Wahner Angelika D, Bronstein Jeff M, Bordelon Yvette M, Ritz Beate
Department of Epidemiology, UCLA School of Public Health, Box 951772, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA.
Neurology. 2007 Nov 6;69(19):1836-42. doi: 10.1212/01.wnl.0000279519.99344.ad.
Markers of neuroinflammation, including activated microglia and increased levels of circulating proinflammatory cytokines, have been observed in the brains and CSF of patients with Parkinson disease (PD). Yet the link between anti-inflammatory agents and PD in humans remains uncertain, despite indications that neuroinflammation may contribute to cell death in the PD brain and experimental evidence of anti-inflammatory agents such as nonsteroidal anti-inflammatory drugs (NSAIDs) exerting neuroprotective effects in animal models.
Using a population-based approach, we studied NSAID use among 293 incident idiopathic PD cases and 286 age-, race-, and gender-matched controls from three rural California counties.
Our data suggested a decreased risk of PD among regular (>or=2 pills/week for at least 1 month) aspirin NSAID users (OR, 0.80; 95% CI, 0.56 to 1.15). A stronger protective effect was observed for regular nonaspirin NSAID users (OR, 0.52; 95% CI, 0.35 to 0.79), particularly those who reported 2 or more years of use (OR, 0.44; 95% CI, 0.26 to 0.74). The aspirin effect estimates differed by gender, showing a protective effect only in women, especially among long term (>or=24 months) regular users (OR, 0.51; 95% CI, 0.26 to 1.02).
Our study contributes to the growing body of literature suggesting a protective role for nonsteroidal anti-inflammatory drugs (NSAIDs) in Parkinson disease (PD). Given our results and the biologic plausibility of a neuroprotective function for NSAIDs there is a pressing need for further studies elucidating the protective role such drugs may play in PD.
在帕金森病（PD）患者的大脑和脑脊液中已观察到神经炎症标志物，包括活化的小胶质细胞和循环促炎细胞因子水平升高。然而，尽管有迹象表明神经炎症可能导致PD大脑中的细胞死亡，且非甾体抗炎药（NSAIDs）等抗炎药物在动物模型中具有神经保护作用的实验证据，但抗炎药物与人类PD之间的联系仍不确定。
我们采用基于人群的方法，研究了来自加利福尼亚州三个农村县的293例新发特发性PD病例和286例年龄、种族和性别匹配的对照者使用NSAIDs的情况。
我们的数据表明，规律（每周≥2片，至少1个月）使用阿司匹林NSAIDs的患者患PD的风险降低（OR，0.80；95%CI，0.56至1.15）。规律使用非阿司匹林NSAIDs的患者观察到更强的保护作用（OR，0.52；95%CI，0.35至0.79），特别是那些报告使用2年或更长时间的患者（OR，0.44；95%CI，0.26至0.74）。阿司匹林的效应估计因性别而异，仅在女性中显示出保护作用，尤其是长期（≥24个月）规律使用者（OR，0.51；95%CI，0.26至1.02）。
我们的研究为越来越多的文献表明非甾体抗炎药（NSAIDs）在帕金森病（PD）中具有保护作用做出了贡献。鉴于我们的结果以及NSAIDs具有神经保护功能的生物学合理性，迫切需要进一步研究阐明此类药物在PD中可能发挥的保护作用。
