阿尔茨海默病及其治疗 - - 昨天,今天和明天
A Y Kim1, S Al Jerdi1,2,3,4, R MacDonald3
1Medical Education, Weill Cornell Medicine-Qatar, Doha, Qatar.
Frontiers in pharmacology
|June 13, 2024
概括
阿尔茨海默病 (AD) 影响全球数百万人,目前的治疗只能提供症状缓解. 本综述质疑将粉样β (Aβ) 作为唯一的解决方案,倡导更广泛的治疗策略和并发症管理.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 老年学是指老年学的学科.
背景情况:
- 阿尔茨海默病 (AD) 是一种进展性神经退行性疾病,是最常见的痴呆症,影响全球超过4700万人.
- 预计到2050年,阿尔茨海默病的全球患病率将超过1.3亿,这将产生重大的经济和社会影响.
- 轻度认知障碍 (MCI) 是AD的公认前体,影响数百万,突出了早期干预策略的必要性.
研究的目的:
- 批判性地评估AD的病理生理基础.
- 评估当前症状治疗的疗效和局限性,包括乙胆酶抑制剂 (AChEI) 和记忆剂.
- 分析用于AD治疗的抗粉胺β (Aβ) 单克隆抗体 (MAB) 的治疗潜力和临床试验数据.
主要方法:
- 关于AD病理生理学和治疗学的现有文献的叙事综述.
- 对抗AβMABs (aducanumab,lecanemab,donanemab) 的临床试验数据的批判性分析.
- 对抗阿尔茨海默症治疗的不同药物类别的益处和缺点的比较.
主要成果:
- 目前的药物,如ACHEI和美曼丁,提供症状缓解,但不能阻止AD的进展.
- 抗AβMABs的有效性有限,挑战了粉样蛋白假设作为AD的普遍治疗标.
- 伴随性疾病如高血压,糖尿病,肥胖和抑郁症是阿尔茨海默病的重要风险因素,需要综合管理.
结论:
- 单独准β-粉样蛋白不太可能是大多数阿兹海默症患者的"神奇药".
- 新的研究方向和替代药物点对于开发更有效的AD疗法至关重要.
- 综合性疾病的综合管理对于减轻AD风险和改善患者生活质量至关重要.
相关概念视频
Alzheimer's Disease: Treatment
179
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
179
Alzheimer's Disease: Overview
462
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
462
Parkinson's Disease: Treatment
255
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
255
Dementia
110
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
The progression of dementia is generally gradual....
110
Parkinson's Disease: Overview
524
Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
524
Drug Therapy
42
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
42


