oa Current Allergy & Clinical Immunology - Inflammation, immunity and Alzheimer's disease : review articles

Volume 21 Number 3
  • ISSN : 1609-3607



Alzheimer's disease (AD) is the commonest neurodegenerative disorder of the elderly and results in progressive cognitive impairment. The main pathological features of the disease are the formation of extracellular amyloid plaques, intraneuronal neurofibrillary tangles and cerebral amyloid angiopathy. In addition, there is also an inflammatory response, in which activated microglial cells of the innate immune system appear to play a central role. This inflammation may help to protect neurones but an excessive or exaggerated response may cause neuronal damage or death through the release of potentially neurotoxic inflammatory mediators. Systemic infections may further activate the microglial cells in the central nervous system and so drive the neurodegenerative process. Long-term use of nonsteroidal anti-inflammatory drugs protects against the development of AD. However, the mechanisms by which this occurs may be unrelated to cyclo-oxygenase inhibition and suppression of inflammation. Rather, these drugs may reduce the formation of amyloidogenic fragments from the amyloid precursor protein. Abnormalities of the peripheral immune system have been described in AD. Immunisation with antiamyloid-beta antibodies, to stimulate the clearance of amyloid plaques in the brain, has been attempted in humans but further modifications of this form of therapy will be needed in the future to prevent undesirable side-effects.

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