小胶质细胞介导的神经炎症在阿尔茨海默病中的作用机制及靶向治疗研究进展

    Research Progress on the Mechanism and Targeted Therapy of Microglia-Mediated Neuroinflammation in Alzheimer’s Disease

    • 摘要: 阿尔茨海默病(alzheimer’s disease,AD)是一种严重威胁老年人健康的进行性神经退行性疾病,其发病机制复杂,神经炎症 β 淀粉样蛋白(amyloid-β peptide,Aβ)沉积及 tau 蛋白过度磷酸化是核心病理特征,给家庭和社会带来沉重负担。小胶质细胞作为中枢神经系统主要免疫细胞,其功能异常是 AD 神经炎症发生发展的关键驱动力,而髓系细胞触发受体2(triggering receptor expressed on myeloid cells 2,TREM2)与 NOD 样受体家族含 pyrin 结构域蛋白3(nod-,lrr- and pyrin domain-containing protein 3,NLRP3)炎症小体是调控小胶质细胞活化及神经炎症的核心分子。本文系统梳理了 TREM2 与 NLRP3 炎症小体在 AD 神经炎症中的作用机制,重点阐述二者的交互调控关系:TREM2 可通过磷脂酰肌醇 3-激酶(phosphatidylinositol 3-kinase,PI3K) /蛋白激酶 B(protein kinase b,AKT) /雷帕霉素哺乳动物靶蛋白(mammalian target of rapamycin,MTOR)和Toll 样受体 4(toll-like receptor 4,TLR4) /核因子 κB(nuclear factor-kappa B,NF-κB)等信号通路调控小胶质细胞表型转化,抑制 NLRP3 炎症小体活化及促炎因子释放,参与 Aβ 清除及神经元保护;NLRP3 炎症小体异常激活则会通过形成“炎症因子分泌-病理损伤”恶性循环,加剧神经炎症及 AD 病理进程,且可负向调控 TREM2 信号。同时,总结了靶向 TREM2、NLRP3 炎症小体及二者联合干预的 AD 治疗策略,分析了当前治疗研究的进展与挑战。本文为深入阐明 AD 神经炎症的分子调控机制,以及开发高效、安全的 AD 靶向治疗药物提供理论依据和研究思路。

       

      Abstract: Alzheimer’s disease(AD) is a progressive neurodegenerative disease that seriously endangers the health of the elderly, with a complex pathogenesis. Neuroinflammation, amyloid-β peptide(Aβ) deposition, and excessive tau protein phosphorylation are its core pathological features, imposing a heavy burden on families and society. As the major immune cells in the central nervous system, the dysfunction of microglia is a key driving force for the occurrence and development of neuroinflammation in AD. Triggering receptor expressed on myeloid cells 2(TREM2) and the NOD-, LRR-, and pyrin domain-containing protein 3(NLRP3) inflammasome are the core molecules that regulate microglial activation and neuroinflammation. This paper systematically reviews the mechanisms of TREM2 and the NLRP3 inflammasome in neuroinflammation of AD, with a focus on their interactive regulatory relationship: TREM2 can regulate the phenotypic transformation of microglia through signaling pathways such as phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR) and toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB), inhibit the activation of the NLRP3 inflammasome and the release of proinflammatory factors, and participate in Aβ clearance and neuronal protection. Abnormal activation of the NLRP3 inflammasome will exacerbate neuroinflammation and the pathological processes of AD by forming a vicious cycle of "inflammatory factor secretion-pathological damage" and can negatively regulate the TREM2 signaling pathway. Meanwhile, this paper summarizes the therapeutic strategies for AD targeting TREM2, the NLRP3 inflammasome, and their combined intervention, and analyzes the current progress and challenges in therapeutic research. This work provides a theoretical basis and research ideas for further clarifying the molecular regulatory mechanism of neuroinflammation in AD and developing efficient and safe targeted therapeutic drugs for AD.

       

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