icon fsr

文献詳細

雑誌文献

BRAIN and NERVE-神経研究の進歩60巻8号

2008年08月発行

総説

アルツハイマー病に対する新ワクチン療法―現状とわれわれの試み

著者: 大倉良夫1 松本陽1

所属機関: 1東京都神経科学総合研究所分子病理学部門

ページ範囲:P.931 - P.940

文献概要

はじめに

 アルツハイマー病は今から100年前,ドイツの精神医学者Alois Alzheimerにより最初に報告された神経疾患である。認知障害(記憶障害,見当識障害,学習の障害,注意の障害,空間認知機能,問題解決能力の障害など)を主症状として中年期以降に多発し,世界中で1,200万人を超える患者が存在すると考えられている1)。発症後数年の経過を経て徐々に症状は進行し,重度になると摂食や着替え,意思疎通なども不可能となり,数年から十数年で寝たきりになり死に至る。経過中に被害妄想,幻覚や暴言・暴力・徘徊・不潔行為などの問題行動が出現することが多く,患者本人ばかりか家族や介護者を含めて大きな社会問題となっている。

参考文献

1) Citron M: Alzheimer's disease: treatments in discovery and development. Nat Neurosci 5 Suppl: 1055-1057, 2002
2) Hardy J, Allsop D: Amyloid deposition as the central event in the aetiology of Alzheimer's disease. Trends Pharmacol Sci 12: 383-388, 1991
3) Schenk D, Barbour R, Dunn W, Gordon. G, Grajeda H, et al: Immunization with amyloid-beta attenuates Alzheimer-disease-like pathology in the PDAPP mouse. Nature 400: 173-177, 1999
4) Morgan D, Diamond DM, Gottschall PE, Ugen KE, Dickey C, et al: A beta peptide vaccination prevents memory loss in an animal model of Alzheimer's disease. Nature 408: 982-985, 2000
5) Janus C, Pearson J, McLaurin J, Mathews PM, Jiang Y, et al: A beta peptide immunization reduces behavioural impairment and plaques in a model of Alzheimer's disease. Nature 408: 979-982, 2000,
6) Hock C, Konietzko U, Papassotiropoulos A, Wollmer A, Streffer J, et al: Generation of antibodies specific for beta-amyloid by vaccination of patients with Alzheimer disease. Nat Med 8: 1270-1275, 2002
7) Orgogozo JM, Gilman S, Dartigues JF, Laurent B, Puel M, et al: Subacute meningoencephalitis in a subset of patients with AD after Abeta42 immunization. Neurology 61: 46-54, 2003
8) Nicoll JA, Wilkinson D, Holmes C, Steart P, Markham H, et al: Neuropathology of human Alzheimer disease after immunization with amyloid-beta peptide: a case report. Nat Med 9: 448-452, 2003
9) Gilman S, Koller M, Black RS, Jenkins L, Griffith SG, et al: Clinical effects of Abeta immunization (AN1792) in patients with AD in an interrupted trial. Neurology 64: 1553-1562, 2005
10) Maier M, Seabrook TJ, Lemere CA: Developing novel immunogens for an effective, safe Alzheimer's disease vaccine. Neurodegener Dis 2: 267-272, 2005
11) Masters CL, Beyreuther K: Alzheimer's centennial legacy: prospects for rational therapeutic intervention targeting the Abeta amyloid pathway. Brain 129: 2823-2839, 2006
12) Maier M, Seabrook TJ, Lazo ND, Jiang L, Das P, et al: Short amyloid-beta (Abeta) immunogens reduce cerebral Abeta load and learning deficits in an Alzheimer's disease mouse model in the absence of an Abeta-specific cellular immune response. J Neurosci 26: 4717-4728, 2006
13) Frenkel D, Maron R, Burt DS, Weiner HL: Nasal vaccination with a proteosome-based adjuvant and glatiramer acetate clears beta-amyloid in a mouse model of Alzheimer disease. J Clin Invest 115: 2423-2433, 2005
14) Bard F, Cannon C, Barbour R, Burke RL, Games D, et al: Peripherally administered antibodies against amyloid beta-peptide enter the central nervous system and reduce pathology in a mouse model of Alzheimer disease. Nat Med 6: 916-919, 2000
15) DeMattos RB, Bales KR, Cummins DJ, Dodart JC, Paul SM, et al: Peripheral anti-A beta antibody alters CNS and plasma A beta clearance and decreases brain A beta burden in a mouse model of Alzheimer's disease. Proc Natl Acad Sci U S A 98: 8850-8855, 2001
16) Pfeifer M, Boncristiano S, Bondolfi L, Stalder A, Deller T, et al: Cerebral hemorrhage after passive anti-Abeta immunotherapy. Science 298: 1379, 2002
17) Tang DC, DeVit M, Johnston SA: Genetic immunization is a simple method for eliciting an immune response. Nature 356: 152-154, 1992
18) Barry MA, Lai WC, Johnston SA: Protection against mycoplasma infection using expression-library immunization, Nature 377: 632-635, 1995
19) Ulmer JB, Donnelly JJ, Parker SE, Rhodes GH, Felgner PL, et al: Heterologous protection against influenza by injection of DNA encoding a viral protein. Science 259: 1745-1749, 1993
20) Hoffman SL, Doolan DL, Sedegah M, Gramzinski R, Wang H, et al: Nucleic acid malaria vaccines. Current status and potential. Ann N Y Acad Sci 772: 88-94, 1995
21) Kim HD, Maxwell JA, Kong FK, Tang DC, Fukuchi K: Induction of anti-inflammatory immune response by an adenovirus vector encoding 11 tandem repeats of Abeta1-6: toward safer and effective vaccines against Alzheimer's disease. Biochem Biophys Res Commun 336: 84-92, 2005
22) Zhang J, Wu X, Qin C, Qi J, Ma S, et al: A novel recombinant adeno-associated virus vaccine reduces behavioral impairment and beta-amyloid plaques in a mouse model of Alzheimer's disease. Neurobiol Dis 14: 365-379, 2003
23) Hara H, Monsonego A, Yuasa K, Adachi K, Xiao X, et al: Development of a safe oral Abeta vaccine using recombinant adeno-associated virus vector for Alzheimer's disease. J Alzheimer Dis 6: 483-488, 2004
24) Marshall E: Gene therapy. Second child in French trial is found to have leukemia. Science 299: 320, 2003
25) Check E: Gene therapy put on hold as third child develops cancer. Nature 433: 561, 2005
26) Urabe M, Ding C, Kotin RM: Insect cells as a factory to produce adeno-associated virus type 2 vectors. Hum Gene Ther 13: 1935-1943, 2002
27) Nishikawa M, Huang L: Nonviral vectors in the new millennium: delivery barriers in gene transfer. Hum Gene Ther 12: 861-870, 2001
28) Nishikawa M, Hashida M: Nonviral approaches satisfying various requirements for effective in vivo gene therapy. Biol Pharm Bull 25: 275-283, 2002
29) Ghochikyan A, Vasilevko V, Petrushina I, Movsesyan N, Babikyan D, et al: Generation and characterization of the humoral immune response to DNA immunization with a chimeric beta-amyloid-interleukin-4 minigene. Eur J Immunol 33: 3232-3241, 2003
30) Schiltz JG, Salzer U, Mohajeri MH, Franke D, Heinrich J, et al: Antibodies from a DNA peptide vaccination decrease the amyloid burden in a mouse model of Alzheimer's disease. J Mol Med 82: 706-714, 2004
31) Matsumoto Y, Jee Y, Sugisaki M: Successful TCR-based immunotherapy for autoimmune myocarditis with DNA vaccines after rapid identification of pathogenic TCR. J Immunol 164: 2248-2254, 2000
32) Okura Y, Miyakoshi A, Kohyama K, Park IK, Staufenbiel M, et al: Nonviral Abeta DNA vaccine therapy against Alzheimer's disease: long-term effects and safety. Proc Natl Acad Sci U S A 103: 9619-9624, 2006
33) Marshall E: Gene therapy death prompts review of adenovirus vector. Science 286: 2244-2245, 1999
34) Check E: A tragic setback. Nature 420: 116-118, 2002
35) Kay MA: AAV vectors and tumorigenicity. Nat Biotechnol 25: 1111-1113, 2007
36) Donsante A, Miller DG, Li Y, Vogler C, Brunt EM, Russell DW, et al: AAV vector integration sites in mouse hepatocellular carcinoma. Science 317: 477, 2007
37) Ledwith BJ, Manam S, Troilo PJ, Barnum AB, Pauley CJ, et al: Plasmid DNA vaccines: investigation of integration into host cellular DNA following intramuscular injection in mice. Intervirology 43: 258-272, 2000
38) Bard F, Barbour R, Cannon C, Carretto R, Fox M, et al: Epitope and isotype specificities of antibodies to beta-amyloid peptide for protection against Alzheimer's disease-like neuropathology. Proc Natl Acad Sci U S A 100: 2023-2028, 2003
39) Wilcock DM, Munireddy SK, Rosenthal A, Ugen KE, Gordon MN, et al: Microglial activation facilitates Abeta plaque removal following intracranial anti-Abeta antibody administration. Neurobiol Dis 15: 11-20, 2004
40) Bacskai BJ, Kajdasz ST, McLellan ME, Games D, Seubert P, Schenk D, Hyman BT: Non-Fc-mediated mechanisms are involved in clearance of amyloid-beta in vivo by immunotherapy. J Neurosci 22: 7873-7878, 2002
41) Solomon B, Koppel R, Frankel D, Hanan-Aharon E: Disaggregation of Alzheimer beta-amyloid by site-directed mAb. Proc Natl Acad Sci U S A 94: 4109-4112, 1997
42) Dodart JC, Bales KR, Gannon KS, Greene SJ, DeMattos RB, et al: Immunization reverses memory deficits without reducing brain Abeta burden in Alzheimer's disease model. Nat Neurosci 5: 452-457, 2002
43) DeMattos RB, Bales KR, Cummins DJ, Paul SM, Holtzman DM: Brain to plasma amyloid-beta efflux: a measure of brain amyloid burden in a mouse model of Alzheimer's disease. Science 295: 2264-2267, 2002
44) O'Toole M, Janszen DB, Slonim DK, Reddy PS, Ellis DK, et al: Risk factors associated with beta-amyloid(1-42) immunotherapy in preimmunization gene expression patterns of blood cells. Arch Neurol 62: 1531-1536, 2005
45) Selkoe DJ: Alzheimer's disease is a synaptic failure. Science 298: 789-791, 2002
46) Kotilinek LA, Bacskai B, Westerman M, Kawarabayashi T, Younkin L, et al: Reversible memory loss in a mouse transgenic model of Alzheimer's disease. J Neurosci 22: 6331-6335, 2002

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1344-8129

印刷版ISSN:1881-6096

雑誌購入ページに移動
icon up

本サービスは医療関係者に向けた情報提供を目的としております。
一般の方に対する情報提供を目的としたものではない事をご了承ください。
また,本サービスのご利用にあたっては,利用規約およびプライバシーポリシーへの同意が必要です。

※本サービスを使わずにご契約中の電子商品をご利用したい場合はこちら