淀粉样前体蛋白在阿尔茨海默病分子生物学和临床医学中的研究进展

阿尔茨海默病(Alzheimer's disease,AD)是一种常见的老年性痴呆症,主要病理表现有两种,即:细胞内发生神经纤维缠结(neurofibrillary tangles,NFTs)、细胞外产生淀粉样沉积物(俗称老年斑,senile plaques,SP).NFTs的聚集主要是微管Tau蛋白异常高度磷酸化的生成;SP的淀粉样沉积物主要成份是β-淀粉样肽(Aβ,包括Aβ40和Aβ42),由淀粉样前体蛋白(amyloid precursor protein,APP)分解而来,被认为在AD的发病机制中起着十分重要的作用.近年来很多研究都集中在α、β和γ-分泌酶对APP的作用和Aβ生成的影响上,以及家族性AD(FAD)和散发性AD(SAD)的发病原因和进程的研究.本文主要综述了APP的代谢通路与淀粉样物生成对AD发病的假说;早发性和迟发性AD与APP、PS1、PS2和ApoE基因突变的关系,以及目前Aβ疫苗对AD治疗和预防作用的研究进展.

Advances in molecular biology and clinical study of amyloid precursor protein for Alzheimer's disease

Alzheimer's disease (AD) is the most common cause of dementia in elderly population. There are two hallmark pathological lesions: the intracellular neurofibrillary tangles (NFTs) and the extracellular amyloid deposits in the senile plaques (SP). The NFTs are aggregates of hyperphosphorylated microtubule Tau protein. The amyloid deposits in the SP are the beta-amyloid (Abeta) peptides-Abeta40 and Abeta42. The Abeta peptides are derived from the amyloid precursor protein (APP) which is considered very important for the AD pathogenesis. In recent years, studies have focused on understanding the generation of Abeta peptides by the alpha-, beta- and gamma- secretase activity on APP, as cause and progression of both familial and sporadic AD (FAD and SAD). This review covers the trafficking and processing of APP, the amyloid cascade hypothesis in AD pathogenesis, the mutations in the genes encoding APP, PS1 and PS2 of early-onset and late-onset AD. The risk factor apolipoprotein E (ApoE) for AD and therapeutic anti-beta-amyloid vaccination strategies for prevention of AD are also discussed.