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阿尔茨海默病与抗氧化治疗:路漫漫其修远兮

Alzheimer's disease and antioxidant therapy: how long how far?

机构信息

CIQ/Departamento de Quimica e Bioquimica, Faculdade de Ciencias, Universidade do Porto, Porto 4169-007, Portugal.

出版信息

Curr Med Chem. 2013;20(24):2939-52. doi: 10.2174/1871523011320240001.

Abstract

Alzheimer's disease (AD) has become a health problem to societies worldwide affecting millions of people. AD normally ensues in middle and late life but its specific cause remains unknown. Besides amyloid-β deposition and hyperphosphorylated tau protein, increased production of reactive species (RS) has also been described to be a hallmark in early steps of this disorder. Antioxidant therapy has received considerable attention over the last years as a promising approach to delay or slow the neurodegeneration progression in AD either by boosting the pool of endogenous antioxidants (e.g.vitamins, coenzyme Q10 or melatonin) or by the intake of dietary antioxidants, such as phenolic compounds of flavonoid or non-flavonoid type. However, the majority of antioxidants studied so far have limited success in clinical trials, a fact that could be related to their poor distribution and with the inherent difficulties to cross the blood brain barrier and attain the target sites. Despite the evidence that different classes of antioxidants are neuroprotectants in vitro, the clinical data is not consistent. Alzheimer's disease and antioxidant therapy is still an open question: the research is far from the end but the success may not be so time-consuming if the data obtained so far are gathered and rationally analyzed either by checking new targets or by the obtention of new and effective compounds, for instance by the rational modification of the previous ones.

摘要

阿尔茨海默病(AD)已成为全球社会的健康问题,影响着数百万人。AD 通常发生在中年和晚年,但具体病因仍不清楚。除了淀粉样蛋白-β沉积和过度磷酸化的 tau 蛋白外,活性物质(RS)的产生增加也被描述为这种疾病早期的一个标志。抗氧化治疗近年来受到了相当多的关注,被认为是一种有前途的方法,可以通过增加内源性抗氧化剂(如维生素、辅酶 Q10 或褪黑素)的储备,或通过摄入膳食抗氧化剂,如类黄酮或非类黄酮类型的酚类化合物,来延缓或减缓 AD 中的神经退行性进展。然而,迄今为止研究的大多数抗氧化剂在临床试验中都收效甚微,这一事实可能与其分布不良以及固有困难有关,难以穿过血脑屏障并到达靶位。尽管有证据表明,不同类别的抗氧化剂在体外是神经保护剂,但临床数据并不一致。阿尔茨海默病和抗氧化治疗仍然是一个悬而未决的问题:研究还远未结束,但如果迄今为止获得的数据得到收集和合理分析,成功可能不会那么耗时,无论是通过检查新的靶点,还是通过获得新的和有效的化合物,例如通过对以前的化合物进行合理修饰。

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