Müller W E, Eckert G P, Eckert A
Department of Pharmacology, Biocenter University of Frankfurt, Germany.
Pharmacopsychiatry. 1999 Mar;32 Suppl 1:2-9. doi: 10.1055/s-2007-979230.
Extensive research of the recent years has demonstrated that piracetam is effective in the treatment of cognitive decline in aging and dementia. It is usually much more active in situations of impaired brain function. Accordingly, its mechanism of action has been associated with neurochemical deficits of the aged brain relevant to cognitive dysfunctions. Since many of these neurochemical deficits depend on changes of membrane properties, including fluidity, it is of special importance that piracetam not only modifies membrane properties by interacting with the polar head moieties of the phospholipid bilayer, but also that this effect is more pronounced in membranes of aged as opposed to young animal and human brains, and that this mechanism also has specific relevance for brain membranes of Alzheimer's disease patients. Altering membrane properties might also be involved in vascular effects of piracetam such as improved erythrocyte deformability and normalization of hyperactive platelet aggregation. This novel mechanism of piracetam thus combines a rather non-specific physico-chemical mode of action with the pharmacological and clinical experience with this unique drug - effects are always much more pronounced when function is impaired.
近年来的大量研究表明，吡拉西坦在治疗衰老和痴呆引起的认知衰退方面有效。在脑功能受损的情况下，它通常更为活跃。因此，其作用机制与老年大脑中与认知功能障碍相关的神经化学缺陷有关。由于许多这些神经化学缺陷取决于膜特性的变化，包括流动性，特别重要的是，吡拉西坦不仅通过与磷脂双层的极性头部基团相互作用来改变膜特性，而且这种作用在老年动物和人类大脑的膜中比在年轻大脑的膜中更为明显，并且这种机制对阿尔茨海默病患者的脑膜也具有特定的相关性。改变膜特性也可能与吡拉西坦的血管效应有关，如改善红细胞变形能力和使过度活跃的血小板聚集正常化。因此，吡拉西坦的这种新机制将一种相当非特异性的物理化学作用方式与这种独特药物的药理和临床经验结合起来——当功能受损时，效果总是更为明显。
