Insulin, cognition, and dementia.
Insulin, cognition, and dementia.
复制标题
DOI：
10.1016/j.ejphar.2013.08.008
复制
发表时间：
2013-11-05
影响因子：
5
通讯作者：
Craft S
中科院分区：
文献类型：
--
作者：
Cholerton B;Baker LD;Craft S
老龄化认知障碍对当今社会的社会和经济福利构成严重威胁。现在广泛认识到，与这些病症相关的病理学，特别是阿尔茨海默病，可能在临床痴呆症状发作前数年或数十年就开始了。这一发现使研究人员考虑候选机制，沉淀级联的神经病理学事件，最终导致临床阿尔茨海默病。胰岛素是一种在大脑中具有强效作用的激素，最近因其在认知功能中的潜在有益和保护作用而受到广泛关注。胰岛素抵抗是指靶组织对胰岛素有利作用的敏感性降低，与已知影响认知和增加痴呆风险的多种慢性疾病有关。随着胰岛素抵抗相关疾病的流行，阿尔茨海默病和其他认知障碍的患病率将继续呈指数级上升。幸运的是，这些与胰岛素相关的慢性疾病可以通过药物干预来治疗。因此，专注于增加大脑中胰岛素敏感性的新治疗策略可能是保护或治疗认知衰退的重要目标。以下综述将突出我们目前对胰岛素在脑中的作用的理解，胰岛素抵抗和痴呆之间联系的潜在机制，以及目前旨在通过改变脑的胰岛素敏感性来改善认知功能的实验治疗策略。
Cognitive disorders of aging represent a serious threat to the social and economic welfare of current society. It is now widely recognized that pathology related to such conditions, particularly Alzheimer’s disease, likely begins years or decades prior to the onset of clinical dementia symptoms. This revelation has led researchers to consider candidate mechanisms precipitating the cascade of neuropathological events that eventually lead to clinical Alzheimer’s disease. Insulin, a hormone with potent effects in the brain, has recently received a great deal of attention for its potential beneficial and protective role in cognitive function. Insulin resistance, which refers to the reduced sensitivity of target tissues to the favorable effects of insulin, is related to multiple chronic conditions known to impact cognition and increase dementia risk. With insulin resistance-associated conditions reaching epidemic proportions, the prevalence of Alzheimer’s disease and other cognitive disorders will continue to rise exponentially. Fortunately, these chronic insulin-related conditions are amenable to pharmacological intervention. As a result, novel therapeutic strategies that focus on increasing insulin sensitivity in the brain may be an important target for protecting or treating cognitive decline. The following review will highlight our current understanding of the role of insulin in brain, potential mechanisms underlying the link between insulin resistance and dementia, and current experimental therapeutic strategies aimed at improving cognitive function via modifying the brain’s insulin sensitivity.