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      Physical Exercise and Alzheimer’s Disease: Effects on Pathophysiological Molecular Pathways of the Disease

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          Abstract

          Alzheimer’s disease (AD), the most common form of neurodegenerative dementia in adults worldwide, is a multifactorial and heterogeneous disorder characterized by the interaction of genetic and epigenetic factors and the dysregulation of numerous intracellular signaling and cellular/molecular pathways. The introduction of the systems biology framework is revolutionizing the study of complex diseases by allowing the identification and integration of cellular/molecular pathways and networks of interaction. Here, we reviewed the relationship between physical activity and the next pathophysiological processes involved in the risk of developing AD, based on some crucial molecular pathways and biological process dysregulated in AD: (1) Immune system and inflammation; (2) Endothelial function and cerebrovascular insufficiency; (3) Apoptosis and cell death; (4) Intercellular communication; (5) Metabolism, oxidative stress and neurotoxicity; (6) DNA damage and repair; (7) Cytoskeleton and membrane proteins; (8) Synaptic plasticity. Moreover, we highlighted the increasingly relevant role played by advanced neuroimaging technologies, including structural/functional magnetic resonance imaging, diffusion tensor imaging, and arterial spin labelling, in exploring the link between AD and physical exercise. Regular physical exercise seems to have a protective effect against AD by inhibiting different pathophysiological molecular pathways implicated in AD.

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          The amyloid hypothesis of Alzheimer's disease: progress and problems on the road to therapeutics.

          It has been more than 10 years since it was first proposed that the neurodegeneration in Alzheimer's disease (AD) may be caused by deposition of amyloid beta-peptide (Abeta) in plaques in brain tissue. According to the amyloid hypothesis, accumulation of Abeta in the brain is the primary influence driving AD pathogenesis. The rest of the disease process, including formation of neurofibrillary tangles containing tau protein, is proposed to result from an imbalance between Abeta production and Abeta clearance.
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            Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer's disease.

            Eleven susceptibility loci for late-onset Alzheimer's disease (LOAD) were identified by previous studies; however, a large portion of the genetic risk for this disease remains unexplained. We conducted a large, two-stage meta-analysis of genome-wide association studies (GWAS) in individuals of European ancestry. In stage 1, we used genotyped and imputed data (7,055,881 SNPs) to perform meta-analysis on 4 previously published GWAS data sets consisting of 17,008 Alzheimer's disease cases and 37,154 controls. In stage 2, 11,632 SNPs were genotyped and tested for association in an independent set of 8,572 Alzheimer's disease cases and 11,312 controls. In addition to the APOE locus (encoding apolipoprotein E), 19 loci reached genome-wide significance (P < 5 × 10(-8)) in the combined stage 1 and stage 2 analysis, of which 11 are newly associated with Alzheimer's disease.
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              Alzheimer Disease: An Update on Pathobiology and Treatment Strategies

              Alzheimer disease (AD) is a heterogeneous disease with a complex pathobiology. The presence of extracellular amyloid-β deposition as neuritic plaques and intracellular accumulation of hyperphosphorylated tau as neurofibrillary tangles remain the primary neuropathologic criteria for AD diagnosis. However, a number of recent fundamental discoveries highlight important pathological roles for other critical cellular and molecular processes. Despite this, no disease modifying treatment currently exists and numerous phase 3 clinical trials have failed to demonstrate benefit. We review here recent advances in our understanding of AD pathobiology and discuss current treatment strategies, highlighting recent clinical trials and opportunities for developing future disease modifying therapies.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                12 March 2021
                March 2021
                : 22
                : 6
                : 2897
                Affiliations
                [1 ]i+HeALTH Research Group, Department of Health Sciences, European University Miguel de Cervantes, 47012 Valladolid, Spain; slopezo@ 123456uemc.es (S.L.-O.); fjpinto@ 123456uemc.es (J.P.-F.); jmartinh@ 123456uemc.es (J.M.-H.); maria.medina.seisdedos@ 123456gmail.com (M.M.S.); asantos@ 123456uemc.es (A.S.-L.)
                [2 ]Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; pedroluis.valenzuela@ 123456universidadeuropea.es (P.L.V.); oscar.garcia@ 123456universidadeuropea.es (O.G.-L.); simone.lista@ 123456icm-institute.org (S.L.)
                [3 ]Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; toschi@ 123456med.uniroma2.it (N.T.); francesco.garaci@ 123456uniroma2.it (F.G.)
                [4 ]Department of Radiology, “Athinoula A. Martinos” Center for Biomedical Imaging, Boston, MA 02129, USA
                [5 ]Harvard Medical School, Boston, MA 02115, USA
                [6 ]Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; francescadigiuliano@ 123456msn.com
                [7 ]Casa di Cura “San Raffaele Cassino”, 03043 Cassino, Italy
                [8 ]Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; mercurin@ 123456med.uniroma2.it
                [9 ]Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
                [10 ]Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, 00161 Rome, Italy; robert.nistico@ 123456gmail.com
                [11 ]School of Pharmacy, University of Rome “Tor Vergata”, 00133 Rome, Italy
                [12 ]2E Science, Robbio, 27038 Pavia, Italy; enzo.emanuele@ 1234562escience.com
                [13 ]Research Institute of the Hospital 12 de Octubre (“imas12”), 28041 Madrid, Spain
                [14 ]Centro de Investigación Biomeédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain
                Author notes
                [†]

                Senior co-authorship.

                Author information
                https://orcid.org/0000-0003-1730-3369
                https://orcid.org/0000-0003-1929-5833
                https://orcid.org/0000-0002-6067-183X
                https://orcid.org/0000-0002-2309-3583
                Article
                ijms-22-02897
                10.3390/ijms22062897
                7999827
                33809300
                4af534ad-4636-402c-b131-3b7298823976
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 14 February 2021
                : 09 March 2021
                Categories
                Review

                Molecular biology
                physical exercise,alzheimer’s disease,amyloid-β peptide,tau protein,molecular pathways

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