中国神经再生研究(英文版) ›› 2018, Vol. 13 ›› Issue (6): 985-986.doi: 10.4103/1673-5374.233439

• 观点:脑损伤修复保护与再生 • 上一篇    下一篇

什么引发了慢性创伤性脑病的Tau蛋白病?

  

  • 收稿日期:2018-04-28 出版日期:2018-06-15 发布日期:2018-06-15

What triggers tauopathy in chronic traumatic encephalopathy?

Liam Chen   

  1. Neuropathology Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • Received:2018-04-28 Online:2018-06-15 Published:2018-06-15
  • Contact: Liam Chen, M.D., Ph.D., lchen99@jhmi.edu.

摘要:

orcid: 0000-0001-5553-5473 (Liam Chen)

Abstract:

Chronic traumatic encephalopathy (CTE) is a neuropathologically defined tauopathy: CTE is closely related with repetitive,traumatic brain injury. In a most recent study of 202 deceased players of American football from a brain donation program,CTE was neuropathologically diagnosed in 177 players across all levels of play (87%), including 110 of 111 former National Football League players (99%) . Consistent with a progressive and neurodegenerative nature, the CTE presentation does not appear until midlife, usually decades after the repetitive brain trauma, and are not simply the aggravation of symptoms from earlier concussions or injuries. At early stage, patient may complain about headache and loss of attention, short-term memory difficulties, depression and impulse control problems. As the disease progresses, symptoms become more severe, with worsening memory impairment, worsening executive dysfunction, language difficulties,and motor disturbance. The patient would become eventually demented and more than 30% patients are suicidal at end stage. As the presentation differs in each individual and most symptoms are rather non-specific, the definitive diagnosis can only be made by postmortem neuropathologic examination. In 2016, the first National Institute of Neurological Disorders and Stroke/National Institute of Biomedical Engineering and Bioengineering (NINDS/NIBIB) consensus meeting defined CTE as a clearly distinct neurodegenerative disease consisting of p-tau aggregates in neurons, astrocytes, and cell processes around small vessels at the depths of the cortical sulci. It is critical to note that the pathognomonic change has only been found in individuals who were exposed to brain trauma, typically multiple episodes. This is important because neuronal and glial tau inclusions are the pathologic hall marker for other major neurodegenerative diseases, including Alzheimer’s disease (AD) and various tauopathies of frontotemporal lobar degeneration (FTLD-tau). Nevertheless, like in AD and primary tauopathies, what triggers the pathological conversion of the physiologically microtubule-associated protein to misfold and aggregate in CTE is still elusive.