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阿尔茨海默病的实验室诊断测试。

Laboratory diagnostic tests for Alzheimer's disease.

作者信息

Iqbal K, Wang G P, Grundke-Iqbal I, Wisniewski H M

机构信息

New York State Institute for Basic Research in Developmental Disabilities, Staten Island 10314.

出版信息

Prog Clin Biol Res. 1989;317:679-87.

PMID:2690116
Abstract

Alzheimer disease/senile dementia of the Alzheimer type (AD/SDAT) is a neuro-degenerative disease which is characterized by the accumulation of paired helical filaments (PHF) in the form of neurofibrillary tangles and neuritic (senile) plaques in the brain. The clinical diagnosis of AD/SDAT is made by excluding other causes of dementia and is uncertain in 10-50% of the cases. The histopathological diagnosis of AD/SDAT can be made only on brain biopsy or after the patient has died on autopsied brain. Presently no laboratory diagnostic test for AD/SDAT is available. Employing a monoclonal antibody to PHF, CSF from clinically diagnosed AD/SDAT and a control group of non-AD/SDAT living patients were probed by a competitive ELISA (enzyme linked immunosorbent assay). The PHF immunoreactivity was found higher in AD/SDAT as compared to control cases suggesting that a laboratory diagnostic test based on this assay might be feasible. Screening of a large number of cases, especially with histopathological confirmation, at multiple AD/SDAT medical centers must be carried out to evaluate the specificity and the sensitivity of the test.

摘要

阿尔茨海默病/阿尔茨海默型老年痴呆症(AD/SDAT)是一种神经退行性疾病,其特征是大脑中出现成对螺旋丝(PHF),以神经原纤维缠结和神经炎性(老年)斑的形式存在。AD/SDAT的临床诊断是通过排除其他痴呆病因来做出的,在10%至50%的病例中诊断并不确定。AD/SDAT的组织病理学诊断只能通过脑活检或在患者死后对大脑进行尸检来做出。目前尚无针对AD/SDAT的实验室诊断测试。使用针对PHF的单克隆抗体,通过竞争性酶联免疫吸附测定(ELISA)对临床诊断为AD/SDAT的患者和非AD/SDAT在世患者的对照组的脑脊液进行检测。结果发现,与对照病例相比,AD/SDAT患者的PHF免疫反应性更高,这表明基于该检测方法的实验室诊断测试可能是可行的。必须在多个AD/SDAT医疗中心对大量病例进行筛查,尤其是经过组织病理学确认的病例,以评估该检测的特异性和敏感性。

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