Modulating neuroinflammation in neurodegeneration-related dementia: can microglial toll-like receptors pull the plug?

Metab Brain Dis. 2021 Jun;36(5):829-847. doi: 10.1007/s11011-021-00696-6. Epub 2021 Mar 11.

Abstract

Neurodegeneration-associated dementia disorders (NADDs), namely Alzheimer and Parkinson diseases, are developed by a significant portion of the elderly population globally. Extensive research has provided critical insights into the molecular basis of the pathological advancements of these diseases, but an efficient curative therapy seems elusive. A common attribute of NADDs is neuroinflammation due to a chronic inflammatory response within the central nervous system (CNS), which is primarily modulated by microglia. This response within the CNS is positively regulated by cytokines, chemokines, secondary messengers or cyclic nucleotides, and free radicals. Microglia mediated immune activation is regulated by a positive feedback loop in NADDs. The present review focuses on evaluating the crosstalk between inflammatory mediators and microglia, which aggravates both the clinical progression and extent of NADDs by forming a persistent chronic inflammatory milieu within the CNS. We also discuss the role of the human gut microbiota and its effect on NADDs as well as the suitability of targeting toll-like receptors for an immunotherapeutic intervention targeting the deflation of an inflamed milieu within the CNS.

Keywords: Alzheimer disease; Human microbiome; Immunotherapy; Neurodegeneration; Neuroinflammation; Parkinson disease; Toll-like receptors.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain / metabolism*
  • Brain / pathology
  • Dementia / metabolism*
  • Dementia / pathology
  • Humans
  • Inflammation / metabolism*
  • Inflammation / pathology
  • Microglia / metabolism*
  • Microglia / pathology
  • Nerve Degeneration / metabolism*
  • Nerve Degeneration / pathology
  • Toll-Like Receptors / metabolism*

Substances

  • Toll-Like Receptors