摘要
阿尔茨海默氏病是痴呆症最常见的形式。由于缺乏有效的干预措施,因此强调了对新干预措施进行早期准确诊断。但是,在诊断之前,明显的神经元丢失和神经病理损害会严重损害大脑。随着我们对神经炎症在阿尔茨海默氏病发病机理中的作用的了解不断增长,炎症性生物标志物在诊断中引起了越来越多的兴趣。这篇综述的重点是通过神经影像,脑脊液和外周血检测到的炎症生物标记物在诊断阿尔茨海默氏病中的用途,并提出了临床意义。这篇综述包括以下生物标志物:神经影像学,各种与转运蛋白(TSPO)结合的配体;脑脊液,在髓样细胞(sTREM2),人软骨糖蛋白39(YKL-40)和单核细胞趋化蛋白1(MCP-1)上表达的可溶性触发受体,以及外周血中的各种生物标志物。尽管越来越多的证据表明这些炎症性生物标志物在诊断AD中具有潜在作用,但它们的使用仍存在局限性。但是,将这些生物标记物与常规诊断线索(例如基因型和淀粉样蛋白病理)结合使用,可以改善患者的分层和选择,以进行有针对性的早期干预。
关键词: 阿尔茨海默氏病,神经炎症,生物标志物,神经影像学,脑脊液,血浆,轻度认知障碍,小胶质细胞
[http://dx.doi.org/10.1101/cshperspect.a006239] [PMID: 22908189]
[http://dx.doi.org/10.1016/j.jalz.2007.04.381] [PMID: 19595937]
[http://dx.doi.org/10.1016/j.jalz.2008.05.2479] [PMID: 18790458]
[http://dx.doi.org/10.1176/appi.books.9780890425596]
[http://dx.doi.org/10.1016/j.trci.2018.06.014] [PMID: 30406177]
[http://dx.doi.org/10.3389/fncel.2013.00034] [PMID: 23596391]
[http://dx.doi.org/10.1101/cshperspect.a006346] [PMID: 22315714]
[http://dx.doi.org/10.1016/S1474-4422(15)70016-5] [PMID: 25792098]
[http://dx.doi.org/10.1100/2012/756357] [PMID: 22566778]
[http://dx.doi.org/10.1016/j.biocel.2004.07.009] [PMID: 15474976]
[http://dx.doi.org/10.1002/pnp.444]
[http://dx.doi.org/10.1097/nen.0b013e31812503e1] [PMID: 17882012]
[http://dx.doi.org/10.1016/j.cell.2013.03.030] [PMID: 23622250]
[http://dx.doi.org/10.1016/j.neuron.2013.04.014] [PMID: 23623698]
[http://dx.doi.org/10.1152/physrev.00011.2010] [PMID: 21527731]
[http://dx.doi.org/10.1016/j.tips.2017.07.005] [PMID: 28867259]
[http://dx.doi.org/10.1371/journal.pone.0056293] [PMID: 23393609]
[http://dx.doi.org/10.1016/j.cell.2013.11.030] [PMID: 24360280]
[http://dx.doi.org/10.1016/S1474-4422(16)00070-3] [PMID: 27068280]
[http://dx.doi.org/10.1016/j.dadm.2017.01.001] [PMID: 28239640]
[http://dx.doi.org/10.1016/j.dadm.2015.12.003] [PMID: 27019866]
[http://dx.doi.org/10.1126/science.1190929]
[http://dx.doi.org/10.1038/nrd3295] [PMID: 21119734]
[http://dx.doi.org/10.1016/j.pharmthera.2018.09.003] [PMID: 30189290]
[http://dx.doi.org/10.1016/j.tips.2006.06.005] [PMID: 16822554]
[http://dx.doi.org/10.1016/j.tips.2016.02.008] [PMID: 27113160]
[http://dx.doi.org/10.2967/jnumed.107.046151] [PMID: 18413395]
[http://dx.doi.org/10.1016/j.neulet.2006.09.093] [PMID: 17127001]
[http://dx.doi.org/10.1016/S0969-8051(03)00016-7] [PMID: 12831989]
[http://dx.doi.org/10.1016/j.nucmedbio.2007.12.009] [PMID: 18355686]
[http://dx.doi.org/10.1038/jcbfm.2012.53] [PMID: 22549622]
[http://dx.doi.org/10.1016/j.neurobiolaging.2007.11.005] [PMID: 18178291]
[http://dx.doi.org/10.1016/j.expneurol.2009.01.002] [PMID: 19320004]
[http://dx.doi.org/10.1016/j.neurobiolaging.2012.04.016] [PMID: 22651996]
[http://dx.doi.org/10.2174/157015911798376325] [PMID: 22654722]
[http://dx.doi.org/10.1111/j.1365-2990.2008.01006.x] [PMID: 19077109]
[http://dx.doi.org/10.1007/s11910-017-0733-2] [PMID: 28283959]
[http://dx.doi.org/10.1093/brain/aww017] [PMID: 26984188]
[http://dx.doi.org/10.1007/s40336-016-0171-1] [PMID: 27340650]
[http://dx.doi.org/10.1016/j.parkreldis.2012.07.002] [PMID: 22841687]
[http://dx.doi.org/10.1016/j.neurobiolaging.2012.04.021] [PMID: 22840559]
[http://dx.doi.org/10.1007/s00259-014-2955-8] [PMID: 25412766]
[http://dx.doi.org/10.1016/j.biopsych.2008.04.021] [PMID: 18514164]
[http://dx.doi.org/10.1111/bpa.12763] [PMID: 31276244]
[http://dx.doi.org/10.1038/mp.2015.1] [PMID: 25707397]
[http://dx.doi.org/10.1016/j.neurobiolaging.2016.04.011] [PMID: 27318133]
[http://dx.doi.org/10.1007/s00259-010-1612-0] [PMID: 20844871]
[http://dx.doi.org/10.1016/j.jalz.2014.06.016] [PMID: 25239737]
[http://dx.doi.org/10.1093/brain/awt145] [PMID: 23775979]
[http://dx.doi.org/10.1212/01.wnl.0000338622.27876.0d] [PMID: 19122031]
[http://dx.doi.org/10.1016/j.pscychresns.2011.08.013] [PMID: 22892349]
[http://dx.doi.org/10.3390/ijms18040785] [PMID: 28387722]
[http://dx.doi.org/10.1016/S0140-6736(01)05625-2] [PMID: 11513911]
[http://dx.doi.org/10.1001/archneurol.2008.511] [PMID: 19139300]
[http://dx.doi.org/10.1007/s00259-013-2359-1] [PMID: 23436070]
[http://dx.doi.org/10.1038/jcbfm.2014.261] [PMID: 25649991]
[http://dx.doi.org/10.1038/s41380-020-0745-1] [PMID: 32398717]
[http://dx.doi.org/10.1007/s00259-010-1628-5] [PMID: 20936410]
[http://dx.doi.org/10.2967/jnumed.108.058669] [PMID: 19223401]
[http://dx.doi.org/10.1046/j.1471-4159.2002.01243.x] [PMID: 12472885]
[http://dx.doi.org/10.1111/j.1471-4159.2009.06042.x] [PMID: 19302484]
[http://dx.doi.org/10.1084/jem.20041611] [PMID: 15728241]
[http://dx.doi.org/10.4049/jimmunol.177.4.2051] [PMID: 16887962]
[http://dx.doi.org/10.1038/nrn.2016.7] [PMID: 26911435]
[http://dx.doi.org/10.1084/jem.20160844] [PMID: 28209725]
[http://dx.doi.org/10.1016/j.cell.2015.01.049] [PMID: 25728668]
[http://dx.doi.org/10.1002/glia.20710] [PMID: 18551625]
[http://dx.doi.org/10.15252/emmm.201606370] [PMID: 27402340]
[http://dx.doi.org/10.1056/NEJMoa1211103] [PMID: 23150908]
[http://dx.doi.org/10.1093/hmg/ddu277] [PMID: 24899047]
[http://dx.doi.org/10.1056/NEJMoa1211851] [PMID: 23150934]
[http://dx.doi.org/10.1136/jnnp-2014-308883.7]
[http://dx.doi.org/10.1016/j.jalz.2014.12.009] [PMID: 25936935]
[http://dx.doi.org/10.1007/s00401-016-1533-5] [PMID: 26754641]
[http://dx.doi.org/10.1093/brain/awaa021] [PMID: 32065223]
[http://dx.doi.org/10.1126/scitranslmed.aag1767] [PMID: 27974666]
[http://dx.doi.org/10.15252/emmm.201506123] [PMID: 26941262]
[http://dx.doi.org/10.1016/j.dadm.2016.12.002] [PMID: 28149943]
[http://dx.doi.org/10.1186/s13024-016-0071-x] [PMID: 26754172]
[http://dx.doi.org/10.15252/emmm.201606245] [PMID: 26976613]
[http://dx.doi.org/10.1016/j.jalz.2016.06.005] [PMID: 27423963]
[PMID: 17087877]
[http://dx.doi.org/10.1002/jbmr.5650070506] [PMID: 1615759]
[PMID: 19437893]
[http://dx.doi.org/10.1186/1742-2094-7-34] [PMID: 20540736]
[http://dx.doi.org/10.1186/1742-2094-3-27] [PMID: 17005052]
[http://dx.doi.org/10.1016/j.neurobiolaging.2015.10.022] [PMID: 26827642]
[http://dx.doi.org/10.1016/j.neurobiolaging.2015.03.001] [PMID: 25865441]
[http://dx.doi.org/10.1186/s13195-015-0161-y] [PMID: 26698298]
[http://dx.doi.org/10.1186/s13195-015-0142-1] [PMID: 26383836]
[http://dx.doi.org/10.3233/JAD-140624] [PMID: 25024322]
[http://dx.doi.org/10.1371/journal.pone.0135458] [PMID: 26270969]
[http://dx.doi.org/10.1001/jamaneurol.2015.1285] [PMID: 26147946]
[http://dx.doi.org/10.1038/tp.2016.252] [PMID: 28072416]
[http://dx.doi.org/10.1038/nm838] [PMID: 12612547]
[http://dx.doi.org/10.1038/nm1555] [PMID: 17351623]
[http://dx.doi.org/10.1006/cyto.1997.0232] [PMID: 9344508]
[http://dx.doi.org/10.1590/S0004-282X2011000400009] [PMID: 21755121]
[http://dx.doi.org/10.1001/archneur.63.4.538] [PMID: 16606766]
[http://dx.doi.org/10.1159/000089137] [PMID: 16244482]
[http://dx.doi.org/10.1371/journal.pone.0030525] [PMID: 22303443]
[http://dx.doi.org/10.1212/WNL.0000000000006082]
[PMID: 23774427]
[http://dx.doi.org/10.1002/glia.22350] [PMID: 22674585]
[http://dx.doi.org/10.1042/BST0390898] [PMID: 21787320]
[http://dx.doi.org/10.1016/j.bbi.2007.05.005] [PMID: 17604598]
[http://dx.doi.org/10.1161/01.STR.0000143224.36527.44] [PMID: 15459438]
[http://dx.doi.org/10.1212/01.wnl.0000260066.98681.2e] [PMID: 17452586]
[http://dx.doi.org/10.3389/fnagi.2014.00171] [PMID: 25120476]
[http://dx.doi.org/10.1111/psyg.12403] [PMID: 30790387]
[http://dx.doi.org/10.1016/j.jalz.2018.02.014] [PMID: 29605221]
[http://dx.doi.org/10.1136/jnnp-2017-316201] [PMID: 28794151]
[http://dx.doi.org/10.1177/1533317515602087] [PMID: 26340961]
[http://dx.doi.org/10.1093/gerona/gls187] [PMID: 22982688]
[http://dx.doi.org/10.1016/j.biopsych.2010.06.012] [PMID: 20692646]
[http://dx.doi.org/10.1136/jnnp-2018-319148] [PMID: 30630955]
[http://dx.doi.org/10.1212/WNL.0b013e318266fa70] [PMID: 22855860]
[http://dx.doi.org/10.1038/nm1653] [PMID: 17934472]
[http://dx.doi.org/10.1001/archneurol.2012.1070] [PMID: 22801723]
[http://dx.doi.org/10.1371/journal.pone.0034341] [PMID: 22485168]
[http://dx.doi.org/10.1212/WNL.43.8.1609] [PMID: 8351023]
[http://dx.doi.org/10.1371/journal.pone.0001475] [PMID: 18213383]
[http://dx.doi.org/10.1038/sj.npp.1300690] [PMID: 15742005]
[http://dx.doi.org/10.1001/jama.289.21.2819] [PMID: 12783912]
[http://dx.doi.org/10.1212/WNL.53.1.197] [PMID: 10408559]
[http://dx.doi.org/10.1212/WNL.54.3.588] [PMID: 10680787]
[http://dx.doi.org/10.1016/S1474-4422(07)70293-4] [PMID: 18068522]
[http://dx.doi.org/10.1016/S0140-6736(01)05623-9] [PMID: 11513909]
[http://dx.doi.org/10.1016/j.jalz.2008.09.004] [PMID: 19328435]
[http://dx.doi.org/10.1016/j.jalz.2010.12.014] [PMID: 21784351]
[PMID: 21560159]
[http://dx.doi.org/10.1212/WNL.48.3.626] [PMID: 9065537]
[http://dx.doi.org/10.1517/14656566.3.4.365] [PMID: 11934339]
[http://dx.doi.org/10.1007/BF03325217] [PMID: 19448381]
[http://dx.doi.org/10.1007/s00401-013-1177-7] [PMID: 24052108]
[http://dx.doi.org/10.1016/j.jalz.2018.01.008] [PMID: 29494807]
[http://dx.doi.org/10.1016/j.jalz.2008.01.004] [PMID: 18631971]
[http://dx.doi.org/10.1212/01.wnl.0000284596.95156.48] [PMID: 18003940]
[http://dx.doi.org/10.1176/appi.ajp.2012.11121815] [PMID: 22952074]
[http://dx.doi.org/10.1016/j.neurobiolaging.2012.09.012] [PMID: 23062700]
[http://dx.doi.org/10.1093/geronb/58.4.P228] [PMID: 12878651]
[http://dx.doi.org/10.1017/S104161021200049X] [PMID: 22687143]
[http://dx.doi.org/10.1016/j.neuroscience.2014.09.061] [PMID: 25286385]