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Neurodegeneration and neuroinflammation: two processes, one target

The etiology of neurodegenerative diseases is diverse, however most of them share common characteristics: accumulation of misfolded proteins, chronic and sustained neuroinflammation, and the dysfunction and death of certain populations of neurons. The brain of Alzheimer's disease (AD) patients presents amyloid plaques and aggregation of hyperphosphorylated tau. The latter is also present in neurodegenerative tauopathies and in Parkinson's disease (PD). Aggregates of α-synuclein is the characteristic hallmark of PD. In amyotrophic lateral sclerosis (ALS) the mutation of SOD1 promotes its accumulation; and the polyglutamine expansion in huntingtin protein favors its aggregation in Huntington's disease (HD). Thus, the initial proteinopathy could be responsible for triggering the activation of the immunological defenses in the nervous system, as it has been demonstrated in some cases. Microglia and astrocytes are the main glial cells involved in the innate inflammatory response in the central nervous system (CNS). These cells are capable of detecting danger signals, and when activated they secrete inflammatory mediators to try to protect or prevent damage. However, in some cases the inflammatory response becomes sustained by an amplified feedback of release of factors between microglia and astrocytes that further activate these cells. This promotes the recruitment of more glial cells that prolongs and up-regulates the neuroinflammatory response contributing to the progression of the disease (the review of Glass et al. (2010) outlines in detail the contribution of glial cells in neurodegenerative diseases). Neurodegeneration has a remarkable apoptotic component; sustained neuroinflammatory response along with the deregulation of protective mechanisms trigger neuronal death.