阿尔茨海默病中氧化应激相关信号通路及抗氧化治疗
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长江大学医学部,荆州 434023

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国家自然科学基金(82271514)资助项目。


Oxidative Stress-related Signaling Pathways and Antioxidant Therapy in Alzheimer’s Disease
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College of Medicine, Yangtze University, Jingzhou 434023, China

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This work was supported by a grant from The National Natural Science Foundation of China (82271514).

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    摘要:

    阿尔茨海默病 (Alzheimer’s disease, AD) 是一种以认知功能减退、 生活能力下降及精神行为异常为临床表现的神经系统退行性疾病,是老年期痴呆的最常见类型。随着对AD研究的深入,人们提出了许多致病机制,其中氧化应激在AD的发病机制中起着重要作用,引起了广泛关注。氧化应激是机体固有的生理过程,当其失衡时会导致细胞损伤,在AD患者的大脑中,氧化应激水平显著升高。氧化应激对AD有多种影响,包括损伤神经细胞,干扰β淀粉样蛋白(amyloid β-protein,Aβ)代谢,影响微管相关蛋白(tubulin associated unit,tau)磷酸化,导致线粒体功能障碍,引起神经炎症等。本文重点综述了AD中与氧化应激相关的信号通路,包括核转录因子红系2相关因子2(nuclear factor-erythroid 2-related factor 2,Nrf2)、钙调磷酸酶调节蛋白1(regulator of calcineurin 1,RCAN1)、蛋白磷酸酶 2A(protein phosphatase 2A,PP2A)、环磷酸腺苷应答元件结合蛋白质(cyclic AMP response element binding protein,CREB)、Notch1、核因子κB(nuclear factor-κB,NF-κB)、载脂蛋白E(apolipoprotein E,ApoE)和铁死亡相关信号通路,并总结了当前临床应用和研究中的抗氧化治疗相关策略。通过综合运用不同信号通路的治疗特点,期待未来开发出更加完善的多靶点联合治疗方案以及联合纳米分子递送系统突破血脑屏障,为AD提供更多更有效的治疗策略。

    Abstract:

    Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline, functional impairment, and neuropsychiatric symptoms. It represents the most prevalent form of dementia among the elderly population. Accumulating evidence indicates that oxidative stress plays a pivotal role in the pathogenesis of AD. Notably, elevated levels of oxidative stress have been observed in the brains of AD patients, where excessive reactive oxygen species (ROS) can cause extensive damage to lipids, proteins, and DNA, ultimately compromising neuronal structure and function. Amyloid β-protein (Aβ) has been shown to induce mitochondrial dysfunction and calcium overload, thereby promoting the generation of ROS. This, in turn, exacerbates Aβ aggregation and enhances tau phosphorylation, leading to the formation of two pathological features of AD: extracellular Aβ plaque deposition and intracellular neurofibrillary tangles (NFTs). These events ultimately culminate in neuronal death, forming a vicious cycle. The interplay between oxidative stress and these pathological processes constitutes a core link in the pathogenesis of AD. The signaling pathways mediating oxidative stress in AD include Nrf2, RCAN1, PP2A, CREB, Notch1, NF-κB, ApoE, and ferroptosis. Nrf2 signaling pathway serves as a key regulator of cellular redox homeostasis, exerts important antioxidant capacity and protective effects in AD. RCAN1 signaling pathway, as a calcineurin inhibitor, and modulates AD progression through multiple mechanisms. PP2A signaling pathway is involved in regulating tau phosphorylation and neuroinflammation processes. CREB signaling pathway contributes to neuroplasticity and memory formation; activation of CREB improves cognitive function and reduce oxidative stress. Notch1 signaling pathway regulates neuronal development and memory, participates in modulation of Aβ production, and interacts with Nrf2 to co-regulate antioxidant activity. NF-κB signaling pathway governs immune and inflammatory responses; sustained activation of this pathway forms “inflammatory memory”, thereby exacerbating AD pathology. ApoE signaling pathway is associated with lipid metabolism; among its isoforms, ApoE-ε4 significantly increases the risk of AD, leading to elevated oxidative stress, abnormal lipid metabolism, and neuroinflammation. The ferroptosis signaling pathway is driven by iron-dependent lipid peroxidation, and the subsequent release of lipid peroxidation products and ROS exacerbate oxidative stress and neuronal damage. These interconnected pathways form a complex regulatory network that regulates the progression of AD through oxidative stress and related pathological cascades. In terms of therapeutic strategies targeting oxidative stress, among the drugs currently used in clinical practice for AD treatment, memantine and donepezil demonstrate significant therapeutic efficacy and can improve the level of oxidative stress in AD patients. Some compounds with antioxidant effects (such as α-lipoic acid and melatonin) have shown certain potential in AD treatment research and can be used as dietary supplements to ameliorate AD symptoms. In addition, non-drug interventions such as calorie restriction and exercise have been proven to exerted neuroprotective effects and have a positive effect on the treatment of AD. By comprehensively utilizing the therapeutic characteristics of different signaling pathways, it is expected that more comprehensive multi-target combination therapy regimens and combined nanomolecular delivery systems will be developed in the future to bypass the blood-brain barrier, providing more effective therapeutic strategies for AD.

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汤莉,沈云龙,彭德健,冉天璐,潘子恒,曾心怡,刘辉.阿尔茨海默病中氧化应激相关信号通路及抗氧化治疗[J].生物化学与生物物理进展,2025,52(10):2486-2498

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  • 收稿日期:2025-04-25
  • 最后修改日期:2025-10-12
  • 录用日期:2025-07-22
  • 在线发布日期: 2025-07-24
  • 出版日期: 2025-10-28
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