首页|期刊导航|中山大学学报(医学科学版)|水通道蛋白4介导的类淋巴功能障碍与帕金森病

水通道蛋白4介导的类淋巴功能障碍与帕金森病OA

Aquaporin-4 Mediated Glymphatic Dysfunction and Parkinson's Disease

中文摘要英文摘要

帕金森病(PD)是一种起病隐匿、进展缓慢的中枢神经退行性疾病,以黑质致密部多巴胺能神经元的进行性丢失及α-突触核蛋白(α-Syn)的异常聚集形成的路易小体为主要病理特征,这些病理改变导致患者出现运动功能障碍、睡眠障碍、认知功能下降等症状,影响患者生存质量.目前治疗仍以多巴胺替代及脑深部电刺激(DBS)等对症手段为主,亟待解决长期用药产生的副作用及晚期疗效减退等问题.因此,研究延缓或逆转病程的疾病修饰治疗尤为重要.水通道蛋白4(AQP4)是脑内最重要的水通道,主要表达于星形胶质细胞足突,在维持脑水稳态、血脑屏障完整性和类淋巴系统(GS)功能中起关键作用.近年来研究发现,AQP4的表达量和极化状态在PD动物模型和患者脑组织中发生改变,且与GS功能、α-Syn清除、中枢神经系统(CNS)稳态及神经炎症激活密切相关.本文以"AQP4异常—类淋巴清除受损—α-Syn沉积—神经炎症—PD进展"为主线,概述AQP4极化定位与GS功能基础,总结其异常对α-Syn清除与炎症放大的可能机制,并归纳相关临床证据与干预进展.然而,现有研究在模型与PD亚型间结论不一,AQP4的因果作用及人群异质性仍待澄清.未来仍需开展大样本、长期随访并进行亚型分层研究,围绕AQP4探索精准调控策略,以验证其作为PD修饰治疗新靶点的安全性和有效性.

Parkinson's disease(PD)is a central neurodegenerative disorder with insidious onset and slow progression.It is pathologically characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta and the abnormal aggregation of α-synuclein(α-Syn),resulting in the formation of Lewy bodies.These pathological changes give rise to motor dysfunction,sleep disturbances,cognitive impairment,and other symptoms,thereby markedly reducing patients'quality of life.Current treatments remain largely symptomatic,including dopaminergic replacement therapy and deep brain stimulation(DBS),while long-term adverse effects and declining efficacy in advanced stages remain unresolved.Therefore,the development of disease-modifying therapies capable of delaying or reversing disease progression is of critical importance.Aquaporin-4(AQP4)is the most abundant water channel in the brain and is predominantly expressed in astrocytic endfeet,where it plays a key role in maintaining cerebral water homeostasis,blood-brain barrier integrity,and glymphatic waste clearance.Recent studies have demonstrated that both the expression level and polarization of AQP4 are altered in PD animal models and in brain tissues from patients with PD,and these alterations are closely associated with glymphatic dysfunction,impaired α-Syn clearance,disruption of central nervous system homeostasis,and activation of neuroinflammation.Following the cascade of"AQP4 alteration-impaired glymphatic clearance-α-Syn deposition-neuroinflammation-PD progression",this review outlines the basis of AQP4 polarization and glymphatic function,summarizes the potential mechanisms by which AQP4 abnormalities promote α-Syn accumulation and inflammatory amplification,and synthesizes current clinical evidence and therapeutic advances.Nevertheless,inconsistencies across experimental models and PD subtypes remain,and the causal role of AQP4 as well as population heterogeneity has yet to be fully elucidated.Future large-scale,long-term,subtype-stratified studies are warranted to explore precise regulatory strategies targeting AQP4 and to validate its safety and efficacy as a novel disease-modifying therapeutic target for PD.

魏圣楠;任彬彬

河南中医药大学康复医学院,河南 郑州 450046||河南中医药大学第一附属医院康复中心,河南 郑州 450000河南中医药大学第一附属医院康复中心,河南 郑州 450000

医药卫生

帕金森病水通道蛋白4α-突触核蛋白类淋巴系统神经炎症疾病修饰治疗

Parkinson's diseaseaquaporin-4α-Synucleinglymphatic systemneuroinflammationdisease-modifying therapy

《中山大学学报(医学科学版)》 2026 (3)

440-450,11

河南省中医药传承与创新人才工程(仲景工程)中医药学科拔尖人才(CZ0262-10-02)河南省中医药科学研究传承创新中心专项课题(HY-B0366-42)

10.11714/jsysu.med.YX20250178

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