Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Alzheimers Dement. 2017 Apr;13(4):374-380. doi: 10.1016/j.jalz.2017.02.006. Epub 2017 Mar 14.
In the history of medicine, one means to progress is when we make the decision that our assumptions and definitions of disease are no longer consistent with the scientific evidence, and no longer serve our health care needs. The arc of scientific progress is now requiring a change in how we diagnose Alzheimer's disease. Both the National Institute on Aging-Alzheimer's Association (NIA-AA) 2011 workgroup and the International Work Group (IWG) have proposed guidelines that use detectable measures of biological changes in the brain, commonly known as biological markers, or biomarkers, as part of the diagnosis. This Special Report examines how the development and validation of Alzheimer's disease biomarkers-including those detectable in the blood or cerebral spinal fluid, or through neuroimaging-is a top research priority. This has the potential to markedly change how we diagnose Alzheimer's disease and, as a result, how we count the number of people with this disease. As research advances a biomarker-based method for diagnosis and treatment at the earliest stages of Alzheimer's disease, we envision a future in which Alzheimer's disease is placed in the same category as other chronic diseases, such as cardiovascular disease or diabetes, which can be readily identified with biomarkers and treated before irrevocable disability occurs.
在医学史上，进步的一个手段是，当我们做出决定，即我们对疾病的假设和定义不再与科学证据一致，也不再满足我们的医疗保健需求时。科学进步的轨迹现在要求我们改变阿尔茨海默病的诊断方式。美国国家老龄化研究所-阿尔茨海默病协会（NIA-AA）2011 工作组和国际工作组（IWG）都提出了指南，将大脑中可检测到的生物变化（通常称为生物标志物或生物标志物）作为诊断的一部分。本特别报告探讨了阿尔茨海默病生物标志物的开发和验证——包括可在血液或脑脊液中检测到的生物标志物，或通过神经影像学检测到的生物标志物——如何成为一项首要研究重点。这有可能显著改变我们诊断阿尔茨海默病的方式，进而改变我们统计这种疾病患者数量的方式。随着研究在阿尔茨海默病的早期阶段推进基于生物标志物的诊断和治疗方法，我们设想未来阿尔茨海默病将被归入其他慢性疾病类别，如心血管疾病或糖尿病，这些疾病可以通过生物标志物轻松识别，并在不可逆转的残疾发生之前进行治疗。
