中国神经再生研究(英文版) ›› 2014, Vol. 9 ›› Issue (15): 1413-1417.doi: 10.4103/1673-5374.139453

• 观点:神经损伤修复保护与再生 •    下一篇

哺乳动物雷帕霉素靶蛋白的美好未来:促进神经元存活及再生

  

  • 收稿日期:2014-06-19 出版日期:2014-08-12 发布日期:2014-08-12

Driving neural regeneration through the mammalian target of rapamycin

Kenneth Maiese   

  1. Cellular and Molecular Signaling, Newark, NJ, USA
  • Received:2014-06-19 Online:2014-08-12 Published:2014-08-12
  • Contact: Kenneth Maiese, M.D., Cellular and Molecular Signaling, Newark, NJ 07101, USA, wntin75@yahoo.com.

摘要:

随着人口老龄化的加剧,预计在未来十年,神经退行性疾病的发病率将会大幅增加。如何治疗神经退行性疾病已成为全世界学者研究的焦点。美国新泽西医科和牙科大学Kenneth Maiese博士的最新研究表明,哺乳动物雷帕霉素靶蛋白(mTOR)在促进神经再生方面具有重要作用。mTOR可以调控磷脂酰肌醇3 - 激酶(PI3-K)和蛋白激酶B(AKT)以及生长因子、转录因子、沉默调节蛋白、神经递质和细胞代谢在内的多种中枢机制,实现多种神经保护途径。Maiese指出,用于抑制mTOR的某些药物可导致包括高胆固醇血症和免疫抑制等不良反应,因此,“当务之急是要瞄准mTOR的级联反应。此外,在生物系统内,mTOR的表达水平也同样重要,恰当水平表达可以预防或修复神经的变性损伤,但长时间的mTOR活化可导致临床致残。Maiese的研究发现了mTOR与程序性细胞死亡、自噬和坏死状凋亡之间有着复杂的联系。由于这些途径之间的亲密联系,在临床上有时需要增加mTOR的活性来促进保护,防止神经细胞凋亡,有时又需要促进自噬与mTOR的途径封锁,以防止神经变性疾病。总体而言,针对mTOR和其各自的途径的研究可为神经退行性病变的治疗提供引人注目的新策略。

Abstract:

Neurodegenerative disorders affect more than 30 million individuals throughout the world and lead to significant disability as well as death. These statistics will increase almost exponentially as the lifespan and age of individuals increase globally and individuals become more susceptible to acute disorders such as stroke as well as chronic diseases that involve cognitive loss, Alzheimer’s disease, and Parkinson’s disease. Current therapies for such disorders are effective only for a small subset of individuals or provide symptomatic relief but do not alter disease progression. One exciting therapeutic approach that may turn the tide for addressing neurodegenerative disorders involves the mammalian target of rapamycin (mTOR). mTOR is a component of the protein complexes mTOR Complex 1 (mTORC1) and mTOR Complex 2 (mTORC2) that are ubiquitous throughout the body and control multiple functions such as gene transcription, metabolism, cell survival, and cell senescence. mTOR through its relationship with phosphoinositide 3-kinase (PI 3-K) and protein kinase B (Akt) and multiple downstream signaling pathways such as p70 ribosomal S6 kinase (p70S6K) and proline rich Akt substrate 40 kDa (PRAS40) promotes neuronal cell regeneration through stem cell renewal and oversees critical pathways such as apoptosis, autophagy, and necroptosis to foster protection against neurodegenerative disorders. Targeting by mTOR of specific pathways that drive long-term potentiation, synaptic plasticity, and β-amyloid toxicity may offer new strategies for disorders such as stroke and Alzheimer’s disease. Overall, mTOR is an essential neuroprotective pathway but must be carefully targeted to maximize clinical efficacy and eliminate any clinical toxic side effects.

Key words: Alzheimer’s disease, apoptosis, autophagy, mTOR, necroptosis, rapamycin, stem cells, stroke