Parkinson's and Alzheimer's disease as system-wide neurodegenerative disorders

© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature..

BACKGROUND: Parkinson's and Alzheimer's disease (PD/AD) are characterized by cellular pathological changes that precede clinical manifestation and symptom onset by decades (prodromal period) as well as by a heterogeneity of clinical symptoms. Both diseases are recognized as system-wide diseases with organ-transgressing dysregulation and involvement of immunological and neuroinflammatory mechanisms facilitating pathological protein aggregation and neurodegeneration.

OBJECTIVES: Overview of natural course, phenotypes and classification of PD/AD with a focus on underlying (system-wide) immunological and neuroinflammatory mechanisms.

METHODS: Literature research and consideration of expert opinions.

RESULTS: The accumulation of misfolded proteins such as amyloid‑β and synuclein in the course of neurodegenerative processes forms the basis of the current biological classifications, understanding of course and subtypes. Protein aggregation in PD/AD induces an innate immune response by activating microglia and the release of inflammatory mediators such as cytokines and chemokines and leading to further spread of neurodegeneration and accumulation of intracellular neurofibrillary tangles (NFTs). There is also growing evidence that adaptive immune responses involving auto-antibodies or auto-antigen-specific T‑/B-cell reactions involving tau, amyloid‑β or synuclein might be involved in the disease progression or subtypes of PD/AD.

CONCLUSIONS: Both innate and adaptive immune responses seem to be substantially involved in the pathological cascade leading to neurodegeneration in PD/AD and may contribute to disease progression and clinical subtypes. Thus, future targeted interventions should not only focus on protein aggregation but also on neuroinflammatory and immunological mechanisms.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:94

Enthalten in:

Der Nervenarzt - 94(2023), 10 vom: 06. Okt., Seite 875-884

Sprache:

Deutsch

Weiterer Titel:

Parkinson- und Alzheimer-Erkrankung als Systemerkrankungen

Beteiligte Personen:

Bartsch, Thorsten [VerfasserIn]
Berg, Daniela [VerfasserIn]
Heneka, Michael [VerfasserIn]
Leypoldt, Frank [VerfasserIn]

Links:

Volltext

Themen:

Biological classification
English Abstract
Immunity, adaptive
Immunity, innate
Journal Article
Neurodegenerative diseases
Neuroinflammation
Review

Anmerkungen:

Date Revised 13.10.2023

published: Print-Electronic

Citation Status Publisher

doi:

10.1007/s00115-023-01542-z

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36169749X