論文標題:Moderate decline in select synaptic markers in the prefrontal cortex (BA9) of patients with Alzheimer’s disease at various cognitive stages
期刊:Scientific Reports
作者:Stéphanie Daumas & Salah El Mestikawy
發表時間:2018/01/17
數字識別碼:10.1038/s41598-018-19154-y
原文連結:https://www.nature.com/articles/s41598-018-19154-y?utm_source=Other_website&utm_medium=Website_links&utm_content=RenLi-Nature-Scientific_Reports-Neurology-China&utm_campaign=SCIREP_USG_JRCN_RL_sciencenet_cortex_4th_Aug
隨著世界人口衰老化,阿爾茨海默病 (AD)的案例日漸增多。現在全球有近五千萬的AD 病人,每年有近一千萬個新病例。中國大約有一千萬的AD病例。AD在中國西部最為普遍,其次是北部,中部和南部。
AD是一種會逐漸惡化的神經系統衰退性疾病。其臨床特徵包括記憶障礙、失語、失用、失認、視空間技能下降、執行功能障礙、性格和行為改變甚至全面性痴呆。AD公認的生物標記包括β澱粉樣蛋白在神經細胞之間不正常地聚合成的色斑,tau 蛋白在神經細胞內不正常的聚合導致的神經原纖維的混亂狀態和神經突觸的喪失。其他導致AD的因素包括:向大腦輸血的失常和神經細胞外的排洩物引發的炎症。雖然研究界已經發現諸多與AD有關的標記和因素,但是其病因迄今未明。
有元分析顯示神經突觸的損失和思維功能障礙有緊密的關係。在分子層面上,穀氨酸能通路的標記和腦力衰退有關,而伽馬安基丁酸能(GABA能)和膽鹼能通路在AD病人裡都有受損。但在人腦裡,突觸標記的密度和突觸的損失之間的關係有待研究。把眾多的不確定放在一邊,現在領域內被接受的設想是,恢復突觸功能能夠治療AD,而且突觸裡活躍的蛋白質可以被用作痴呆症發展的標記。
最近在《科學報告》發表的名為Moderate decline in select synaptic markers in the prefrontal cortex (BA9) of patients with Alzheimer’s disease at various cognitive stages 的文章裡,法國索邦大學神經科學系的Salah El Mestikawy 博士的團隊研究了突觸裡的蛋白標記和痴呆症的發展之間的關係。
作者們指出,以前的元分析裡的研究的樣本量較小,平均只有十個對比和十個病人,會影響結論。所以這裡他們大幅度地增加了樣本量。他們研究了在新皮質裡的突觸,因為新皮層是負責高等功能,即會AD裡衰退的功能,比如知覺、運動指令的產生、空間推理、語言。他們測量了新皮層裡神經傳遞相關的標記的含量,比如穀氨酸能通路的VGLUT1, VGLUT2, PSD95, 和EAAT2, GABA能通路上的 VIAAT 和 somatostatin,以及和膽鹼能通路上的choline acetyl transferase和 ChAT。
普遍領域內的理論預測這些標記會在晚期痴呆病人裡有明顯的下降。然而作者們發現,除了VGLUT1,其他標記的下降程度不大。採用線性組合分析和主成分分析,他們發現這七個標記不能成為臨床痴呆評定量表的標記。作者們的發現和領域內被接受的理論有所出入。他們的結論是,突觸在新皮層的損失和痴呆的發展之間關係可能比想像中更加微妙, 需要更深入的研究。
摘要:Synaptic loss, plaques and neurofibrillary tangles are viewed as hallmarks of Alzheimer’s disease (AD). This study investigated synaptic markers in neocortical Brodmann area 9 (BA9) samples from 171 subjects with and without AD at different levels of cognitive impairment. The expression levels of vesicular glutamate transporters (VGLUT1&2), glutamate uptake site (EAAT2), post-synaptic density protein of 95 kD (PSD95), vesicular GABA/glycine transporter (VIAAT), somatostatin (som), synaptophysin and choline acetyl transferase (ChAT) were evaluated. VGLUT2 and EAAT2 were unaffected by dementia. The VGLUT1, PSD95, VIAAT, som, ChAT and synaptophysin expression levels significantly decreased as dementia progressed. The maximal decrease varied between 12% (synaptophysin) and 42% (som). VGLUT1 was more strongly correlated with dementia than all of the other markers (polyserial correlation = −0.41). Principal component analysis using these markers was unable to differentiate the CDR groups from one another. Therefore, the status of the major synaptic markers in BA9 does not seem to be linked to the cognitive status of AD patients. The findings of this study suggest that the loss of synaptic markers in BA9 is a late event that is only weakly related to AD dementia.
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