Department of Psychiatry, University of Texas Southwestern Medical Center Dallas, TX, USA.
Neuropsychiatr Dis Treat. 2008 Aug;4(4):765-77. doi: 10.2147/ndt.s2012.
Alzheimer's disease (AD) is an incurable neurodegenerative disorder that produces cognitive impairments that increase in severity as the disease progresses. The clinical symptoms are related to the presence of neuritic plaques and neurofibrillary tangles in the cerebral cortex which represent the pathophysiological hallmarks of AD. The debilitating nature of the disease can result in clinical burden for the patient, emotional strain for those that care for patients with Alzheimer's, and significant financial burden to society. The goals of current treatments, such as cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonist, are to reduce the severity or slow the progression of cognitive symptoms. Although these treatments have demonstrated modest clinical benefit, they are unable to prevent, prohibit, or reverse the underlying pathophysiology of AD. Considerable progress has been made toward the development of disease-modifying treatments. Treatments currently under development mainly target the production, aggregation, and removal of existing amyloid beta-peptide aggregates which are believed to instigate the overall development of the neuropathology. Additional strategies that target tau pathology are being studied to promote neural protection against AD pathology. The current research has continued to expand our knowledge toward the development of disease modifying Alzheimer's therapies; however, no specific treatment strategy capable of demonstrating empirical efficacy and safety has yet to emerge.
阿尔茨海默病(AD)是一种无法治愈的神经退行性疾病,会导致认知能力逐渐下降,病情逐渐加重。临床症状与大脑皮层中的神经原纤维缠结和神经纤维缠结有关,这代表了 AD 的病理生理学特征。该疾病的致残性质可能会给患者带来临床负担,给照顾阿尔茨海默病患者的人带来情绪压力,给社会带来巨大的经济负担。目前治疗方法的目标,如胆碱酯酶抑制剂和 N-甲基-D-天冬氨酸受体拮抗剂,是减轻认知症状的严重程度或减缓其进展。尽管这些治疗方法已经显示出一定的临床益处,但它们无法预防、阻止或逆转 AD 的潜在病理生理学。在开发疾病修饰治疗方法方面已经取得了相当大的进展。目前正在开发的治疗方法主要针对现有淀粉样β肽聚集物的产生、聚集和清除,因为人们认为这些聚集物引发了神经病理学的整体发展。还在研究针对 tau 病理学的其他策略,以促进对 AD 病理学的神经保护。目前的研究继续扩展了我们对开发疾病修饰性阿尔茨海默病疗法的认识;然而,还没有出现一种能够证明疗效和安全性的特定治疗策略。