Turkiye Klinikleri Journal of Medical Sciences

.: REVIEW
Alzheimer Hastalığında Monoaminerjik Sistem Değişiklikleri: Geleneksel Bir Derleme
Alterations of Monoaminergic Systems in Alzheimer's Disease: A Traditional Review
Raviye ÖZEN KOCAa, Z. Işık SOLAK GÖRMÜŞa, Hatice SOLAKb
aNecmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Fizyoloji ABD, Konya, Türkiye
bKütahya Sağlık Bilimleri Üniversitesi Tıp Fakültesi, Fizyoloji ABD, Kütahya, Türkiye
Turkiye Klinikleri J Med Sci. 2022;42(4):323-34
doi: 10.5336/medsci.2022-89011
Article Language: TR
Full Text
ÖZET
 Alzheimer hastalığı (AH); karakteristik klinik ve patolojik özelliklere sahip, yaşla ilişkili, nörodejeneratif bir hastalıktır. AH'den kaynaklanan ölüm oranı, 2020 yılında koronavirüs hastalığı 2019 pandemisi ile daha da şiddetlenmiştir. En çok bilinen nöropatolojik bulgular; ekstranöronal senil plaklar ve intranöronal nörofibriler yumaklardır. AH, monoaminerjik sistemleri de içeren birçok nöronal yapıyı etkileyen multisistemik bir hastalıktır. AH fizyopatolojisi ile nörotransmitterlerde meydana gelen fonksiyonel değişiklikler yakından ilişkilidir. Nöronal sinapsların kaybı ve nöron ölümü sonucunda asetilkolin gibi birçok nörotransmitterin azaldığı bilinmektedir. AH'de monoaminerjik sistemde temel olarak, dopaminerjik innervasyonu sağlayan substansia nigra çekirdeği, serotonerjik innervasyonu sağlayan dorsal rafe çekirdeği ve noradrenerjik innervasyonu sağlayan lokus seruleus çekirdeği, histaminerjik innervasyonu sağlayan tüberomamiller çekirdek önemli dejenerasyona maruz kalmaktadır. Bu çekirdeklerden projeksiyon alan bölgelerde ilgili nörotransmitterlerin düzeylerinde değişiklikler olmaktadır. Kombine tedavi (bilişsel geliştirici tedaviler, nöropsikiyatrik semptomları tedavi eden ilaçlar, hastalığı modifiye edici tedaviler) Alzheimer hastalarında davranışsal anormallikleri azaltmak ve kognitif fonksiyonları etkili şekilde restore etmek için önemlidir. AH için oluşturulacak tedavi stratejileri, monoaminerjik sistemin arkasındaki moleküler mekanizmayı anlamayı gerektirmektedir. Bu geleneksel derleme ile AH'de monoaminerjik sistemde özellikle dopamin, noradrenalin, serotonin ve histamin mekanizmalarında meydana gelen değişiklikleri ayrıntılı bir şekilde tartışıp, bu konuda bir bakış açısı sunmayı hedefliyoruz. Sonuç olarak monoaminerjik sistemin sinyalizasyon mekanizmasının ve monoaminerjik reseptörlerin etkilerinin daha iyi anlaşılması için insanlarda ve hayvan modellerinde daha çok çalışma yapılması gerekmektedir. Böylece, AH için yeni tedavi stratejilerinin gelişimi hızlanacaktır.

Anahtar Kelimeler: Alzheimer hastalığı; monoaminler; dopamin; noradrenalin; serotonin
ABSTRACT
 Alzheimer's disease (AD) is an age-related, neurodegenerative disease with characteristic clinical and pathological features. The death rate from AD was exacerbated by the coronavirus disease 2019 pandemic in 2020. The most common neuropathological findings are extraneuronal senile plaques and intraneuronal neurofibrillary tangles. AD is a multisystemic disease that affects many neuronal structures, including monoaminergic systems. Functional changes in neurotransmitters are closely related to the pathophysiology of AD. It is known that many neurotransmitters such as acetylcholine decrease as a result of loss of neuronal synapses and neuronal death. In the monoaminergic system, basically, the substantia nigra nucleus providing the dopaminergic innervation, the dorsal raphe nucleus providing the serotonergic innervation, the locus ceruleus nucleus providing the noradrenergic innervation, and the tuberomamillar nucleus providing the histaminergic innervation are exposed to significant degeneration in AD. There are changes in the levels of relevant neurotransmitters in the regions projected from these nuclei. Combined therapy (cognitive enhancing treatments, drugs to treat neuropsychiatric symptoms, disease-modifying therapies) important to reduce behavioral abnormalities and effectively restore cognitive functions in AD patients. Treatment strategies for AD require understanding the molecular mechanism behind the monoaminergic system. With this traditional review, we aim to discuss in detail the changes that occur in the monoaminergic system, especially in dopamine, noradrenaline, serotonin and histamine mechanisms in AD, and present a perspective on this issue. As a result; more studies in humans and animal models are needed to better understand the signaling mechanism of the monoaminergic system and the effects of monoaminergic receptors. Thus, the development of new treatment strategies for AD will accelerate.

Keywords: Alzheimer's disease; monoamines; dopamine; noradrenaline; serotonin
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5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com