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阿尔茨海默病的当前和未来治疗方法。

Current and future treatments for Alzheimer's disease.

机构信息

Neurological Department, Laiko General Hospital of Athens, 15127Ag. Thoma 17, Athens, Greece.

出版信息

Ther Adv Neurol Disord. 2013 Jan;6(1):19-33. doi: 10.1177/1756285612461679.

Abstract

Alzheimer's dementia (AD) is increasingly being recognized as one of the most important medical and social problems in older people in industrialized and non-industrialized nations. To date, only symptomatic treatments exist for this disease, all trying to counterbalance the neurotransmitter disturbance. Three cholinesterase inhibitors (CIs) are currently available and have been approved for the treatment of mild to moderate AD. A further therapeutic option available for moderate to severe AD is memantine, an N-methyl-D-aspartate receptor noncompetitive antagonist. Treatments capable of stopping or at least effectively modifying the course of AD, referred to as 'disease-modifying' drugs, are still under extensive research. To block the progression of the disease they have to interfere with the pathogenic steps responsible for the clinical symptoms, including the deposition of extracellular amyloid β plaques and intracellular neurofibrillary tangle formation, inflammation, oxidative damage, iron deregulation and cholesterol metabolism. In this review we discuss current symptomatic treatments and new potential disease-modifying therapies for AD that are currently being studied in phase I-III trials.

摘要

阿尔茨海默病(AD)日益被认为是工业化和非工业化国家老年人中最重要的医学和社会问题之一。迄今为止,这种疾病只有对症治疗,所有这些治疗都试图平衡神经递质紊乱。目前有三种乙酰胆碱酯酶抑制剂(CIs)可用于治疗轻度至中度 AD,并已获得批准。对于中度至重度 AD,另一种可供选择的治疗方法是美金刚,一种 N-甲基-D-天冬氨酸受体非竞争性拮抗剂。能够阻止或至少有效改变 AD 病程的治疗方法,称为“疾病修饰”药物,仍在广泛研究中。为了阻止疾病的进展,它们必须干扰导致临床症状的致病步骤,包括细胞外淀粉样β斑块的沉积和细胞内神经原纤维缠结的形成、炎症、氧化损伤、铁失调和胆固醇代谢。在这篇综述中,我们讨论了目前正在进行的 AD 的对症治疗和新的潜在疾病修饰疗法,这些疗法目前正在 I-III 期临床试验中进行研究。

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