Forette Françoise, Hauw Jean-Jacques
AP-HP, Hôpital Broca, Université Paris V, Fondation Nationale de Gérontologie-ILC, Paris, France.
Therapie. 2010 Sep-Oct;65(5):429-37. doi: 10.2515/therapie/2010055. Epub 2010 Dec 13.
The progressive neuronal loss in Alzheimer's disease leads to neurochemical abnormalities which provide the basis for symptomatic treatments. Four cholinesterase inhibitors were released in this indication. Meta-analyses have confirmed a beneficial effect on cognitive functioning and activities of daily living. The NMDA receptor antagonist, memantine, was also approved for the treatment of moderate to severe and may be associated. Progress in the patho-physiology of the disease offers some hope of new treatments acting on the cerebral lesions. The amyloid hypothesis allowed the emergence of active or passive immunotherapies, and of secretase inhibitors or modulators. Recent studies have targeted the P tau protein. The brain plasticity and the uses of stem cells offer more distant hope.
阿尔茨海默病中神经元的进行性丧失会导致神经化学异常,这为对症治疗提供了基础。有四种胆碱酯酶抑制剂已获批用于该适应症。荟萃分析证实了其对认知功能和日常生活活动有有益作用。N-甲基-D-天冬氨酸(NMDA)受体拮抗剂美金刚也被批准用于治疗中度至重度患者,且可能会有相关作用。该疾病病理生理学的进展为作用于脑部病变的新治疗方法带来了一些希望。淀粉样蛋白假说催生了主动或被动免疫疗法以及分泌酶抑制剂或调节剂。最近的研究以磷酸化tau蛋白为靶点。大脑可塑性和干细胞的应用带来了更长远的希望。