胰岛素信号通路参与阿尔兹海默症发病机制的研究进展

阿尔兹海默病(Alzheimer's Disease,AD)是一种以老年斑和神经纤维缠结为主要病理学特征的中枢神经系统退行性疾病,其发病机制极为复杂。胰岛素信号通路作为胰岛素生理作用中的主要信号传导途径,在代谢、神经保护和调节认知功能障碍等方面发挥着重要作用。研究显示AD患者常伴随着胰岛素信号通路障碍和胰岛素抵抗(insulin resistance,IR)等症状的发生,提示胰岛素信号通路可能与AD的发病过程密切相关。本文以胰岛素信号通路为切入点,阐述该通路参与AD发病的可能机制,以期为预防和治疗阿尔兹海默病提供新线索。     

干扰视黄醇结合蛋白4对猪脂肪细胞PI3K/Akt信号通路的影响

视黄醇结合蛋白4(Retinol binding protein 4,RBP4)是一种脂肪细胞分泌因子,其表达水平的升高与胰岛素抵抗及Ⅱ型糖尿病等疾病密切相关,但具体作用机制尚不清楚。为明确此机制,通过包装RBP4干扰慢病毒并侵染猪前体脂肪细胞。运用胰岛素激活及诱导胰岛素抵抗模型,利用QRT-PCR及Western blotting方法检测RBP4的干扰效率及处理组PI3K/Akt信号通路相关基因的表达。结果显示RBP4的基因及蛋白的干扰效率达到60%(P<0.01)以上。进一步研究发现在胰岛素诱导及胰岛素抵抗的情况下,LH1-shRBP4干扰后可显著提高胰岛素信号通路AKT2、PI3K、GLUT4和IRS1基因mRNA的表达;明显促进AKT2、PI3K和IRS1蛋白的磷酸化;提高AKT2、PI3K和GLUT4基因的总蛋白水平。总之,RBP4干扰通过上调PI3K/Akt胰岛素信号通路相关因子的表达及其磷酸化水平,提高了胰岛素敏感性。此研究将为胰岛素抵抗相关疾病的治疗提供新思路。     

PI3K/Akt/mTOR信号传导通路与成人T淋巴细胞白血病关系的研究进展

成人T淋巴细胞白血病(ATL)是严重危害人类健康的一种疾病,它是由与H IV类似的逆转录病毒HTLV-I感染CD4+T细胞而诱发的恶性肿瘤。HTLV-Ⅰ导致ATL中起主要作用的是Tax蛋白,其反式激活作用占有重要地位,它可以激活PI3K/AKT/mTOR信号途径。PI3K/Akt/mTOR被认为是蛋白质合成的主要信号调节通路,研究表明该信号传导通路是与细胞增殖和细胞凋亡关系最密切的信号传导通路之一,其在成人T淋巴细胞白血病的发生、发展治疗及转归中发挥重要作用,并且已经成为治疗的新靶点。本文就PI3K/Akt/mTOR信号传导通路以及与ATL关系的研究进展作如下综述。     

阿尔茨海默病血清miR-137、miR-138表达与认知功能损害和外周血淋巴细胞PI3K/Akt信号通路的关系研究

摘要 目的：探讨阿尔茨海默病（AD）患者血清微小核糖核酸（miR）-137、miR-138表达与认知功能损害和外周血淋巴细胞磷脂酰肌醇-3激酶/蛋白激酶（PI3K/Akt）信号通路的关系。方法：选取2020年1月至2022年5月青岛大学附属医院神经内科收治的95例AD患者（AD组）,根据临床痴呆评定量表（CDR）评分将患者分为轻度组（1分,35例）、中度组（2分,42例）、重度组（3分,18例）,另选取63例体检健康志愿者为对照组。检测AD组、对照组血清miR-137、miR-138表达水平以及外周血淋巴细胞PI3K/Akt信号通路相关蛋白表达,采用简易智能精神状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）评估认知功能。分析血清miR-137、miR-138与MMSE、MoCA评分以及外周血淋巴细胞PI3K、Akt、B淋巴细胞瘤-2基因（Bcl-2）、Bcl-2相关X蛋白基因（Bax）表达的相关性。结果：AD组血清miR-137水平、外周血淋巴细胞PI3K、Akt、Bcl-2蛋白表达水平及MMSE、MoCA评分低于对照组（P＜0.05）,血清miR-138、外周血淋巴细胞Bax蛋白表达水平高于对照组（P＜0.05）。重度组血清miR-137水平、外周血淋巴细胞PI3K、Akt、Bcl-2蛋白表达水平及MMSE、MoCA评分低于中度组和轻度组（P＜0.05）,且中度组低于轻度组（P＜0.05）;重度组血清miR-138、外周血淋巴细胞Bax蛋白表达水平高于中度组和轻度组（P＜0.05）,且中度组高于轻度组（P＜0.05）。AD患者血清miR-137水平与MMSE、MoCA评分、外周血淋巴细胞PI3K、Akt、Bcl-2蛋白表达呈正相关（P＜0.05）,与外周血淋巴细胞Bax蛋白表达呈负相关（P＜0.05）;AD患者血清miR-138水平与MMSE、MoCA评分、外周血淋巴细胞PI3K、Akt、Bcl-2蛋白表达呈负相关（P＜0.05）,与外周血淋巴细胞Bax蛋白表达呈正相关（P＜0.05）。结论：AD患者的血清miR-137表达水平降低、miR-138表达水平增高,与认知功能障碍有关,且miR-137、miR-138可能通过调控PI3K/Akt信号通路参与AD发病过程。     

青蒿素经PI3K/Akt通路改善突触可塑性减轻糖尿病小鼠认知障碍

目的 本研究旨在阐明青蒿素对II型糖尿病（T2DM）小鼠认知功能障碍的改善作用及其机制。方法 C57BL/6J小鼠单次腹腔注射STZ（100 mg/kg）后联合高脂饲料喂养建立T2DM模型。T2DM小鼠随后腹腔注射青蒿素（40 mg/kg/d）或等体积溶剂。干预4周后，新物体识别、Y迷宫和Morris水迷宫实验检测小鼠的学习和记忆能力。蛋白质印迹法（Western blot）检测海马PI3K、Akt、磷酸化Akt、SYN和PSD-95蛋白的表达。透射电镜观察海马CA1区突触密度和突触超微结构改变。结果 与模型组相比，青蒿素干预组T2DM小鼠的认知功能显著改善，海马中PI3K和磷酸化Akt水平升高，SYN和PSD-95蛋白表达增加，CA1区神经元丢失减少。此外，青蒿素干预组小鼠CA1区的突触密度、PSD-95和突触界面曲率增加，突触间隙宽度减小。结论 青蒿素可能通过激活海马PI3K/Akt途径增强突触可塑性，从而减轻T2DM小鼠认知功能障碍；青蒿素有望成为治疗糖尿病性认知功能障碍的新型药物。     

PI3K/Akt 通路在电针预处理诱导脑缺血耐受中的机制研究

目的:通过观察电针预处理对磷脂酰肌醇3激酶/蛋白质丝氨酸苏氨酸激酶(PI3K/Akt)通路的变化以及该通路抑制剂对电针预处理的脑保护的影响,探讨电针预处理诱导脑缺血耐受的可能机制。方法:线栓法单侧阻断大脑中动脉120min,再灌注24h制备大鼠大脑局灶性缺血再灌注(I/R)模型;Western Blot检测Akt磷酸化水平的变化;侧脑室注射PI3K/Akt通路抑制剂LY294002;神经行为学评分(Garcia标准)及TTC染色检测脑梗死体积比评价脑损伤程度。结果:电针预处理使大鼠神经行为学评分增高,脑梗死体积比降低(P<0.05);可上调Akt磷酸化水平,I/R2h达高峰(P<0.05)。侧脑室注射PI3K/Akt抑制剂LY294002,拮抗电针预处理的脑保护作用(P<0.05)。结论:电针预处理增加Ak(tSer473)磷酸化水平,在缺血再灌注早期上调PI3K/Akt通路可能是诱导大鼠脑缺血耐受的产生的主要机制。     

用抗糖尿病药物GLP-1及其类似物治疗阿尔茨海默病

流行病学和基础研究表明阿尔茨海默病（Alzheimert＇s disease,AD）与2型糖尿病（type 2 diabetes mellitus,T2DM）存在密切关联：T2DM是AD的危险因素之一;而AD脑内也出现胰岛素信号异常、胰岛素抵抗状态,因而被称为“第3类型的糖尿病”。近年来治疗T2DM的新药——胰高血糖素样肽-1（glucagon-1ike peptide-1,GLP-1）及其类似物,已被证实具有神经保护作用,且能改善AD模型的记忆和认知功能,为AD治疗药物的研究提供了新的策略。     

NOK与Akt相互作用并增强Akt的活化

NOK是一个新近鉴定的受体型蛋白酪氨酸激酶分子,它能够促进肿瘤的形成和转移.前期的研究表明,NOK在小鼠前B细胞(BaF3)中能够激活磷脂酰肌醇3-激酶(PI3K)信号通路.但是,人们并不清楚NOK在细胞内是如何激活PI3K信号通路的.研究发现,NOK与PI3K下游的效应分子蛋白激酶B(Akt)具有直接的相互作用.并且,在人胚肾细胞(HEK293T)中,NOK能明显增强Akt的活性.通过NOK缺失突变体的免疫共沉淀实验,确定了Akt能直接结合NOK的激酶结构域.同时,Akt的激酶活性缺失体并不影响其与NOK的结合,但也观察到,持续活化的Akt跟NOK具有更强的相互作用.最后,发现NOK对胰岛素介导的Akt激活并没有产生叠加效应.实验结果显示,NOK可以与Akt直接相互作用并增强PI3K/Akt信号通路的活化.     

大脑胰岛素信号途径受损导致2型糖尿病时阿尔茨海默病发病风险增高

大脑胰岛素不仅可调节血糖,而且可改善记忆和认知,而大脑胰岛素缺乏常导致Alzheimer病（Alzheimer’s disease, AD）的发生. 本研究检测了正常及2型糖尿病（type 2 diabetes, T2D）大鼠外周及大脑胰岛素信号传导途径,以探讨T2D时由于大脑胰岛素异常导致AD发病的可能性.以同龄正常SD大鼠为对照（CTL组）,高糖、高脂、高蛋白饮食加链脲佐菌素（streptozotocin, STZ）腹腔注射建造T2D大鼠模型（T2D组）.葡萄糖氧化酶法检测血浆血糖,放免法检测脑脊液及血浆胰岛素,免疫印迹技术检测大脑海马tau蛋白上部分位点磷酸化水平,大脑及肝脏、肌肉组织胰岛素信号传导途径中磷脂酰肌醇3 激酶（phosphatidylinositol 3 kinase, PI3K）/ 蛋白激酶B（protein kinase B,Akt)、糖原合成激酶3β（glycogen synthase kinase 3β, GSK 3β）活性. 结果显示：和对照组相比,T2D大鼠血浆葡萄糖水平及胰岛素水平显著升高,脑脊液胰岛素水平显著降低,大脑海马组织tau蛋白上所检测位点均呈过度磷酸化改变,海马及外周组织（肝脏、肌肉）胰岛素信号传导途径PI3K/Akt活性均显著下降,GSK 3β活性升高. 研究结果表明：2型糖尿病大鼠大脑胰岛素缺乏及其信号传导途径下调可能是导致阿尔茨海默病发病的重要原因.     

Prosaposin对细胞增殖和凋亡的调控及其分子机制

为研究鞘脂激活蛋白原(Prosaposin)对细胞增殖、细胞凋亡的调控及其可能的分子机制, 以pcDNA3.1 in NIH3T3阴性对照细胞株和过表达prosaposin的Psap-Myc in NIH3T3细胞株为模型, 噻唑蓝(MTT)比色法检测prosaposin对细胞增殖的影响; Annexin V联合碘化丙啶(Propidium iodide, PI)法检测血清饥饿状态下prosaposin对细胞凋亡的影响; Western blotting检测PI3K/Akt信号通路中蛋白磷酸化水平的变化; Real-time PCR检测PI3K/Akt信号通路下游靶分子表达水平的改变。结果表明prosaposin可活化PI3K/Akt信号通路, 提高Akt^Ser473的磷酸化水平, 抑制细胞周期抑制基因P27^KIP1的表达, 上调细胞周期蛋白Cyclin D1的表达, 促进细胞周期从G1→S期进展; 诱导survival基因cIAP1、cIAP2的表达, 促进细胞存活。这些结果提示, prosaposin对细胞增殖和凋亡的调控可能是通过PI3K/Akt信号通路及其下游靶分子进行的。     

Insulin resistance and amyloidogenesis as common molecular foundation for type 2 diabetes and Alzheimer's disease

Characterized as a peripheral metabolic disorder and a degenerative disease of the central nervous system respectively, it is now widely recognized that type 2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) share several common abnormalities including impaired glucose metabolism, increased oxidative stress, insulin resistance and amyloidogenesis. Several recent studies suggest that this is not an epiphenomenon, but rather these two diseases disrupt common molecular pathways and each disease compounds the progression of the other. For instance, in AD the accumulation of the amyloid-beta peptide (Aβ), which characterizes the disease and is thought to participate in the neurodegenerative process, may also induce neuronal insulin resistance. Conversely, disrupting normal glucose metabolism in transgenic animal models of AD that over-express the human amyloid precursor protein (hAPP) promotes amyloid-peptide aggregation and accelerates the disease progression. Studying these processes at a cellular level suggests that insulin resistance and Aβ aggregation may not only be the consequence of excitotoxicity, aberrant Ca²⁺ signals, and proinflammatory cytokines such as TNF-α, but may also promote these pathological effectors. At the molecular level, insulin resistance and Aβ disrupt common signal transduction cascades including the insulin receptor family/PI3 kinase/Akt/GSK3 pathway. Thus both disease processes contribute to overlapping pathology, thereby compounding disease symptoms and progression.     

Adiponectin Attenuates Streptozotocin-Induced Tau Hyperphosphorylation and Cognitive Deficits by Rescuing PI3K/Akt/GSK-3β Pathway

Clinical studies have demonstrated that decreased adiponectin is associated with the development of Type 2 diabetes mellitus (T2DM) and Alzheimer’s disease (AD). We focused on determining the neuroprotective effect offered by adiponectin against streptozotocin-induced brain damage in ICV-STZ rat model. We found that adiponectin supplements significantly restored the cognitive deficits in ICV-STZ rat model including shorter escape latency, more crossing times and increased time spent in the target quadrant. Adiponectin supplements also increased number of dendritic branches and mushroom percentage. In addition, adiponectin supplements attenuated tau hyperphosphorylation at multiple AD-related sites through activation of protein Ser9-phosphorylated glycogen synthase kinase-3β (Ser9-GSK-3β) with increased the Akt and PI3K activity. Our data suggest that adiponectin supplements have neuroprotective effects on the ICV-STZ rat model, which may be mediated by the activation of the PI3K/Akt/GSK-3β signaling pathway.     

Neuroprotective effects of treadmill exercise on BDNF and PI3-K/Akt signaling pathway in the cortex of transgenic mice model of Alzheimer’s disease

(AD). Although physical exercise and AD have received attention in the scientific literature, the mechanism through which treadmill exercise may impact the brain insulin signaling of AD has not been elucidated. This study aimed to evaluate the neuroprotective effects of treadmill exercise on apoptotic factors (Bcl-2/Bax ratio, caspase-3), HSP70, COX-2, BDNF and PI3-K/Akt signaling pathway in the cortex of NSE/hPS2m transgenic mice model of AD. Treadmill exercise ameliorated cognitive function in water maze test and significantly increased the level of Bcl-2/Bax ratio and HSP-70 in Tg-exe group compared to Tg-con group; on the other hand, it significantly decreased the expression of caspase-3 and COX-2 in Tg-exe group compared to Tg-con group. In addition, treadmill exercise significantly increased the expression of BDNF and PI3K/Akt in Tg-exe group compared to Tg-con group. Consequently, treadmill exercise improves cognitive function possibly via activating neurotrophic factor, BDNF and PI3k/Akt signaling pathway, and Aβ-induced neuronal cell death in the cortex of Tg mice was markedly suppressed following treadmill exercise. These results suggest that treadmill exercise may be beneficial in preventing or treating Alzheimer’s disease.     

Exenatide promotes cognitive enhancement and positive brain metabolic changes in PS1-KI mice but has no effects in 3xTg-AD animals

Recent studies have shown that type 2 diabetes mellitus (T2DM) is a risk factor for cognitive dysfunction or dementia. Insulin resistance is often associated with T2DM and can induce defective insulin signaling in the central nervous system as well as increase the risk of cognitive impairment in the elderly. Glucagone like peptide-1 (GLP-1) is an incretin hormone and, like GLP-1 analogs, stimulates insulin secretion and has been employed in the treatment of T2DM. GLP-1 and GLP-1 analogs also enhance synaptic plasticity and counteract cognitive deficits in mouse models of neuronal dysfunction and/or degeneration. In this study, we investigated the potential neuroprotective effects of long-term treatment with exenatide, a GLP-1 analog, in two animal models of neuronal dysfunction: the PS1-KI and 3xTg-AD mice. We found that exenatide promoted beneficial effects on short- and long-term memory performances in PS1-KI but not in 3xTg-AD animals. In PS1-KI mice, the drug increased brain lactate dehydrogenase activity leading to a net increase in lactate levels, while no effects were observed on mitochondrial respiration. On the contrary, exenatide had no effects on brain metabolism of 3xTg-AD mice. In summary, our data indicate that exenatide improves cognition in PS1-KI mice, an effect likely driven by increasing the brain anaerobic glycolysis rate.     

Diabetes as a risk factor for Alzheimer’s disease in the Middle East and its shared pathological mediators

The incidence of Alzheimer’s disease (AD) has risen exponentially worldwide over the past decade. A growing body of research indicates that AD is linked to diabetes mellitus (DM) and suggests that impaired insulin signaling acts as a crucial risk factor in determining the progression of this devastating disease. Many studies suggest people with diabetes, especially type 2 diabetes, are at higher risk of eventually developing Alzheimer's dementia or other dementias. Despite nationwide efforts to increase awareness, the prevalence of Diabetes Mellitus (DM) has risen significantly in the Middle East and North African (MENA) region which might be due to rapid urbanization, lifestyle changes, lack of physical activity and rise in obesity. Growing body of evidence indicates that DM and AD are linked because both conditions involve impaired glucose homeostasis and altered brain function. Current theories and hypothesis clearly implicate that defective insulin signaling in the brain contributes to synaptic dysfunction and cognitive deficits in AD. In the periphery, low-grade chronic inflammation leads to insulin resistance followed by tissue deterioration. Thus insulin resistance acts as a bridge between DM and AD. There is pressing need to understand on how DM increases the risk of AD as well as the underlying mechanisms, due to the projected increase in age related disorders. Here we aim to review the incidence of AD and DM in the Middle East and the possible link between insulin signaling and ApoE carrier status on Aβ aggregation, tau hyperphosphorylation, inflammation, oxidative stress and mitochondrial dysfunction in AD. We also critically reviewed mutation studies in Arab population which might influence DM induced AD. In addition, recent clinical trials and animal studies conducted to evaluate the efficiency of anti-diabetic drugs have been reviewed.