Davidson M, Stern R G, Bierer L M, Horvath T B, Zemishlani Z, Markofsky R, Mohs R C
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10028.
Acta Psychiatr Scand Suppl. 1991;366:47-51. doi: 10.1111/j.1600-0447.1991.tb03109.x.
Since the identification of the cholinergic deficit, strategies aimed at enhancing cholinergic neurotransmission have dominated the field of pharmacology in Alzheimer's disease (AD). These strategies include increasing acetylcholine precursor availability, delaying synaptic degradation and stimulating muscarinic receptors. Although most clinical trials report mild symptomatic improvements in some patients, support for large-scale clinical use of cholinomimetics in AD is not yet available. This article presents the most representative clinical trials, discusses the limitations of the cholinergic strategies and suggests future directions in the treatment of AD.
自从胆碱能缺陷被发现以来，旨在增强胆碱能神经传递的策略在阿尔茨海默病（AD）药理学领域占据主导地位。这些策略包括增加乙酰胆碱前体的可用性、延缓突触降解以及刺激毒蕈碱受体。尽管大多数临床试验报告称部分患者有轻微的症状改善，但胆碱能拟似物在AD大规模临床应用方面的支持尚不具备。本文介绍了最具代表性的临床试验，讨论了胆碱能策略的局限性，并提出了AD治疗的未来方向。
