Составная часть фосфатидилхолина

Один из возможных механизмов — саморазрушение мембран нейронов. Как я уже отмечал, холинэргические нейроны — единственный тип клеток, которым холин нужен сразу для двух целей: как предшественник медиатора и как составная часть фосфатидилхолина их мембран. Поэтому они должны быть особенно чувствительны к недостатку холина. (Уровень холина в крови и спинномозговой жидкости при болезни Альцгеймера не снижается; однако в некоторых холинэргических окончаниях он может упасть ниже нормы, если ослабляется их способность потреблять холин или синтезировать лецитин либо если они особенно нуждаются в холине для производства ацетилхолина). Испытывая недостаток в свободном холине, окончания этих нейронов могут ради синтеза ацетилхолина начать расщеплять фосфат идилхолин своих собственных мембран. Этот процесс повредит функционированию мембран и в конце концов вызовет разрушение окончаний.

Уязвимость холинэргических нейронов, возможно, связана и с недостаточностью какого-то стимулирующего фактора; поиски такого фактора сейчас идут в нескольких лабораториях. И, наконец, если болезнь вызывается инфекционным агентом, причиной избирательного поражения холинэргических нейронов в базальной части мозга, аксоны которых идут к гиппокампу и коре, может быть просто то, что именно эти клетки чувствительны к возбудителю.

Ацегнлхолиновая модель, конечно, несовершенна; в частности, она не объясняет того факта, что при болезни Альцгеймера в мозгу нередко сильно не хватает и других медиаторов (а именно, норадрсналина и серотонина). Подобно ацетилхолину, в гиппокампе и в коре головного мозга эти медиаторы функционируют преимущественно в окончаниях нейронов, тела которых находятся в более примитивных отделах мозга.

 

 

 

 

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