La malattia di Alzheimer è la forma più comune di
demenza senile, una patologia progressiva ed irreversibile che colpisce il
cervello e per la quale a tutt’oggi non ci sono cure. Il morbo di Alzheimer comporta
la perdita di funzioni cognitive, dato che colpisce aree del cervello implicate
nella memoria, nel linguaggio e nell’elaborazione dei pensieri.
Dati sempre più consistenti stanno portando alla luce
l’importanza del sonno, non solo come momento necessario a ristabilire le funzioni
vegetative di base e a immagazzinare le informazioni acquisite durante la
giornata, ma anche come momento indispensabile al cervello per “fare pulizia”,
ovvero eliminare i metaboliti di scarto accumulati durante l’intera giornata.
Why is sleeping so important?
Our body carries out
many different functions, whose roles are well known, but understanding why we
spend a third of our lives sleeping is less intuitive.
Sleeping
is necessary to vital functions, since the long-term effects of sleep
deprivation lead to death rodents and flies within a short period of time.
Moreover, by sleeping we restore vegetative functions as well as we elaborate
information experienced during the day.
A new study, by Maiken Nedergaard and colleagues at
the University of Rochester in New York, provides a better understanding on the
role of sleep: by sleeping the brain clears out toxic peptides.
Alzheimer
disease (AD) is the most common form of dementia and one of the major
pathological hallmarks of the disease is the formation of extracellular amyloid
plaques, which are abnormal aggregates of the amyloid-β peptide (Aβ). Aβ is aggregation prone, and, by aggregating, it forms deposits
that may surround brain cells.
On the way torward the formation of amyloid
plaques, transient forms of aggregated Aβ cause
biochemical changes within the cells that culminate in the impairment of
synaptic functions.
It seems then that the brain needs to clear out this
peptide, especially when the equilibrium that controls the level of Aβ is
mysregulated in favour of its accumulation.
One of the mechanism foresees to
clear Aβ via the cerebrospinal fluid (CSF). The CSF is a fluid that circulates in the brain and
interchanges with the interstitial fluid (the blood), so that all the molecules
that enter the CSF can diffuse into the blood stream.
On the other way around, molecules
within the interstitial fluid can diffuse in the CSF and exert their effect on
brain cells, but this process is under the tight control of the blood brain
barrier, an interface that keeps separated the brain from the circulatory
system.
The CSF is a sort of “lymphatic” system, which flush out metabolic
waste, since the brain is the only organ in the human body that lacks a
clearance system as the lymphatic one.
Nedergaard and coll have used the in
vivo two-photon imaging technique, which can reveal dye molecules in living
cells, to compare the circulating CSF into the cortex of awake and sleeping
mice. They injected labeled Aβ and found out that during sleep CSF cleared away this
toxic peptide twofold faster than in awake mice, mainly because during sleep it
is increased the efflux from the CSF toward the interstitial fluid.
The main
point of this study is that sleep deprivation may have a correlation with the
onset of neurological disorders, by preventing the brain from removing toxic
metabolites.
Can sleeplessness become an alarm bell for
neurological dysfunctions?
Emerging data reveal that the build-up of amyloid
plaques is favoured by poor sleep.
Brain metabolism and activity pivot the
production of end products that need to be removed, so sleep seems to be
necessary to the brain to “clean” itself.
Investigating the importance of sleep
is becoming very attractive in neuroscience, since other neurodegenerative
disorders, such as Parkinson’s disease or chronic traumatic encephalopathy, are
also associated with the accumulation of toxic peptides within the brain. To
clarify the aspects underlying the real importance of better sleep will require
further investigations and efforts, but, in the meantime, it could be a good
strategy to keep the brain “in trim” in order to prevent the onset of
neurological disorders.
Bibliography
Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M,
O'Donnell J, Christensen DJ, Nicholson C, Iliff JJ, Takano T, Deane R,
Nedergaard M (2013) Sleep drives metabolite clearance from the adult brain.
Science 342: 373-377.
Livia Civitelli, PhD
Università di Linkoping Svezia - IKE
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