Center for Neurologic Diseases, Department of Neurology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA.
CNS Neurol Disord Drug Targets. 2010 Apr;9(2):197-206. doi: 10.2174/187152710791012017.
Alzheimer's disease (AD) is a progressive, degenerative disorder of the brain and the most common form of dementia among the elderly. As the population grows and lifespan is extended, the number of AD patients will continue to rise. Current clinical therapies for AD provide partial symptomatic benefits for some patients; however, none of them modify disease progression. Amyloid-beta (Abeta) peptide, the major component of senile plaques in AD patients, is considered to play a crucial role in the pathogenesis of AD thereby leading to Abeta as a target for treatment. Abeta immunotherapy has been shown to induce a marked reduction in amyloid burden and an improvement in cognitive function in animal models. Although preclinical studies were successful, the initial human clinical trial of an active Abeta vaccine was halted due to the development of meningoencephalitis in approximately 6% of the vaccinated AD patients. Some encouraging outcomes, including signs of cognitive stabilization and apparent plaque clearance, were obtained in subset of patients who generated antibody titers. These promising preliminary data support further efforts to refine Abeta immunotherapy to produce highly effective and safer active and passive vaccines for AD. Furthermore, some new human clinical trials for both active and passive Abeta immunotherapy are underway. In this review, we will provide an update of Abeta immunotherapy in animal models and in human beings, as well as discuss the possible mechanisms underlying Abeta immunotherapy for AD.
阿尔茨海默病(AD)是一种进行性、退行性脑疾病,也是老年人中最常见的痴呆症形式。随着人口的增长和寿命的延长,AD 患者的数量将继续上升。目前 AD 的临床治疗方法为部分患者提供了部分症状缓解,但都不能改变疾病进展。淀粉样β(Abeta)肽是 AD 患者老年斑的主要成分,被认为在 AD 的发病机制中起关键作用,从而导致 Abeta 成为治疗靶点。Abeta 免疫疗法已被证明可在动物模型中显著减少淀粉样蛋白负荷并改善认知功能。尽管临床前研究取得了成功,但由于接种 AD 患者中约有 6%出现脑膜炎脑炎,主动 Abeta 疫苗的首次人体临床试验被停止。在产生抗体滴度的患者亚组中,获得了一些令人鼓舞的结果,包括认知稳定和明显的斑块清除迹象。这些有希望的初步数据支持进一步努力完善 Abeta 免疫疗法,为 AD 开发更有效和更安全的主动和被动疫苗。此外,一些针对主动和被动 Abeta 免疫疗法的新的人体临床试验正在进行中。在这篇综述中,我们将提供 Abeta 免疫疗法在动物模型和人类中的最新进展,并讨论 Abeta 免疫疗法治疗 AD 的可能机制。