Although multiple studies have suggested a role for alterations of zinc (Zn) and zinc transport (ZnT) proteins in the pathogenesis of Alzheimer's disease (AD), the exact role of this essential trace element in the progression of AD remains unclear. The following review discusses the normal role of Zn and ZnT proteins in brain and the potential effects of their alteration in the pathogenesis of AD particularly in the processing of the amyloid precursor protein and amyloid beta peptide generation and aggregation. Keywords zinc; zinc transport proteins; mild cognitive impairment; early Alzheimer's disease
AD and MCIAlzheimer's disease (AD) is the fourth leading cause of death in the United States and in 2000 affected 4.5 million Americans [87]. Estimates indicate that ~3% of Americans between ages 65 and 74, 19% ages 75 -84, and 47% over age 85 are victims of the disease [67] and that 6 0% of nursing home patients over age 65 suffer from AD. Clinically AD is characterized by a progressive decline in multiple cognitive functions and is thought to begin with amnestic mild cognitive impairment (MCI), widely considered to be a transition between normal aging and dementia. Current data suggest that conversion from MCI to dementia occurs at a rate of 10 to 15% per year [156] with ~80% conversion by the sixth year of followup; although ~5% of MCI subjects remain stable or convert back to normal [13,52]. Progression from MCI leads to early AD (EAD) which is clinically characterized by a) a decline in cognitive function from a previous higher level, b). decline in one or more areas of cognition in addition to memory, c) a clinical dementia rating scale score of 0.5 to 1, d) impaired ADLs, and e) a clinical evaluation that excludes other causes of dementia. The disease eventually progresses to late stage AD (LAD) characterized by severe dementia with disorientation, profound memory impairment, global cognitive deficits and immobility. Without preventive strategies, there may be 14 million Americans with AD by the year 2040 [87].Pathologically AD is characterized by an abundance of neurofibrillary tangles (NFT), senile plaques (SP), neuropil thread formation, and Aβ deposition; neuron and synapse loss; and proliferation of reactive astrocytes, particularly in the hippocampus, amygdala, entorhinal cortex, and neocortex. NFT are composed of intracellular deposits of paired helical filaments
Zinc and Zinc Homeostasis in BrainZinc is an essential trace element [159] that is redox inert with structural, catalytic, and regulatory roles [17,80,186] and functions as a crucial component in over 300 enzymes and transcription factors where it serves as an essential cofactor for catalytic activity [70] or by conferring structural stability to Zn finger domains of DNA binding proteins [42] including stimulating protein-1 (sp-1), a transcription factor responsible for ~30% of APP transcription [18,48,49]. In addition to its structural and catalytic roles, recent studies suggest free Zn has important signaling functions including i...