Diabetes Mellitus’un Alzheimer İle Olası İlişkisi

Year 2018, Volume: 1 Issue: 2, 1 - 12, 15.10.2018

Duygu Şahin

Abstract

Diabetes Mellitus, pankreasın insülin salgısının tam ya da kısmi yetersizliği ya da insülin etkisinin

yetersizliği ile oluşan, kendini hiperglisemi ile belli eden, karbonhidrat, lipid ve protein metabolizma

bozukluğu ile de karakterize bir endokrin ve metabolizma hastalığıdır. Beyinde insülin reseptörlerinin

keşfi ile insülinin beyin fizyolojisinde önemli bir rol oynadığı, serebral insülin sinyalinde ve glukoz

homeostazında meydana gelen bozuklukların beyin patolojisine katkıda bulunduğu belirtilmektedir.

İnsülin, reseptörü aracılığıyla kan-beyin bariyerini aşarak santral sinir sistemine girmekte, beyin

glukoz metabolizmasında regülatör etkisine ek olarak, nöromodülatör ve nöroendokrin bir molekül

gibi davranmakta, nöronal gelişim ve sağkalımda önemli bir rol almaktadır. İnsülin periferde olduğu

gibi, beyinde de etkilerini, reseptörü aracılığıyla, insülin reseptör substrat/fosfotidilinozitol 3-kinaz

(IRS/PI3K) ve mitojen aktive protein kinaz (MAPK) sinyal yolu aracılığıyla göstermektedir. PI3K

sinyal yolağının aktivasyonu, protein kinaz B (Akt) aracılığı ile, Alzheimer’ın en belirgin iki

patolojik karakteristiği olan, tau hiperfosforilasyonu ile oluşan intraselüler nörofibriler yumaklar ve

β-amiloid agregatlarının oluşturduğu ekstraselüler senil plakların metabolizmasının regülasyonunda

etkili olmaktadır. Son yıllarda yapılan çalışmalarla, Alzheimer, Merkezi Sinir Sisteminde insülin

reseptör duyarlılığının ve sinyal iletiminin bozulmasından kaynaklanan insülin rezistansının

gelişimine bağlı olarak meydana gelen tau ve Aβ metabolizmasındaki değişiklikleri içerdiğinden,

Diabetes Mellitus’un beyin spesifik formu (Tip 3 DM) olarak tanımlanmaktadır.

Keywords

Diabetes Mellitus, Insülin, Tau hiperfosforilasyonu, Alzheimer

References

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