de Jong D, Jansen R W M M, Verbeek M M, Kremer H P H
Afd. Neurologie, Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen,
Ned Tijdschr Geneeskd. 2002 Nov 2;146(44):2074-8.
Ever since inflammatory mediators were detected in and around amyloid plaques in the brain of patients with Alzheimer's disease, there has been great interest in the inflammatory hypothesis and the possibility of treating Alzheimer's disease with anti-inflammatory drugs. Various epidemiological studies have now demonstrated that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is indeed associated with a reduced risk of developing Alzheimer's disease. The effect of NSAIDs in Alzheimer's disease is probably mediated by activation of the peroxisome proliferator-activated receptor-gamma. Administration of NSAIDs in a mouse model of Alzheimer's disease appears to suppress amyloid plaque formation and inflammatory mediators. These findings suggest that NSAIDs may also be able to slow down Alzheimer's disease progression. So far, only one small clinical trial has shown that treatment with NSAIDs significantly delayed cognitive decline in Alzheimer's disease patients. Large randomized double-blind placebo-controlled trials are needed to provide definitive evidence that NSAIDs have a therapeutic effect on Alzheimer's disease.
自从在阿尔茨海默病患者大脑的淀粉样斑块内及周围检测到炎症介质以来，人们对炎症假说以及使用抗炎药物治疗阿尔茨海默病的可能性产生了浓厚兴趣。现在各种流行病学研究已证明，使用非甾体抗炎药（NSAIDs）确实与降低患阿尔茨海默病的风险相关。NSAIDs 在阿尔茨海默病中的作用可能是通过激活过氧化物酶体增殖物激活受体γ介导的。在阿尔茨海默病小鼠模型中给予 NSAIDs 似乎能抑制淀粉样斑块形成和炎症介质。这些发现表明，NSAIDs 或许还能够减缓阿尔茨海默病的进展。到目前为止，仅有一项小型临床试验表明，用 NSAIDs 治疗可显著延缓阿尔茨海默病患者的认知衰退。需要进行大规模随机双盲安慰剂对照试验，以提供确凿证据证明 NSAIDs 对阿尔茨海默病具有治疗作用。
