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炎症与痴呆之间是否存在因果关系?

Is there a causal link between inflammation and dementia?

机构信息

Department of Cellular and Molecular Medicine, School of Medicine, "Carol Davila" University of Medicine and Pharmacy, 8 Eroilor Sanitari, District 5, Bucharest 050474, Romania.

出版信息

Biomed Res Int. 2013;2013:316495. doi: 10.1155/2013/316495. Epub 2013 Jun 6.

Abstract

Neuroinflammation is a constant event in Alzheimer's disease (AD), but the current knowledge is insufficient to state whether inflammation is a cause, a promoter, or simply a secondary phenomenon in this inexorably progressive ailment. In the current paper, we review research data showing that inflammation is not a prerequisite for onset of dementia, and, although it may worsen the course of the disease, recent evidence shows that chronic inhibition of inflammatory pathways is not necessarily beneficial for patients. Prospective clinical trials with anti-inflammatory drugs failed to stop disease progression, measurements of inflammatory markers in serum and cerebrospinal fluid of patients yielded contradictory results, and recent bench research proved undoubtedly that neuroinflammation has a protective side as well. Knockout animal models for TNFRs or ILRs do not seem to prevent the pathology or the cognitive decline, but quite the contrary. In AD, the therapeutic intervention on inflammatory pathways still has a research future, but its targets probably need reevaluation.

摘要

神经炎症是阿尔茨海默病(AD)的一个持续事件,但目前的知识还不足以说明炎症是这种不可避免的进行性疾病的病因、促进因素还是仅仅是一种次要现象。在目前的论文中,我们回顾了研究数据,这些数据表明炎症不是痴呆发作的前提条件,尽管它可能会使疾病的进程恶化,但最近的证据表明,慢性抑制炎症途径对患者不一定有益。具有抗炎作用的药物的前瞻性临床试验未能阻止疾病的进展,对患者血清和脑脊液中炎症标志物的测量得出了相互矛盾的结果,最近的基础研究无可置疑地证明了神经炎症也有保护作用。针对 TNFR 或 ILR 的基因敲除动物模型似乎并不能预防病理或认知能力下降,情况恰恰相反。在 AD 中,炎症途径的治疗干预仍然具有研究前景,但它的靶点可能需要重新评估。

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