目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年...目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年期痴呆患者为研究对象,根据随机数字表法将其分为常规组、对照组和观察组,每组各30例。常规组患者给予盐酸美金刚片治疗,对照组患者在常规组基础上加以音乐疗法,观察组患者在常规组基础上加以重复经颅磁刺激治疗,三组均连续治疗12周。比较三组患者的BPSD严重程度、痴呆严重程度、认知功能、日常生活能力、ApoE基因多态性。结果治疗前,三组患者的神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)、简明精神状态检查量表(mini-mental state examination,MMSE)、日常生活能力评定量表(activity of daily living scale,ADL)评分比较差异均无统计学意义(P>0.05);治疗后,三组患者的NPI、CDR评分均显著低于本组治疗前,MMSE、ADL评分均显著高于本组治疗前(P<0.05);观察组和对照组患者的NPI、CDR评分均显著低于常规组,MMSE、ADL评分均显著高于常规组(P<0.05)。ApoE共有ε2、ε3、ε4三种等位基因,其中ε3表达频率最高,共55例,其次为ε4和ε2;三组患者的ApoE不同基因检出率比较差异无统计学意义(P>0.05)。ApoEε4型患者的NPI评分显著高于ApoEε3型与ApoEε2型(P<0.05)。结论非药物治疗老年期痴呆患者效果显著,可减轻BPSD和痴呆表现,提高患者的认知功能和日常生活能力,ApoEε4型基因与老年期痴呆患者的BPSD存在紧密联系。展开更多
Apolipoprotein E receptor 2(ApoER2)is a receptor for the protein ApoE,the most common genetic risk factor for late-onset Alzheimer's disease(AD).It is also a key modulator of syna ptic homeostasis,in part through ...Apolipoprotein E receptor 2(ApoER2)is a receptor for the protein ApoE,the most common genetic risk factor for late-onset Alzheimer's disease(AD).It is also a key modulator of syna ptic homeostasis,in part through its effect on the expression of neuronal genes including those implicated in AD and other neuropsychiatric disorders.In this perspective,we highlight several genes affected by ApoER2 and its alternatively spliced forms and how aberrant expression can be rescued by the reintroduction of the ApoER2 intracellular domain in the mouse hippocampus.展开更多
Background:Apolipoprotein E4(ApoE4)allele is the strongest genetic risk factor for late-onset Alzheimer's disease,and it can aggravate depressive symptoms in non-AD patients.However,the impact of ApoE4 on AD-assoc...Background:Apolipoprotein E4(ApoE4)allele is the strongest genetic risk factor for late-onset Alzheimer's disease,and it can aggravate depressive symptoms in non-AD patients.However,the impact of ApoE4 on AD-associated depression-l ike behaviors and its underlying pathogenic mechanisms remain unclear.Methods:This study developed a 5xFAD mouse model overexpressing human ApoE4(E4FAD).Behavioral assessments and synaptic function tests were conducted to explore the effects of ApoE4 on cognition and depression in 5xFAD mice.Changes in peripheral and central lipid metabolism,as well as the levels of serotonin(5-HT)andγ-aminobutyric acid(GABA)neurotransmitters in the prefrontal cortex,were examined.In addition,the protein levels of 24-dehydrocholesterol reductase/glycogen synthase kinase-3 beta/mammalian target of rapamycin(DHCR24/GSK3β/m TOR)and postsynaptic density protein 95/calmodulin-dependent protein kinase II/brain-derived neurotrophic factor(PSD95/CaMK-II/BDNF)were measured to investigate the molecular mechanism underlying the effects of ApoE4 on AD mice.Results:Compared with 5xFAD mice,E4FAD mice exhibited more severe depressionlike behaviors and cognitive impairments.These mice also exhibited increased amyloid-beta deposition in the hippocampus,increased astrocyte numbers,and decreased expression of depression-related neurotransmitters 5-HT and GABA in the prefrontal cortex.Furthermore,lipid metabolism disorders were observed in E4FAD,manifesting as elevated low-density lipoprotein cholesterol and reduced high-density lipoprotein cholesterol in peripheral blood,decreased cholesterol level in the prefrontal cortex,and reduced expression of key enzymes and proteins related to cholesterol synthesis and homeostasis.Abnormal expression of proteins related to the DHCR24/GSK3β/m TOR and PSD95/CaMK-II/BDNF pathways was also observed.Conclusion:This study found that ApoE4 overexpression exacerbates depressionlike behaviors in 5xFAD mice and confirmed that ApoE4 reduces cognitive function in these mice.The mechanism may involve the induction of central and peripheral lipid metabolism disorders.Therefore,modulating ApoE expression or function to restore cellular lipid homeostasis may be a promising therapeutic target for AD comorbid with depression.This study also provided a better animal model for studying AD comorbid with depression.展开更多
文摘目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年期痴呆患者为研究对象,根据随机数字表法将其分为常规组、对照组和观察组,每组各30例。常规组患者给予盐酸美金刚片治疗,对照组患者在常规组基础上加以音乐疗法,观察组患者在常规组基础上加以重复经颅磁刺激治疗,三组均连续治疗12周。比较三组患者的BPSD严重程度、痴呆严重程度、认知功能、日常生活能力、ApoE基因多态性。结果治疗前,三组患者的神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)、简明精神状态检查量表(mini-mental state examination,MMSE)、日常生活能力评定量表(activity of daily living scale,ADL)评分比较差异均无统计学意义(P>0.05);治疗后,三组患者的NPI、CDR评分均显著低于本组治疗前,MMSE、ADL评分均显著高于本组治疗前(P<0.05);观察组和对照组患者的NPI、CDR评分均显著低于常规组,MMSE、ADL评分均显著高于常规组(P<0.05)。ApoE共有ε2、ε3、ε4三种等位基因,其中ε3表达频率最高,共55例,其次为ε4和ε2;三组患者的ApoE不同基因检出率比较差异无统计学意义(P>0.05)。ApoEε4型患者的NPI评分显著高于ApoEε3型与ApoEε2型(P<0.05)。结论非药物治疗老年期痴呆患者效果显著,可减轻BPSD和痴呆表现,提高患者的认知功能和日常生活能力,ApoEε4型基因与老年期痴呆患者的BPSD存在紧密联系。
基金supported by NIH grants NS093382,NS108115,AG053391,HL063762 (to JH)supported by Blue Field Project to Cure FTD,BrightFocus Foundation (A20135245 and A2016396S)。
文摘Apolipoprotein E receptor 2(ApoER2)is a receptor for the protein ApoE,the most common genetic risk factor for late-onset Alzheimer's disease(AD).It is also a key modulator of syna ptic homeostasis,in part through its effect on the expression of neuronal genes including those implicated in AD and other neuropsychiatric disorders.In this perspective,we highlight several genes affected by ApoER2 and its alternatively spliced forms and how aberrant expression can be rescued by the reintroduction of the ApoER2 intracellular domain in the mouse hippocampus.
基金CAMS initiative for Innovative Medicine of China,Grant/Award Number:2021-I2M-1-034。
文摘Background:Apolipoprotein E4(ApoE4)allele is the strongest genetic risk factor for late-onset Alzheimer's disease,and it can aggravate depressive symptoms in non-AD patients.However,the impact of ApoE4 on AD-associated depression-l ike behaviors and its underlying pathogenic mechanisms remain unclear.Methods:This study developed a 5xFAD mouse model overexpressing human ApoE4(E4FAD).Behavioral assessments and synaptic function tests were conducted to explore the effects of ApoE4 on cognition and depression in 5xFAD mice.Changes in peripheral and central lipid metabolism,as well as the levels of serotonin(5-HT)andγ-aminobutyric acid(GABA)neurotransmitters in the prefrontal cortex,were examined.In addition,the protein levels of 24-dehydrocholesterol reductase/glycogen synthase kinase-3 beta/mammalian target of rapamycin(DHCR24/GSK3β/m TOR)and postsynaptic density protein 95/calmodulin-dependent protein kinase II/brain-derived neurotrophic factor(PSD95/CaMK-II/BDNF)were measured to investigate the molecular mechanism underlying the effects of ApoE4 on AD mice.Results:Compared with 5xFAD mice,E4FAD mice exhibited more severe depressionlike behaviors and cognitive impairments.These mice also exhibited increased amyloid-beta deposition in the hippocampus,increased astrocyte numbers,and decreased expression of depression-related neurotransmitters 5-HT and GABA in the prefrontal cortex.Furthermore,lipid metabolism disorders were observed in E4FAD,manifesting as elevated low-density lipoprotein cholesterol and reduced high-density lipoprotein cholesterol in peripheral blood,decreased cholesterol level in the prefrontal cortex,and reduced expression of key enzymes and proteins related to cholesterol synthesis and homeostasis.Abnormal expression of proteins related to the DHCR24/GSK3β/m TOR and PSD95/CaMK-II/BDNF pathways was also observed.Conclusion:This study found that ApoE4 overexpression exacerbates depressionlike behaviors in 5xFAD mice and confirmed that ApoE4 reduces cognitive function in these mice.The mechanism may involve the induction of central and peripheral lipid metabolism disorders.Therefore,modulating ApoE expression or function to restore cellular lipid homeostasis may be a promising therapeutic target for AD comorbid with depression.This study also provided a better animal model for studying AD comorbid with depression.