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一项对纵向研究阿尔茨海默病生物标志物的系统评价。

A Systematic Review of Longitudinal Studies Which Measure Alzheimer's Disease Biomarkers.

机构信息

Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.

Janssen Prevention Center, Leiden, The Netherlands.

出版信息

J Alzheimers Dis. 2017;59(4):1359-1379. doi: 10.3233/JAD-170261.

Abstract

Alzheimer's disease (AD) is a progressive and fatal neurodegenerative disease, with no effective treatment or cure. A gold standard therapy would be treatment to slow or halt disease progression; however, knowledge of causation in the early stages of AD is very limited. In order to determine effective endpoints for possible therapies, a number of quantitative surrogate markers of disease progression have been suggested, including biochemical and imaging biomarkers. The dynamics of these various surrogate markers over time, particularly in relation to disease development, are, however, not well characterized. We reviewed the literature for studies that measured cerebrospinal fluid or plasma amyloid-β and tau, or took magnetic resonance image or fluorodeoxyglucose/Pittsburgh compound B-positron electron tomography scans, in longitudinal cohort studies. We summarized the properties of the major cohort studies in various countries, commonly used diagnosis methods and study designs. We have concluded that additional studies with repeat measures over time in a representative population cohort are needed to address the gap in knowledge of AD progression. Based on our analysis, we suggest directions in which research could move in order to advance our understanding of this complex disease, including repeat biomarker measurements, standardization and increased sample sizes.

摘要

阿尔茨海默病(AD)是一种进行性和致命的神经退行性疾病,目前尚无有效的治疗方法。金标准疗法将是减缓或阻止疾病进展的治疗方法;然而,在 AD 的早期阶段,对病因的了解非常有限。为了确定可能疗法的有效终点,已经提出了许多疾病进展的定量替代标志物,包括生物化学和影像学标志物。然而,这些各种替代标志物的动态变化,特别是与疾病发展的关系,尚未得到很好的描述。我们对纵向队列研究中测量脑脊液或血浆淀粉样蛋白-β和 tau,或进行磁共振成像或氟脱氧葡萄糖/匹兹堡化合物 B-正电子发射断层扫描的研究进行了文献综述。我们总结了各国主要队列研究的特点,常用的诊断方法和研究设计。我们得出的结论是,需要在代表性人群队列中进行更多具有重复时间测量的研究,以填补 AD 进展知识方面的空白。基于我们的分析,我们提出了研究的方向,以便深入了解这种复杂的疾病,包括重复生物标志物测量、标准化和增加样本量。

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