Department of Pathology and the Boyer Center for Molecular Medicine, Yale University School of Medicine, New Haven, Connecticut 06536, USA.
Am J Pathol. 2012 May;180(5):1762-7. doi: 10.1016/j.ajpath.2012.03.004. Epub 2012 Apr 1.
Alzheimer's disease threatens to become the scourge of the 21st century. Hundreds of millions of aging people throughout the world are at risk, but it is clear that the disease encompasses more than just the natural aging process. Deposits of amyloid β peptides in the brains of demented individuals are a defining feature of the disease, yet two decades of intensive investigation, focusing on reducing or removing amyloid deposits, have failed to produce any meaningful therapeutic interventions. Some researchers question whether amyloid is the appropriate target. Others maintain that early, presymptomatic intervention would be a more informative test, and propose large-scale clinical trials in patients who are believed to be in the earliest, and potentially reversible, stages of the disease. This review explores the wisdom of that approach.
阿尔茨海默病有可能成为 21 世纪的灾难。全世界数以亿计的老年人都面临着患病风险，但很明显，这种疾病并不仅仅是自然衰老过程的一部分。在痴呆症患者的大脑中发现β淀粉样蛋白的沉积是这种疾病的一个明确特征，但 20 年来的密集研究集中在减少或清除淀粉样蛋白沉积上，但都未能产生任何有意义的治疗干预措施。一些研究人员质疑淀粉样蛋白是否是合适的靶点。另一些人则认为早期的、有症状前的干预将是一个更有意义的测试，并提议在那些被认为处于疾病的最早阶段，且可能是可逆阶段的患者中进行大规模临床试验。这篇综述探讨了这种方法的合理性。
