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[淀粉样蛋白正电子发射断层扫描在阿尔茨海默病治疗策略中的应用]

[Amyloid Positron Emission Tomography in the Therapeutic Strategies for Alzheimer's Disease].

作者信息

Ishii Kenji

机构信息

Team for Neuroimaging Research, Tokyo Metropolitan Institute of Gerontology.

出版信息

Brain Nerve. 2017 Jul;69(7):809-818. doi: 10.11477/mf.1416200824.

Abstract

Amyloid positron emission tomography (PET) has been developed as a non-invasive neuroimaging technique that enables us to visualize the accumulation of fibrillar amyloid-beta (Aβ) in the living human brain with histopathological confirmation. As the deposition of fibrillar Aβ is the earliest detectable biomarker of Alzheimer's disease (AD), amyloid PET is useful not only to increase the probability of a correct diagnostic in clinical practice and clinical studies, but also to enrich appropriate participants in the clinical trials of disease modifying drugs for early stage of AD. The amyloid positivity has been shown to be affected by age and APOE ε4 allele presence. In combination with the emerging technique of tau imaging, amyloid PET will reveal details of the early pathophysiological mechanism of AD, which will lead to the development of effective disease modifying therapies and prevention strategies. Amyloid negativity by amyloid PET is the most reliable marker to exclude the possibility of AD in the differential diagnosis of dementia diseases. Therefore, amyloid imaging is also essential for the clinical studies and clinical trials targeting non-AD dementia diseases such as frontotemporal lobar degeneration, argyrophilic grain disease and neurofibrillary tangle dominant disease. Establishing an in vivo imaging technique to visualize tau and alpha synuclein will accelerate further understanding of non-AD dementias.

摘要

淀粉样蛋白正电子发射断层扫描(PET)已发展成为一种非侵入性神经成像技术,使我们能够在活体人脑中可视化纤维状淀粉样β蛋白(Aβ)的积累,并得到组织病理学证实。由于纤维状Aβ的沉积是阿尔茨海默病(AD)最早可检测到的生物标志物,淀粉样蛋白PET不仅有助于提高临床实践和临床研究中正确诊断的概率,还能为AD早期疾病修饰药物的临床试验筛选合适的参与者。淀粉样蛋白阳性已被证明受年龄和APOE ε4等位基因存在情况的影响。结合新兴的tau成像技术,淀粉样蛋白PET将揭示AD早期病理生理机制的细节,这将推动有效疾病修饰疗法和预防策略的发展。在痴呆症的鉴别诊断中,淀粉样蛋白PET显示的淀粉样蛋白阴性是排除AD可能性的最可靠标志物。因此,淀粉样蛋白成像对于针对非AD痴呆症疾病(如额颞叶变性、嗜银颗粒病和神经原纤维缠结为主的疾病)的临床研究和临床试验也至关重要。建立可视化tau蛋白和α突触核蛋白的体内成像技术将加速对非AD痴呆症的进一步了解。

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