老年性痴呆抗体药物研究进展

老年性痴呆(Alzhimer's disease,AD)是一种渐进性神经退化性疾病,其主要表现为记忆功能衰减及识别能力障碍,同时伴有各种神经症状和行为障碍,具有非常高的发病率,目前还没有特异性治疗药物。随着世界人口老龄化,AD发病率逐年增高,成为本世纪威胁人类健康最严重的疾病之一。近年来AD的发病机理和药物研究方面都有突破性进展,尤其是制备针对β淀粉样蛋白（amyloid beta protein,Aβ）特异性抗体药物成为AD治疗极具价值的途径。本文主要对以Aβ为主的AD发病机理和针对Aβ的抗体药物的治疗机制、研究现状及进展进行综述,为进一步研发AD治疗药物提供参考。     

不同寡聚形式的Aβ42与细胞膜作用显示毒性差异

β-淀粉样蛋白（β-amyloid peptide, Aβ）与神经细胞膜的相互作用是阿尔茨海默症（Alzheimer’s disease, AD）发病的重要事件,但不同寡聚形式的Aβ与细胞膜相互作用的差异仍缺乏直接比较。本文通过膜天平、透射电子显微镜、Thioflavin T(ThT)和细胞毒性实验等方法,检测Aβ42单体、ADDL、原纤维等形式的β-淀粉样蛋白与磷脂膜的作用方式,分析不同形式淀粉样蛋白对细胞的毒性作用。结果显示,（1）单层膜的实验数据可以判断Aβ42单体和寡聚体插膜能力存在差异,Aβ42单体能插入磷脂单层膜内,而Aβ42 ADDL不具备插膜能力;（2）透射电镜和ThT荧光检测,定性定量地分析出不同聚集形式的Aβ42具有不同的纤维化能力,Aβ42单体纤维化能力最强,而Aβ42原纤维的纤维化能力次之,Aβ42ADDL很难形成纤维;（3）Aβ42单体细胞毒性较弱,而Aβ42 ADDL和原纤维的细胞毒性较强。由以上结果可以得出结论：在磷脂膜存在的条件下,Aβ42单体可以插入膜内并迅速形成无毒性的Aβ42纤维,因此,细胞毒性较弱。而ADDL及原纤维不能插入膜内,纤维化能力较弱,从而以寡聚体的形式发挥细胞毒性。将单体、ADDL及原纤维形式的Aβ42与细胞膜相互作用进行分析,将为Aβ42在AD中的毒性机制研究提供一定的参考。但各种寡聚体入胞的方式及毒性机制仍需要进一步研究。     

阿尔茨海默病中β淀粉样蛋白的生成及清除的调节

阿尔茨海默病（Alzheimer’s disease, AD）是一种慢性退行性神经系统疾病,临床主要表现为进行性认知能力下降、记忆力衰退、人格改变等。AD的标志性病理特征包括脑细胞外β淀粉样蛋白（β-amyloid protein,Aβ）沉积形成老年斑、细胞内神经纤维缠结(neurofibrillary tangles,NFT)、神经炎症增加以及神经元凋亡。β淀粉样蛋白主要在神经元产生,是淀粉样前体蛋白经过一系列酶解反应生成的由39～42个氨基酸组成的多肽,调节Aβ的生成和清除能够有效延缓甚至逆转阿尔茨海默病的进程,因而具有重大的研究价值。β-分泌酶（β-site APP cleaving enzyme 1,BACE1）为Aβ产生过程中的关键酶,其含量及活性的改变均能影响Aβ产生,在阿尔茨海默病的发生发展中发挥至关重要的作用;老年斑周围炎性细胞的聚集提示,AD与神经炎症高度相关,神经炎症相关细胞能够参与Aβ的清除,多种炎性因子也能调节Aβ的生成;非编码RNA虽很少直接参与Aβ的产生、沉积和清除,但其可以通过多种途径调节Aβ的产生。本文从β淀粉样蛋白生成及清除的机制着手,重点阐述了BACE1、神经炎症、非编码RNA对Aβ调控的重要作用,以期为AD发病机制的进一步研究提供思路,并对阿尔茨海默病早期干预及治疗提供理论参考。     

Tau蛋白寡聚体与阿尔茨海默病

阿尔茨海默病（AD）是严重影响老年人健康的一种神经退行性疾病。AD主要两个病理特征是tau蛋白组成的神经原纤维缠结和β淀粉样蛋白组成的Aβ斑块。Tau蛋白是目前研究AD机制和防治药物的一个重要靶点。Tau蛋白的寡聚体形式被认为是最具神经毒性的,并且其能在神经元之间传播,诱导胞内的正常tau蛋白聚集。本综述结合近年来的文献报道,对tau寡聚体的制备手段、形成机理、神经毒性、传播机制以及治疗前景等方面做了系统总结和讨论,为人们深入认识tau寡聚体提供参考。     

二甲双胍降低肥胖大鼠海马内PPARγ、IDE表达伴随TNF-α和Aβ42表达上调

二甲双胍（metformin,MET）常用于肥胖胰岛素抵抗患者改善胰岛素抵抗降低血糖,但MET可增加脑内β-淀粉肽（β-amyloid,Aβ）表达,目前机制不清.Aβ沉积作为阿尔茨海默病（Alzheimer's disease, AD)始发病理生理学改变,在AD中发挥重要作用. 为研究MET对脑内Aβ表达的影响及机制,采用饮食诱导肥胖大鼠模型 （OB组）予MET灌胃4 W后（MET组）,观察海马内Aβ42及相关因子肿瘤坏死因子α （TNF-α）、过氧化物酶体增殖物激活受体γ(peroxisome proliferator-activated receptor γ, PPARγ)、胰岛素降解酶（insulin degrading enzyme, IDE）的表达. 结果显示,OB组大鼠血糖水平较对照组（CTL组）无明显差异,胰岛素含量明显升高（P<0.01), 并存在胰岛素抵抗;OB组大鼠海马内TNF-α、 Aβ42 水平较CTL组上调,PPARγ、IDE表达下降(P<0.05). MET组胰岛素及胰岛素抵抗均较OB组降低(P<0.05),海马内TNF-α、Aβ42表达增加(P<0.01);PPARγ,IDE表达较OB组减少(P<0.01). 上述结果提示,二甲双胍作为治疗肥胖胰岛素抵抗的一线用 药,可改善胰岛素抵抗,但增加海马内炎性因子TNF-α表达、减少PPARγ水平,降低其调控IDE转录作用,使IDE表达减少,伴随Aβ42降解减少沉积增加,从而可能增加AD发病风险.     

模型膜实验方法在β淀粉样蛋白与细胞膜间相互作用中的应用与改进

β淀粉样蛋白(amyloid β peptide,Aβ)与细胞膜间的相互作用很可能是阿尔茨海默症病(Alzheimer disease, AD)重要的风险因素。模型膜研究方法在该领域的应用和更新持续至今,但仍存在一些问题有待解决,例如,Aβ插膜后聚集状态与Aβ融合到脂质体膜聚集状态的差异,Aβ插膜后形成微通道的时间及与磷脂成分的关系等。本文试图解析这两个问题,同时,系统地总结出常用的和更新的模型膜研究方法,这些方法包括单层膜插膜及电镜样品的制备,脂质体制备方法的改进,脂质体膜上Aβ42经过高盐及酸清洗后的Western 印迹检测,ANTS-DPX研究脂质体泄漏等。研究结果显示：(1)胞外及膜内Aβ42单体与脂质体膜作用后的聚集状态存在差异,Aβ42单体插膜后更容易聚集成纤维,而膜内融合的Aβ42呈现寡聚体形式;(2) Sepharose CL-4B柱过滤比微型挤出器制备的脂质体更加均一分散;(3)Aβ42在膜上形成微通道很可能是一个缓慢的过程,且与脂质体的磷脂种类相关。这些方法为Aβ42与细胞膜的相互作用提供了实用的研究手段,同时也为其他膜蛋白质与细胞膜的相互作用提供了可以借鉴的办法。研究结果使β淀粉样蛋白代谢过程更加清晰。     

模型膜实验方法在β淀粉样蛋白与细胞膜间相互作用中的应用与改进

β淀粉样蛋白(amyloid β peptide,Aβ)与细胞膜间的相互作用很可能是阿尔茨海默症病(Alzheimer disease, AD)重要的风险因素。模型膜研究方法在该领域的应用和更新持续至今,但仍存在一些问题有待解决,例如,Aβ插膜后聚集状态与Aβ融合到脂质体膜聚集状态的差异,Aβ插膜后形成微通道的时间及与磷脂成分的关系等。本文试图解析这两个问题,同时,系统地总结出常用的和更新的模型膜研究方法,这些方法包括单层膜插膜及电镜样品的制备,脂质体制备方法的改进,脂质体膜上Aβ42经过高盐及酸清洗后的Western 印迹检测,ANTS-DPX研究脂质体泄漏等。研究结果显示：(1)胞外及膜内Aβ42单体与脂质体膜作用后的聚集状态存在差异,Aβ42单体插膜后更容易聚集成纤维,而膜内融合的Aβ42呈现寡聚体形式;(2) Sepharose CL-4B柱过滤比微型挤出器制备的脂质体更加均一分散;(3)Aβ42在膜上形成微通道很可能是一个缓慢的过程,且与脂质体的磷脂种类相关。这些方法为Aβ42与细胞膜的相互作用提供了实用的研究手段,同时也为其他膜蛋白质与细胞膜的相互作用提供了可以借鉴的办法。研究结果使β淀粉样蛋白代谢过程更加清晰。     

β淀粉样蛋白突变体的寡聚及插膜能力鉴定

β-淀粉样蛋白（β-amyloid peptide, Aβ）的插膜与寡聚是导致阿尔茨海默症（Alzheimer disease, AD）发病的重要事件。已有研究证明,Aβ氨基酸序列29～36与1～28依靠“核心疏水簇”（central hydrophobic cluster,CHC）的作用形成一个稳定的β-发夹结构,Aβ1-40/Aβ1-42的插膜与寡聚需要作用于序列37～40/37～42从而解除序列29～36与N-端之间的结合,但各基元序列如何互作从而贡献出Aβ的寡聚及插膜行为仍不清楚。本文主要研究Aβ1-28、Aβ1-36、Aβ1-40、Aβ1-42、Aβ11-42、Aβ17-42等突变体的寡聚和插膜能力,并探讨各基元序列（motif）在突变体插膜与寡聚过程中的相互作用。Western印迹、硫黄素T荧光分析、透射电镜等实验检测寡聚能力,模型膜实验比较插膜能力。结果显示：与Aβ1-28及Aβ1-36相比,Aβ1-42、Aβ11-42及Aβ17-42均具有较强的寡聚及插膜能力,说明C-端序列37～42在Aβ寡聚及插膜过程中具有重要的起始作用;Aβ1-42及Aβ1-40可以形成原纤维及纤维,但Aβ11-42、Aβ17-42却不能,这显示序列1～17可以稳定纤维结构。Aβ1-28及Aβ1-36插膜及寡聚能力弱,暗示这两个突变体可能形成了不容易插膜且不容易寡聚的自身稳定结构。上述结果证明,Aβ蛋白C-端是诱导插膜与寡聚的主因,N-端可以稳定长纤维,但对插膜和寡聚的影响并不大,中间肽段很可能形成一个自身稳定的区域,这在一定程度上解释Aβ基元序列的相互作用,但具体氨基酸互作分子机制及抑制方法还需进一步研究。     

胰岛素降解酶与阿尔兹海默病的发生

阿尔兹海默病（AD）是以脑中β淀粉样蛋白（Aβ）累积和神经纤维缠绕（NFTs）为主要病理特征的神经退行性疾病,而胰岛素降解酶（IDE）是人体内最主要的Aβ降解酶之一。因此,IDE在AD进程中的作用受到了研究人员的广泛关注。大多数研究显示,AD的病理进程伴随着脑中IDE编码基因的表达和IDE活性的下降。IDE敲除动物也能够表现出AD样表型,同时已有研究尝试靶向于IDE进行AD的治疗。本文通过总结IDE在AD患者和AD模型动物脑中表达情况的变化,以及IDE敲除动物的表型,对近期IDE在AD发生中作用的研究进行了总结。     

谷氧还蛋白rbGrx可延缓CL4176秀丽隐杆线虫中β淀粉样蛋白诱导的毒性

阿尔茨海默病（Alzheimer’s disease,AD）是一种与衰老相关的神经退行性疾病,其中β-淀粉样蛋白（β-amyloid,Aβ）诱导的细胞毒性被认为是其发病的主要原因。本文以Aβ转基因秀丽隐杆线虫CL4176为模型,研究了重组荞麦谷氧还蛋白（recombinant buckwheat glutaredoxin, rbGrx）对Aβ诱导的毒性和氧化应激的影响。结果显示,4 μmol/L rbGrx可以延长CL4176线虫平均寿命达20%左右,并增加衰老虫体运动能力约43.6%,延迟产卵高峰期1 d,同时可以有效延缓Aβ毒性诱导的瘫痪表型。进一步研究发现,在正常条件和Aβ诱导毒性时,rbGrx均能降低CL4176线虫体内活性氧（reactive oxygen species,ROS）水平,并上调SOD活性和GSH含量。另外,rbGrx下调Aβ mRNA水平44.1％,减少Aβ沉积量,并且明显上调热激因子1 hsf-1（2.01倍）和hsp-16.2（2.65倍）mRNA表达水平。这表明,rbGrx通过降低CL4176线虫体内的ROS水平和上调热激蛋白质的转录表达水平,降低CL4176秀丽隐杆线虫中Aβ诱导的毒性。结果提示,rbGrx可能具有预防AD的潜力。     

Retracted: S14G‐humanin inhibits Aβ1–42 fibril formation,disaggregates preformed fibrils,and protects against Aβ‐induced cytotoxicity in vitro

The aggregation of soluble amyloid‐beta (Aβ) peptide into oligomers/fibrils is one of the key pathological features in Alzheimer's disease (AD). The Aβ aggregates are considered to play a pivotal role in the pathogenesis of AD. Therefore, inhibiting Aβ aggregation and destabilizing preformed Aβ fibrils would be an attractive therapeutic target for prevention and treatment of AD. S14G‐humanin (HNG), a synthetic derivative of Humanin (HN), has been shown to be a strong neuroprotective agent against various AD‐related insults. Recent studies have shown that HNG can significantly improve cognitive deficits and reduce insoluble Aβ levels as well as amyloid plaque burden without affecting amyloid precursor protein processing and Aβ production in transgenic AD models. However, the potential mechanisms by which HNG reduces Aβ‐related pathology in vivo remain obscure. In the present study, we found that HNG could significantly inhibit monomeric Aβ1–42 aggregation into fibrils and destabilize preformed Aβ1–42 fibrils in a concentration‐dependent manner by Thioflavin T fluorescence assay. In transmission electron microscope study, we observed that HNG was effective in inhibiting Aβ1–42 fibril formation and disrupting preformed Aβ1–42 fibrils, exhibiting various types of amorphous aggregates without identifiable Aβ fibrils. Furthermore, HNG‐treated monomeric or fibrillar Aβ1–42 was found to significantly reduce Aβ1–42‐mediated cytotoxic effects on PC12 cells in a dose‐dependent manner by MTT assay. Collectively, our results demonstrate for the first time that HNG not only inhibits Aβ1–42 fibril formation but also disaggregates preformed Aβ1–42 fibrils, which provides the novel evidence that HNG may have anti‐Aβ aggregation and fibrillogenesis, and fibril‐destabilizing properties. Together with previous studies, we concluded that HNG may have promising therapeutic potential as a multitarget agent for the prevention and/or treatment of AD. Copyright © 2013 European Peptide Society and John Wiley & Sons, Ltd.     

Role of aggregation conditions in structure, stability, and toxicity of intermediates in the Abeta fibril formation pathway

beta-amyloid peptide (Abeta) is one of the main protein components of senile plaques associated with Alzheimer's disease (AD). Abeta readily aggregates to forms fibrils and other aggregated species that have been shown to be toxic in a number of studies. In particular, soluble oligomeric forms are closely related to neurotoxicity. However, the relationship between neurotoxicity and the size of Abeta aggregates or oligomers is still under investigation. In this article, we show that different Abeta incubation conditions in vitro can affect the rate of Abeta fibril formation, the conformation and stability of intermediates in the aggregation pathway, and toxicity of aggregated species formed. When gently agitated, Abeta aggregates faster than Abeta prepared under quiescent conditions, forming fibrils. The morphology of fibrils formed at the end of aggregation with or without agitation, as observed in electron micrographs, is somewhat different. Interestingly, intermediates or oligomers formed during Abeta aggregation differ greatly under agitated and quiescent conditions. Unfolding studies in guanidine hydrochloride indicate that fibrils formed under quiescent conditions are more stable to unfolding in detergent than aggregation associated oligomers or Abeta fibrils formed with agitation. In addition, Abeta fibrils formed under quiescent conditions were less toxic to differentiated SH-SY5Y cells than the Abeta aggregation associated oligomers or fibrils formed with agitation. These results highlight differences between Abeta aggregation intermediates formed under different conditions and provide insight into the structure and stability of toxic Abeta oligomers.     

Inhibitors of amyloid β-protein aggregation mediated by GM1-containing raft-like membranes

The aggregation (fibril formation) of amyloid β-protein (Aβ) is considered to be a crucial step in the etiology of Alzheimer's disease (AD). The inhibition of Aβ aggregation and/or decomposition of fibrils formed in aqueous solution by small compounds have been studied extensively for the prevention and treatment of AD. However, recent studies suggest that Aβ aggregation also occurs in lipid rafts mediated by a cluster of monosialoganglioside GM1. This study examined the effects of representative compounds on Aβ aggregation and fibril destabilization in the presence of GM1-containing raft-like liposomes. Among the compounds tested, nordihydroguaiaretic acid (NDGA), rifampicin (RIF), tannic acid (TA), and quercetin (QUE) showed strong fibrillization inhibitory activity. NDGA and RIF inhibited the binding of Aβ to GM1 liposomes by competitively binding to the membranes and/or direct interaction with Aβ in solution, thus at least partly preventing fibrils from forming. Coincubation of Aβ with NDGA, RIF, and QUE in the presence of GM1 liposomes resulted in elongate particles, whereas the presence of TA yielded protofibrillar structures. TA and RIF also destabilized fibrils. The most potent NDGA prevented Aβ-induced toxicity in PC12 cells by inhibiting Aβ accumulation. Furthermore, a comparison of the inhibitory effects of various compounds between aqueous-phase and GM1-mediated aggregation of Aβ suggested that the two aggregation processes are not identical.     

Ellagic acid promotes Aβ42 fibrillization and inhibits Aβ42-induced neurotoxicity

Smaller, soluble oligomers of β-amyloid (Aβ) play a critical role in the pathogenesis of Alzheimer’s disease (AD). Selective inhibition of Aβ oligomer formation provides an optimum target for AD therapy. Some polyphenols have potent anti-amyloidogenic activities and protect against Aβ neurotoxicity. Here, we tested the effects of ellagic acid (EA), a polyphenolic compound, on Aβ42 aggregation and neurotoxicity in vitro. EA promoted Aβ fibril formation and significant oligomer loss, contrary to previous results that polyphenols inhibited Aβ aggregation. The results of transmission electron microscopy (TEM) and Western blot displayed more fibrils in Aβ42 samples co-incubated with EA in earlier phases of aggregation. Consistent with the hypothesis that plaque formation may represent a protective mechanism in which the body sequesters toxic Aβ aggregates to render them harmless, our MTT results showed that EA could significantly reduce Aβ42-induced neurotoxicity toward SH-SY5Y cells. Taken together, our results suggest that EA, an active ingredient in many fruits and nuts, may have therapeutic potential in AD.