摘要
肠道菌群在阿尔茨海默病的发病机制中起关键作用的证据已经被解开。微生物-肠道-大脑轴是一个尚未完全理解的双向通信系统,但包括神经、免疫、内分泌和代谢途径。阿尔茨海默病的进展受到肠道微生物群失衡和大脑中淀粉样斑块发展相关机制的支持,这是阿尔茨海默病的起源。肠道微生物组组成的改变导致控制这一系统的途径失调。这通过神经炎症和神经递质失调导致神经退行性变。神经退行性变和血脑屏障的破坏是阿尔茨海默病起源的前沿。此外,肠道菌群中的细菌可以分泌大量的淀粉样蛋白和脂多糖,它们调节信号通路并改变与阿尔茨海默病发病机制相关的促炎细胞因子的产生。重要的是,通过分子拟态,细菌淀粉样蛋白可能引发错误折叠的交叉播种,并在脑-肠-微生物群轴的不同水平诱导微胶质启动。淀粉样蛋白扩散的潜在机制包括神经元到神经元或远端神经元的扩散,直接穿过血脑屏障,或通过其他细胞,如星形胶质细胞、成纤维细胞、小胶质细胞和免疫系统细胞。肠道微生物代谢产物,包括短链脂肪酸、促炎因子和神经递质也可能影响AD的发病机制和相关的认知能力下降。这篇综述的目的是总结和讨论目前可能阐明肠道菌群在阿尔茨海默病发展中的作用的发现。了解潜在的机制可能会为阿尔茨海默病的新治疗策略提供新的见解,如益生菌和靶向低聚糖。
关键词: 阿尔茨海默病,肠道微生物群,神经退行性变,神经炎症,生态失调,血脑屏障。
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