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Alzheimer’s disease: pathogenesis diagnostics and therapeutics

机译:阿尔茨海默氏病:发病机理诊断方法和治疗方法

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摘要

Currently, 47 million people live with dementia globally, and it is estimated to increase more than threefold (~131 million) by 2050. Alzheimer’s disease (AD) is one of the major causative factors to induce progressive dementia. AD is a neurodegenerative disease, and its pathogenesis has been attributed to extracellular aggregates of amyloid β (Aβ) plaques and intracellular neurofibrillary tangles made of hyperphosphorylated τ-protein in cortical and limbic areas of the human brain. It is characterized by memory loss and progressive neurocognitive dysfunction. The anomalous processing of APP by β-secretases and γ-secretases leads to production of Aβ40 and Aβ42 monomers, which further oligomerize and aggregate into senile plaques. The disease also intensifies through infectious agents like HIV. Additionally, during disease pathogenesis, the presence of high concentrations of Aβ peptides in central nervous system initiates microglial infiltration. Upon coming into vicinity of Aβ, microglia get activated, endocytose Aβ, and contribute toward their clearance via TREM2 surface receptors, simultaneously triggering innate immunoresponse against the aggregation. In addition to a detailed report on causative factors leading to AD, the present review also discusses the current state of the art in AD therapeutics and diagnostics, including labeling and imaging techniques employed as contrast agents for better visualization and sensing of the plaques. The review also points to an urgent need for nanotechnology as an efficient therapeutic strategy to increase the bioavailability of drugs in the central nervous system.
机译:目前,全球有4700万人患有痴呆症,估计到2050年将增加三倍多(约1.31亿)。阿尔茨海默氏病(AD)是诱发进行性痴呆症的主要病因之一。 AD是一种神经退行性疾病,其发病机理归因于人脑皮质和边缘区域中淀粉样蛋白β(Aβ)斑块的细胞外聚集和由高磷酸化τ蛋白形成的细胞内神经原纤维缠结。它的特征是记忆力减退和进行性神经认知功能障碍。 β-分泌酶和γ-分泌酶对APP的异常处理导致产生Aβ40和Aβ42单体,这些单体进一步低聚并聚集成老年斑。该疾病还通过诸如HIV的传染源而加剧。另外,在疾病发病机理中,中枢神经系统中高浓度Aβ肽的存在会引发小胶质细胞浸润。进入Aβ附近后,小胶质细胞被激活,吞噬了Aβ,并通过TREM2表面受体促进其清除,同时触发了针对聚集的先天性免疫反应。除了有关导致AD的致病因素的详细报告之外,本综述还讨论了AD治疗和诊断的最新技术,包括用作造影剂的标记和成像技术,以更好地可视化和感知斑块。该评论还指出,迫切需要将纳米技术作为一种有效的治疗策略,以增加药物在中枢神经系统中的生物利用度。

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