Schicktanz Silke, Schweda Mark, Ballenger Jesse F, Fox Patrick J, Halpern Jodi, Kramer Joel H, Micco Guy, Post Stephen G, Thompson Charis, Knight Robert T, Jagust William J
Department of Medical Ethics and History of Medicine, University Medical Center Göttingen Göttingen, Germany.
Department of Medical Ethics and History of Medicine, University Medical Center Göttingen Göttingen, Germany ; Lichtenberg Kolleg, University of Göttingen Göttingen, Germany.
Front Hum Neurosci. 2014 Nov 20;8:921. doi: 10.3389/fnhum.2014.00921. eCollection 2014.
The development of a wide array of molecular and neuroscientific biomarkers can provide the possibility to visualize the course of Alzheimer's disease (AD) at early stages. Many of these biomarkers are aimed at detecting not only a preclinical, but also a pre-symptomatic state. They are supposed to facilitate clinical trials aiming at treatments that attack the disease at its earliest stage or even prevent it. The increasing number of such biomarkers currently tested and now partly proposed for clinical implementation calls for critical reflection on their aims, social benefits, and risks. This position paper summarizes major challenges and responsibilities. Its focus is on the ethical and social problems involved in the organization and application of dementia research, as well as in healthcare provision from a cross-national point of view. The paper is based on a discussion of leading dementia experts from neuroscience, neurology, social sciences, and bioethics in the United States and Europe. It thus reflects a notable consensus across various disciplines and national backgrounds. We intend to initiate a debate on the need for actions within the researchers' national and international communities.
一系列分子和神经科学生物标志物的发展为在早期阶段可视化阿尔茨海默病（AD）的病程提供了可能性。这些生物标志物中的许多不仅旨在检测临床前状态，还旨在检测症状前状态。它们应该有助于开展针对在疾病最早阶段进行治疗甚至预防疾病的临床试验。目前正在测试且部分已提议用于临床应用的此类生物标志物数量不断增加，这就需要对其目标、社会效益和风险进行批判性反思。本立场文件总结了主要挑战和责任。其重点是从跨国角度探讨痴呆症研究的组织和应用以及医疗保健提供中涉及的伦理和社会问题。本文基于对美国和欧洲神经科学、神经病学、社会科学和生物伦理学领域主要痴呆症专家的讨论。因此，它反映了不同学科和国家背景之间的显著共识。我们打算在研究人员的国内和国际群体中引发一场关于采取行动必要性的辩论。
