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阿尔茨海默病治疗进展综述:对抗β-淀粉样蛋白的策略

Review of the advances in treatment for Alzheimer disease: Strategies for combating β-amyloid protein.

作者信息

Folch J, Ettcheto M, Petrov D, Abad S, Pedrós I, Marin M, Olloquequi J, Camins A

机构信息

Unitat de Bioquímica, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Tarragona, España; Centros de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, España.

Unitat de Farmacologia i Farmacognòsia, Facultat de Farmàcia, Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, España.

出版信息

Neurologia (Engl Ed). 2018 Jan-Feb;33(1):47-58. doi: 10.1016/j.nrl.2015.03.012. Epub 2015 May 11.

Abstract

INTRODUCTION

Alzheimer disease (AD) is a major neurodegenerative disorder which eventually results in total intellectual disability. The high global prevalence and the socioeconomic burden associated with the disease pose major challenges for public health in the 21st century. In this review we focus on both existing treatments and the therapies being developed, which principally target the β-amyloid protein.

DISCUSSION

The amyloidogenic hypothesis proposes that β-amyloid plays a key role in AD. Several pharmacological approaches aim to reduce the formation of β-amyloid peptides by inhibiting the β-secretase and γ-secretase enzymes. In addition, both passive and active immunotherapies have been developed for the purpose of inhibiting β-amyloid peptide aggregation.

CONCLUSIONS

Progress in identifying the molecular basis of AD may provide better models for understanding the causes of this neurodegenerative disease. The lack of efficacy of solanezumab (a humanised monoclonal antibody that promotes β-amyloid clearance in the brain), demonstrated by 2 recent Phase III clinical trials in patients with mild AD, suggests that the amyloidogenic hypothesis needs to be revised.

摘要

引言

阿尔茨海默病(AD)是一种主要的神经退行性疾病,最终会导致完全智力残疾。该疾病在全球的高患病率以及与之相关的社会经济负担,对21世纪的公共卫生构成了重大挑战。在本综述中,我们关注现有的治疗方法以及正在研发的疗法,这些疗法主要针对β-淀粉样蛋白。

讨论

淀粉样蛋白生成假说认为β-淀粉样蛋白在AD中起关键作用。几种药理学方法旨在通过抑制β-分泌酶和γ-分泌酶来减少β-淀粉样肽的形成。此外,为了抑制β-淀粉样肽聚集,已经开发了被动和主动免疫疗法。

结论

在确定AD分子基础方面取得的进展可能为理解这种神经退行性疾病的病因提供更好的模型。最近两项针对轻度AD患者的III期临床试验表明,solanezumab(一种促进大脑中β-淀粉样蛋白清除的人源化单克隆抗体)缺乏疗效,这表明淀粉样蛋白生成假说需要修正。

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