disorders, we discuss the common features of these biochemical theories of neurodegeneration separately. Second, we attempt to evaluate possible biochemical links between them and third, we discuss experimental findings that confirm or rule out the involvement of any of these theories in neurodegeneration. Finally, we report some therapeutic strategies evolved from each of these theories.
氧化应激究竟是细胞死亡的主要原因,还是仅仅是一种未知致病因素的结果,目前尚无定论。对于诸如帕金森病和阿尔茨海默病这类慢性病而言,有可能是细胞防御机制的逐渐受损导致细胞损伤,原因在于正常细胞代谢过程中会越来越多地形成有毒物质。这种观点考虑到了这样一种可能性,即除了外源性因素外,神经退行性变的致病过程是由内源性机制触发的,要么是内源性毒素,要么是遗传性代谢紊乱,且随着年龄增长会逐渐变得更加明显。在接下来的综述中,我们将重点关注神经退行性变的氧化应激理论、兴奋性毒素诱导的细胞损伤以及线粒体功能障碍这三种主要有害物质,它们最有可能单独或相互关联地导致细胞死亡。首先,在讨论了运动和认知障碍的临床、病理生理、病理和生化特征后,我们分别讨论这些神经退行性变生化理论的共同特征。其次,我们试图评估它们之间可能的生化联系,第三,我们讨论证实或排除这些理论中任何一种与神经退行性变有关的实验结果。最后,我们报告从这些理论中衍生出的一些治疗策略。