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  • 文章类型: Journal Article
    药物发现通常是低效且资本密集型的过程。对于神经退行性疾病(NDD),考虑到大量的晚期候选药物失败,开发新的治疗方法尤为紧迫.尽管我们对驱动神经变性的致病机制的认识正在增长,需要更多的努力来更好地和最终完整地了解NDD的病理生理基础。除了NDD的病因是异质和多因素的,由于目前的实验模型仅部分概括了在人类中观察到的主要表型,这一过程变得更加复杂。在这种情况下,多组学方法有可能加速识别新的或再利用的药物,以对抗多种驱动NDD的潜在机制.在药物发现过程中实施多维方法的一个主要优点是,这些总体工具能够通过对不同分子层的全面表征来解开疾病状态和模型扰动(即,基因组,转录组,蛋白质组)直至单细胞分辨率。由于最近的进步增加了他们的负担能力和可扩展性,使用组学技术来推动药物发现还处于起步阶段,但在神经科学领域迅速扩张。结合日益先进的体外模型,特别受益于人类iPSC的引入,多元组学正在塑造NDD药物发现的新范式,从疾病表征到治疗学预测和实验筛选。在这次审查中,我们讨论例子,在使用多组学方法在体外发现针对NDD的靶标和疗法方面的主要优势和面临的挑战。
    Drug discovery is a generally inefficient and capital-intensive process. For neurodegenerative diseases (NDDs), the development of novel therapeutics is particularly urgent considering the long list of late-stage drug candidate failures. Although our knowledge on the pathogenic mechanisms driving neurodegeneration is growing, additional efforts are required to achieve a better and ultimately complete understanding of the pathophysiological underpinnings of NDDs. Beyond the etiology of NDDs being heterogeneous and multifactorial, this process is further complicated by the fact that current experimental models only partially recapitulate the major phenotypes observed in humans. In such a scenario, multi-omic approaches have the potential to accelerate the identification of new or repurposed drugs against a multitude of the underlying mechanisms driving NDDs. One major advantage for the implementation of multi-omic approaches in the drug discovery process is that these overarching tools are able to disentangle disease states and model perturbations through the comprehensive characterization of distinct molecular layers (i.e., genome, transcriptome, proteome) up to a single-cell resolution. Because of recent advances increasing their affordability and scalability, the use of omics technologies to drive drug discovery is nascent, but rapidly expanding in the neuroscience field. Combined with increasingly advanced in vitro models, which particularly benefited from the introduction of human iPSCs, multi-omics are shaping a new paradigm in drug discovery for NDDs, from disease characterization to therapeutics prediction and experimental screening. In this review, we discuss examples, main advantages and open challenges in the use of multi-omic approaches for the in vitro discovery of targets and therapies against NDDs.
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  • 文章类型: Journal Article
    欧洲过敏和航空疾病研究与教育论坛(EUFOREA)于2023年11月在柏林举办了每两年一次的EUFOREUM论坛。EUFOREUM2023的目标是强调儿科行动计划,以预防和优化从儿童开始的2型炎症疾病的护理。专注于早期诊断,确保既不低估也不过度诊断,最佳护理,以及改善护理的建议。EUFOREA是一个国际非营利组织,由所有利益相关者组成联盟,致力于通过教育实施最佳患者护理来减少慢性呼吸系统疾病的患病率和负担。研究,和宣传活动。EUFOREA的包容性和多学科方法反映在虚拟EUFOREUM2023(www。Euforea.eu/euforeum)来自儿科,变态反应学,肺科,ENT,皮肤病学,初级卫生保健领域和患者围绕2型炎症的中心主题。由于大多数2型炎症可能始于童年或青春期,大多数儿童在患有呼吸道或皮肤病时都有2型炎症,现在是提高护理野心的时候了,包括预防,早期缓解和疾病改变。本报告全面概述了EUFOREUM2023的教师的关键声明和EUFOREA的雄心,允许呼吸领域的所有利益相关者进行更新,并准备在欧洲及其他地区联合起来。
    The European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi-annual forum EUFOREUM in Berlin in November 2023. The aim of EUFOREUM 2023 was to highlight pediatric action plans for prevention and optimizing care for type 2 inflammatory conditions starting in childhood, with a focus on early-stage diagnosis, ensuring neither under- nor overdiagnosis, optimal care, and suggestions for improvement of care. EUFOREA is an international not-for-profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic respiratory diseases through the implementation of optimal patient care via educational, research, and advocacy activities. The inclusive and multidisciplinary approach of EUFOREA was reflected in the keynote lectures and faculty of the virtual EUFOREUM 2023 (www.euforea.eu/euforeum) coming from the pediatric, allergology, pulmonology, ENT, dermatology, primary health care fields and patients around the central theme of type 2 inflammation. As most type 2 inflammatory conditions may start in childhood or adolescence, and most children have type 2 inflammation when suffering from a respiratory or skin disease, the moment has come to raise the bar of ambitions of care, including prevention, remission and disease modification at an early stage. The current report provides a comprehensive overview of key statements by the faculty of the EUFOREUM 2023 and the ambitions of EUFOREA allowing all stakeholders in the respiratory field to be updated and ready to join forces in Europe and beyond.
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  • 文章类型: Journal Article
    背景:现有研究证实,β淀粉样蛋白(Aβ)对α7烟碱乙酰胆碱受体(α7nAChR)具有高亲和力,与阿尔茨海默病密切相关。相关研究大多集中在Aβ片段(Aβx)的神经保护作用的实验报告上,然而,缺乏对Aβ片段和α7nAChR之间最合适的结合区和作用机制的研究。在研究中,我们使用了四个Aβ1-42片段Aβx,Aβ1-16,Aβ10-16,Aβ12-28和Aβ30-42,其中前三个被证实在直接结合时发挥神经保护作用,与α7nAChR相互作用。
    方法:采用CABS-DOCK的蛋白质-配体对接服务器获得α7nAChR-Aβx复合物。仅使用顶部的α7nAChR-Aβx复合物结合Charmm36力场进行全原子GROMACS动力学模拟,由此确定了α7nAChR-Aβx相互作用的动态行为和这些不同Aβx片段的特定位置。还进行MM-PBSA计算以估计结合自由能和来自Aβx中的残基的不同贡献。结合位点前三个和第四个Aβx片段有两个不同的结果,力量,关键残留物,和方向,解释了为什么第四个在分子水平上不能发挥神经保护作用。
    BACKGROUND: Existing researches confirmed that β amyloid (Aβ) has a high affinity for the α7 nicotinic acetylcholine receptor (α7nAChR), associating closely to Alzheimer\'s disease. The majority of related studies focused on the experimental reports on the neuroprotective role of Aβ fragment (Aβx), however, with a lack of investigation into the most suitable binding region and mechanism of action between Aβ fragment and α7nAChR. In the study, we employed four Aβ1-42 fragments Aβx, Aβ1-16, Aβ10-16, Aβ12-28, and Aβ30-42, of which the first three were confirmed to play neuroprotective roles upon directly binding, to interact with α7nAChR.
    METHODS: The protein-ligand docking server of CABS-DOCK was employed to obtain the α7nAChR-Aβx complexes. Only the top α7nAChR-Aβx complexes were used to perform all-atom GROMACS dynamics simulation in combination with Charmm36 force field, by which α7nAChR-Aβx interactions\' dynamic behavior and specific locations of these different Aβx fragments were identified. MM-PBSA calculations were also done to estimate the binding free energies and the different contributions from the residues in the Aβx. Two distinct results for the first three and fourth Aβx fragments in binding site, strength, key residue, and orientation, account for why the fourth fails to play a neuroprotective role at the molecular level.
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  • 文章类型: Journal Article
    蛋白激酶C(PKC)是对各种器官中的细胞信号传导至关重要的多种酶家族。它的失调与许多疾病有关,包括癌症,心血管疾病,和神经问题。在大脑中,PKC在突触可塑性中起关键作用,学习,记忆,和神经元存活。具体来说,PKC参与阿尔茨海默病(AD)发病机制具有重要意义。PKC信号的失调与神经系统疾病有关,包括AD。这篇综述阐明了PKC在神经健康中的关键作用。特别是其在AD发病机制和慢性酒精成瘾中的意义。AD,以神经变性为特征,PKC失调与突触功能障碍和认知功能下降有关。相反,慢性饮酒引起神经适应与PKC信号交织在一起,加剧成瘾行为。通过揭露PKC参与这些痛苦,潜在的治疗途径出现了,提供改善其衰弱影响的承诺。这篇综述浏览了PKC之间复杂的相互作用,AD病理学,和酒精成瘾,照亮未来神经治疗干预的途径。
    Protein kinase C (PKC) is a diverse enzyme family crucial for cell signalling in various organs. Its dysregulation is linked to numerous diseases, including cancer, cardiovascular disorders, and neurological problems. In the brain, PKC plays pivotal roles in synaptic plasticity, learning, memory, and neuronal survival. Specifically, PKC\'s involvement in Alzheimer\'s Disease (AD) pathogenesis is of significant interest. The dysregulation of PKC signalling has been linked to neurological disorders, including AD. This review elucidates PKC\'s pivotal role in neurological health, particularly its implications in AD pathogenesis and chronic alcohol addiction. AD, characterised by neurodegeneration, implicates PKC dysregulation in synaptic dysfunction and cognitive decline. Conversely, chronic alcohol consumption elicits neural adaptations intertwined with PKC signalling, exacerbating addictive behaviours. By unravelling PKC\'s involvement in these afflictions, potential therapeutic avenues emerge, offering promise for ameliorating their debilitating effects. This review navigates the complex interplay between PKC, AD pathology, and alcohol addiction, illuminating pathways for future neurotherapeutic interventions.
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  • 文章类型: Journal Article
    背景:由于缺乏疾病特征,阿尔茨海默病(AD)和额颞叶痴呆(FTD)的准确诊断代表了健康问题。我们评估了SIMOA小组在43名AD和33名FTD患者的脑脊液(CSF)中的表现,并结合了人口统计学-临床特征。
    方法:136名受试者(AD:n=43,FTD:n=33,对照:n=60)参与。单分子阵列(SIMOA),胶质纤维酸性蛋白(GFAP),神经丝光(NfL),TAU,用多重neuro4plex试剂盒分析CSF中的泛素羧基末端水解酶L1(UCH-L1)。受试者工作特征(ROC)曲线分析比较曲线下面积(AUC),而稀疏偏最小二乘判别分析(sPLS-DA)的原理用于加强自信疾病集群的识别。
    结果:CSF显示与对照相比,AD中所有SIMOA生物标志物的水平增加(AUC:分别为0.71、0.86、0.92和0.94)。在具有NfL的FTD中观察到类似的模式,TAU,和UCH-L1(AUC:0.85、0.72和0.91)。sPLS-DA揭示了两个成分,解释了19%和9%的数据集变异。
    结论:CSF数据在AD中提供了很高的诊断准确性,FTD,控制歧视。人口统计学-临床特征和生物标志物浓度的亚组强调了组合不同类型的数据以成功和更有效的队列聚类的潜力。
    BACKGROUND: Accurate diagnosis of Alzheimer\'s disease (AD) and frontotemporal dementia (FTD) represents a health issue due to the absence of disease traits. We assessed the performance of a SIMOA panel in cerebrospinal fluid (CSF) from 43 AD and 33 FTD patients with 60 matching Control subjects in combination with demographic-clinical characteristics.
    METHODS: 136 subjects (AD: n = 43, FTD: n = 33, Controls: n = 60) participated. Single-molecule array (SIMOA), glial fibrillary acidic protein (GFAP), neurofilament light (NfL), TAU, and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) in CSF were analyzed with a multiplex neuro 4plex kit. Receiver operating characteristic (ROC) curve analysis compared area under the curve (AUC), while the principal of the sparse partial least squares discriminant analysis (sPLS-DA) was used with the intent to strengthen the identification of confident disease clusters.
    RESULTS: CSF exhibited increased levels of all SIMOA biomarkers in AD compared to Controls (AUCs: 0.71, 0.86, 0.92, and 0.94, respectively). Similar patterns were observed in FTD with NfL, TAU, and UCH-L1 (AUCs: 0.85, 0.72, and 0.91). sPLS-DA revealed two components explaining 19% and 9% of dataset variation.
    CONCLUSIONS: CSF data provide high diagnostic accuracy among AD, FTD, and Control discrimination. Subgroups of demographic-clinical characteristics and biomarker concentration highlighted the potential of combining different kinds of data for successful and more efficient cohort clustering.
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  • 文章类型: Journal Article
    背景:阿尔茨海默病(AD)影响大脑并导致认知和情绪困难。目前,没有可行的治疗方法来阻止或减缓AD的进展。金属硫蛋白III(MT-III)具有抗氧化和抗炎特性,表明可能的治疗益处。本研究旨在探讨MT-III对AD病理改变和认知能力的影响。
    方法:在这项研究中,我们采用普遍接受的AD小鼠模型(3xTg-AD)作为测试受试者,并给予载体或MT-III。对小鼠进行Morris水迷宫测试以评估其空间学习和记忆能力。此外,为了评估对海马神经元群的后续影响,Nissl染色和神经元核抗原(NeuN)免疫组织化学用于鉴定细胞形态变化和密度。免疫组织化学还用于检测β-淀粉样蛋白(Aβ)和神经胶质纤维酸性蛋白(GFAP),以测量Aβ的积累和星形胶质细胞的生长。Westernblot也用于测量Tau病理相关的PHD指蛋白1(PHF-1),磷酸化Tau(AT-8),和总Tau蛋白。
    结果:MT-III的给药显著增强了3xTg-AD小鼠的空间学习和记忆功能,如Morris水迷宫试验所证明的(p<0.01)。根据免疫组织化学和获得的发现,观察到用MT-III处理的小鼠的脑组织显示Nissl体和NeuN强度显着增加(p<0.01),而Aβ积累和GFAP显着降低(p<0.01)。此外,MT-III大大降低了Tau磷酸化相关的PHF-1和AT-8的水平(p<0.01),并略微降低了Tau5的水平(p<0.05)。
    结论:总之,我们的研究表明,MT-III有能力改善AD小鼠模型的病理改变,并保护其认知和情绪能力.通过减少β-淀粉样蛋白的积累和降低Tau病理的强度,MT-III保护海马亚区神经元免受病理伤害。此外,MT-III通过抑制星形胶质细胞的异常增殖来减轻炎症。最重要的是,MT-III极大地增强了小鼠与空间学习和记忆相关的认知能力,表明其对AD的有希望的治疗特性。
    BACKGROUND: Alzheimer\'s disease (AD) affects the brain and causes difficulties with cognition and emotions. At present, there are no viable therapies to halt or slow down the advancement of AD. Metallothionein III (MT-III) exhibits antioxidant and anti-inflammatory characteristics, indicating possible therapeutic benefits. This study aimed to explore the influence of MT-III on AD pathological alterations and cognitive abilities.
    METHODS: In this research, we employed the universally accepted AD mouse models (3xTg-AD) as test subjects and administrated vehicle or MT-III. The mice were subjected to the Morris water maze test to assess their spatial learning and memory capabilities. Moreover, to evaluate the consequent effects on neuronal groups in the hippocampus, the Nissl staining and neuronal nuclear antigen (NeuN) immunohistochemistry were used to identify the cellular morphology changes and density. Immunohistochemistry was also used to detect β-amyloid (Aβ) and glial fibrillary acidic protein (GFAP) to measure Aβ accumulation and astrocyte growth. Western blot was also used to measure Tau pathology-related PHD finger protein 1 (PHF-1), phosphorylated Tau (AT-8), and total Tau protein.
    RESULTS: The administration of MT-III notably enhanced spatial learning and memory function in 3xTg-AD mice, as evidenced by the Morris water maze test (p < 0.01). According to immunohistochemistry and the obtained findings, it was observed that brain tissues of mice treated with MT-III showed a notable increase of Nissl bodies and NeuN intensity (p < 0.01) while a remarkable decrease in Aβ accumulation and GFAP (p < 0.01). Additionally, MT-III largely decreased levels of Tau phosphorylation-related PHF-1 and AT-8 (p < 0.01) and slightly reduced the level of Tau 5 (p < 0.05).
    CONCLUSIONS: In summary, our research indicates that MT-III has the capacity to ameliorate pathological alterations in AD mouse models and safeguard their cognitive and emotional abilities. By decreasing β-amyloid accumulation and reducing the intensity of Tau pathology, MT-III protected hippocampal subfield neurons against pathological harm. Furthermore, MT-III reduced inflammation by inhibiting abnormal proliferation of astrocytes. Of utmost importance, MT-III greatly enhanced the cognitive abilities related to spatial learning and memory in mice, suggesting its promising therapeutic properties for AD.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)病理生理学的最新研究包括与海马功能相关的几种认知缺陷。然而,目前的临床研究未能全面考虑AD的异质性认知谱,导致缺乏得出明确诊断和治疗结论所需的具体方法。这还包括用于定制患有AD的人的诊断和治疗方案的体内代谢测量。磁共振波谱和重复经颅磁刺激(rTMS)是两种新的诊断和治疗方法,必须对其进行修改以治疗AD。在本研究中,我们旨在通过评估rTMS治疗前后的体内海马代谢物来研究rTMS在AD患者中的潜在治疗作用.根据我们先前研究中使用功能磁共振成像数据获得的数据以及文献中报道的参考文献,在本研究中,我们决定使用rTMS刺激后的海马NAA数据,发现NAA水平显著升高.据我们所知,没有其他研究评估rTMS对AD患者海马代谢物的影响。
    The latest research into the pathophysiology of Alzheimer\'s Disease (AD) has included several cognitive deficits related to hippocampal functioning. However, current clinical research fails to consider the full extent of the heterogeneous cognitive spectrum of AD, resulting in a lack of the specific methods required to draw definitive diagnostic and therapeutic conclusions. This also includes in-vivo metabolic measurements for tailoring the diagnostic and therapeutic regimens in humans with AD. Magnetic resonance spectroscopy and repetitive transcranial magnetic stimulation (rTMS) are two novel diagnostic and therapeutic approaches that must be modified to treat AD. In the present study, we aimed to investigate the underlying therapeutic role of rTMS in humans with AD by evaluating the in-vivo hippocampal metabolites before and after rTMS treatment. Based on the data obtained using the fMRI data in our previous study and on the references reported in the literature, in the present study, we decided to use hippocampal NAA data after rTMS stimulation and found a significant increase in NAA levels. To the best of our knowledge, no other study has evaluated the effect of rTMS on hippocampal metabolites in humans with AD.
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  • 文章类型: Journal Article
    目的:光生物调节涉及使用低水平光疗法或近红外光疗法,这些疗法可用于治疗多种神经系统疾病。目的:综述光生物调节疗法(PBMT)治疗阿尔茨海默病的机制和临床应用。方法:确保共识声明准确反映专家的观点和该领域的最新进展,专家意见得到了记录和彻底审查。结果:PBMT引起β-淀粉样蛋白斑块减少,线粒体功能的恢复,具有刺激ATP合成的抗炎和抗氧化特性。结论:PBMT可能有助于对传统药物治疗无反应的患者,当引入医学领域时,为阿尔茨海默病的管理提供了重要的帮助。
    阿尔茨海默病(AD)是一种无法治愈的进行性神经退行性疾病,临床表现为认知功能下降。确保共识声明准确反映专家的观点和该领域的最新发展,专家意见得到了记录和彻底审查。PBMT引发各种机制,如减少β-淀粉样蛋白斑块,恢复线粒体功能和维持体内平衡,以及在ATP合成中具有刺激的抗炎和抗氧化特性。PBMT可能有助于对常规药物治疗无反应的患者。当被引入医学领域时,该疗法可以在AD的管理中提供显著的帮助。然而,这需要进行各种深入研究才能进一步得出结论。
    Aim: Photobiomodulation involves the use of low-level light therapy or near-infrared light therapy found to be useful in the treatment of a wide range of neurological diseases. Objective: The aim is to review the mechanism and clinical applications of photobiomodulation therapy (PBMT) in managing Alzheimer\'s disease. Methods: To ensure that the consensus statement accurately reflects both the experts\' viewpoint and the most recent developments in the field, the expert opinions were recorded and thoroughly reviewed. Results: PBMT elicits reduction of beta-amyloid plaque, restoration of mitochondrial function, anti-inflammatory and antioxidant properties with a stimulation in ATP synthesis. Conclusion: The PBMT could be helpful in patients non-responsive to traditional pharmacological therapy providing significant aid in the management of Alzheimer\'s disease when introduced into the medical field.
    Alzheimer\'s disease (AD) is an incurable progressive neurodegenerative disease clinically manifested with a decline in cognitive function. To ensure that the consensus statement accurately reflects both the experts\' viewpoint and the most recent developments in the field, the expert opinions were recorded and thoroughly reviewed. PBMT elicits various mechanisms such as reduction of beta-amyloid plaque, Restoration of mitochondrial function and maintenance the homeostasis, and anti-inflammatory and antioxidant properties with a stimulation in ATP synthesis. The PBMT could be helpful in patients who are non-responsive to conventional pharmacological therapy. This therapy might provide significant aid in the management of AD when introduced into the medical field. However, it requires various intensive research to be conducted for further conclusion.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)是一种复杂的神经退行性疾病,其特征是进行性认知功能下降以及淀粉样蛋白-β斑块和tau缠结的积累。Wnt信号通路因其在神经发育和成人神经发生中的关键作用而闻名,已成为AD治疗干预的潜在靶标。糖原合成酶激酶-3β(GSK-3β),Wnt通路的关键调节因子,通过促进tau蛋白过度磷酸化和神经炎症在AD发病机制中起关键作用。一些临床前研究表明,抑制GSK-3β导致Wnt通路的激活,从而促进神经保护作用。减轻AD动物模型中的认知缺陷。Wnt信号的调节似乎具有多方面的益处,包括减少淀粉样蛋白β的产生,tau过度磷酸化,增强突触可塑性,和抑制神经炎症。这些发现表明靶向GSK-3β以激活Wnt途径可能代表减缓或停止AD进展的新方法。该假设回顾了探索通过抑制GSK-3β激活Wnt途径作为AD的有希望的治疗策略的研究现状。
    Alzheimer\'s disease (AD) is a complex neurodegenerative disorder characterised by progressive cognitive decline and the accumulation of amyloid-β plaques and tau tangles. The Wnt signalling pathway known for its crucial role in neurodevelopment and adult neurogenesis has emerged as a potential target for therapeutic intervention in AD. Glycogen synthase kinase-3 beta (GSK-3β), a key regulator of the Wnt pathway, plays a pivotal role in AD pathogenesis by promoting tau hyperphosphorylation and neuroinflammation. Several preclinical studies have demonstrated that inhibiting GSK-3β leads to the activation of Wnt pathway thereby promoting neuroprotective effects, and mitigating cognitive deficits in AD animal models. The modulation of Wnt signalling appears to have multifaceted benefits including the reduction of amyloid-β production, tau hyperphosphorylation, enhancement of synaptic plasticity, and inhibition of neuroinflammation. These findings suggest that targeting GSK-3β to activate Wnt pathway may represent a novel approach for slowing or halting the progression of AD. This hypothesis reviews the current state of research exploring the activation of Wnt pathway through the inhibition of GSK-3β as a promising therapeutic strategy in AD.
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  • 文章类型: Journal Article
    背景:家族性阿尔茨海默病(fAD)在发病年龄和临床表现方面具有异质性。对fAD变体的致病性以及这些变体如何导致异质性的更深入的理解将更广泛地增强我们对AD机制的理解。
    方法:为了确定未分类的PSEN1P436S突变的致病性,我们研究了八个受影响个体的扩展家族,磁共振成像(MRI)(两个人),患者来源的诱导多能干细胞(iPSC)模型(两个供体),和尸检组织学(一名捐赠者)。
    结果:观察到fAD的常染色体显性遗传模式,症状发作的平均年龄为46岁,特征不典型。iPSC模型和死后组织支持淀粉样β43(Aβ43)的高产量。PSEN1肽成熟未受损。
    结论:我们证实PSEN1中的P436S突变导致非典型fAD。尽管蛋白质成熟适当,但关键PSEN1脯氨酸-丙氨酸-亮氨酸-脯氨酸(PALP)基序中突变的位置可能解释了发病初期。
    结论:PSEN1P436S突变可导致家族性阿尔茨海默病。这种突变与不典型的临床表现有关。诱导多能干细胞(iPSC)和验尸研究支持增加淀粉样蛋白β(Aβ43)的产生。发病年龄早强调了PALP基序在PSEN1功能中的重要性。
    BACKGROUND: Familial Alzheimer\'s disease (fAD) is heterogeneous in terms of age at onset and clinical presentation. A greater understanding of the pathogenicity of fAD variants and how these contribute to heterogeneity will enhance our understanding of the mechanisms of AD more widely.
    METHODS: To determine the pathogenicity of the unclassified PSEN1 P436S mutation, we studied an expanded kindred of eight affected individuals, with magnetic resonance imaging (MRI) (two individuals), patient-derived induced pluripotent stem cell (iPSC) models (two donors), and post-mortem histology (one donor).
    RESULTS: An autosomal dominant pattern of inheritance of fAD was seen, with an average age at symptom onset of 46 years and atypical features. iPSC models and post-mortem tissue supported high production of amyloid beta 43 (Aβ43). PSEN1 peptide maturation was unimpaired.
    CONCLUSIONS: We confirm that the P436S mutation in PSEN1 causes atypical fAD. The location of the mutation in the critical PSEN1 proline-alanine-leucine-proline (PALP) motif may explain the early age at onset despite appropriate protein maturation.
    CONCLUSIONS: PSEN1 P436S mutations cause familial Alzheimer\'s disease. This mutation is associated with atypical clinical presentation. Induced pluripotent stem cells (iPSCs) and post-mortem studies support increased amyloid beta (Aβ43) production. Early age at onset highlights the importance of the PALP motif in PSEN1 function.
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