Mawanda Francis, Wallace Robert
Epidemiol Rev. 2013;35(1):161-80. doi: 10.1093/epirev/mxs007. Epub 2013 Jan 24.
Late-onset Alzheimer's disease (AD) is the most prevalent cause of dementia among older adults, yet more than a century of research has not determined why this disease develops. One prevailing hypothesis is that late-onset AD is caused by infectious pathogens, an idea widely studied in both humans and experimental animal models. This review examines the infectious AD etiology hypothesis and summarizes existing evidence associating infectious agents with AD in humans. The various mechanisms through which different clinical and subclinical infections could cause or promote the progression of AD are considered, as is the concordance between putative infectious agents and the epidemiology of AD. We searched the PubMed, Web of Science, and EBSCO databases for research articles pertaining to infections and AD and systematically reviewed the evidence linking specific infectious pathogens to AD. The evidence compiled from the literature linking AD to an infectious cause is inconclusive, but the amount of evidence suggestive of an association is too substantial to ignore. Epidemiologic, clinical, and basic science studies that could improve on current understanding of the associations between AD and infections and possibly uncover ways to control this highly prevalent and debilitating disease are suggested.
晚发性阿尔茨海默病(AD)是老年人痴呆症最常见的病因,但经过一个多世纪的研究,仍未确定该疾病发病的原因。一个流行的假说是,晚发性AD是由传染性病原体引起的,这一观点在人类和实验动物模型中都得到了广泛研究。这篇综述探讨了感染性AD病因假说,并总结了将传染因子与人类AD相关联的现有证据。文中考虑了不同临床和亚临床感染可能导致或促进AD进展的各种机制,以及假定传染因子与AD流行病学之间的一致性。我们在PubMed、科学网和EBSCO数据库中搜索了与感染和AD相关的研究文章,并系统地回顾了将特定传染性病原体与AD联系起来的证据。从文献中收集到的将AD与感染性病因联系起来的证据尚无定论,但提示存在关联的证据量太大,不容忽视。文中还提出了一些流行病学、临床和基础科学研究建议,可以增进我们目前对AD与感染之间关联的理解,并可能找到控制这种高度流行且使人衰弱疾病的方法。