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Instituto Nacional de Neurología y Neurocirugía

2020, Número 4

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Arch Neurocien 2020; 25 (4)


Mecanismos de asociación entre Enfermedad de Alzheimer y Diabetes Mellitus: La paradoja de la insulina

Hernández-Contreras KA, Martínez-Díaz JA, Hernández-Aguilar ME, Herrera-Covarrubias D, Rojas-Durán F, Aranda-Abreu GE

Idioma: Español
Referencias bibliográficas: 60
Paginas: 45-54
Archivo PDF: 638.99 Kb.


RESUMEN

Entre la Enfermedad de Alzheimer (EA) y la Diabetes Mellitus (DM) ha sido evidenciado que existen múltiples mecanismos en común en ambas patologías, que van desde el deterioro cognitivo en el aspecto clínico hasta alteraciones bioquímicas de las cuales destacan; el aumento de los agentes proinflamatorios y la excitotoxicidad, aumento del estrés oxidativo y aumento de los productos finales de la glicación avanzada (AGEs), alteraciones del metabolismo de la glucosa, así como alteraciones de las vías mTORC1 /S6 y GSK- 3 β; también destaca el papel de la Resistencia a la Insulina (Ri), donde esta alteración está vinculada tanto con EA como con DM en diversos puntos de su fisiopatología, ya sea mediante la influencia en los diferentes mecanismos antes mencionados o bien de forma directa. Objetivo. Describir como la influencia de esta hormona es tal, tanto si sus niveles son altos, efecto conocido como hiperinsulinismo o bajos efecto conocido como hipoinsulinismo, puesto que ambos extremos conducen a efectos neurodegenerativos característicos de EA, principalmente en el aumento de β amiloide (Aβ) y Tau hiperfosforilada (pTau), a través de distintos procesos. Aporte. Describimos este fenómeno nombrando como: “La paradoja de la insulina”, en la cual además destaca la vía insulina/I3K/Akt como punto crucial, ya que independientemente de las condiciones de hiper o hipoinsulinismo esta vía se altera en ambos escenarios. Esta relación entre EA y DM se considera desde el aspecto de los tratamientos hipoglucemiantes dirigidos a la atención de DM, los cuales parecen interferir con EA, a través de varios de los mecanismos en común que tienen estas patologías. Conclusión. Aunque es muy prematuro considerar que estos tratamientos para DM darán los mismos resultados en los casos de EA, estos datos son valiosos precedentes en la búsqueda de alternativas terapéuticas para EA.


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