Brighton and Sussex Medical School, Brighton, UK.
Int J Geriatr Psychiatry. 2013 Dec;28(12):1312-7. doi: 10.1002/gps.3966. Epub 2013 Apr 14.
A potential anti-inflammatory role for acetylcholinesterase inhibitors (AChEIs) has been supported by animal studies. As very limited data exist from individuals with Alzheimer's disease (AD), the aim of this study was to assess the potential influence of AChEIs on blood pro-inflammatory cytokines. We hypothesized that pro-inflammatory cytokine concentrations were lower in individuals with AD stabilized on AChEIs.
Blood interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha concentrations were assessed using specific enzyme-linked immunosorbent assays in three groups of participants: patients with AD stabilized on a therapeutic dose of an AChEI (n = 42); AChEIs drug naïve patients (n = 24); and a cognitively unimpaired control group (n = 35). Patients in the AChEIs group had received medication for an average of one year.
Patients stabilized on an AChEI did not differ significantly from drug naïve patients in relation to the concentrations of interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha (p = 0.874, 0.225, and 0.978, respectively). Within the group taking AChEIs, the levels of cytokines did not differ between those taking donepezil, rivastigmine, or galantamine (p = 0.368, 0.851, and 0.299, respectively).
Results from animal studies suggesting a modulatory anti-inflammatory role for AChEIs was not advanced in this study. In individuals with AD, very limited evidence currently exists to support the hypothesis that AChEIs may influence inflammatory blood markers and function beyond the enhancement of neuronal transmission. However, further studies assessing a wider range of inflammatory markers and processes are still needed before this hypothesis can be ruled out.
动物研究支持乙酰胆碱酯酶抑制剂(AChEIs)具有潜在的抗炎作用。由于阿尔茨海默病(AD)患者的数据非常有限,本研究旨在评估 AChEIs 对血液促炎细胞因子的潜在影响。我们假设,在接受 AChEI 治疗稳定的 AD 患者中,促炎细胞因子浓度较低。
使用特定的酶联免疫吸附试验评估三组参与者的血液白细胞介素-1β、白细胞介素-6 和肿瘤坏死因子-α 浓度:接受治疗剂量 AChEI 稳定的 AD 患者(n=42);AChEI 药物未使用患者(n=24);和认知未受损的对照组(n=35)。AChEI 组的患者接受药物治疗的平均时间为一年。
与药物未使用患者相比,接受 AChEI 治疗稳定的患者在白细胞介素-1β、白细胞介素-6 和肿瘤坏死因子-α 的浓度方面没有显著差异(p=0.874、0.225 和 0.978)。在服用 AChEI 的患者中,服用多奈哌齐、加兰他敏或利凡斯的患者细胞因子水平无差异(p=0.368、0.851 和 0.299)。
动物研究表明 AChEIs 具有调节抗炎作用的结果在本研究中并未得到证实。在 AD 患者中,目前仅有非常有限的证据支持 AChEIs 可能通过增强神经元传递以外的方式影响炎症血液标志物和功能的假设。然而,在排除该假设之前,仍需要进一步研究评估更广泛的炎症标志物和过程。