Department of Neurology, Center for Cognitive Neurology, NYU School of Medicine, New York, NY, USA.
Departments of Neurology, Pathology and Psychiatry, Center for Cognitive Neurology, NYU School of Medicine, New York, NY, USA.
J Alzheimers Dis. 2018;64(s1):S299-S312. doi: 10.3233/JAD-179909.
There is growing genetic and proteomic data highlighting the complexity of Alzheimer's disease (AD) pathogenesis. Greater use of unbiased "omics" approaches is being increasingly recognized as essential for the future development of effective AD research, that need to better reflect the multiple distinct pathway abnormalities that can drive AD pathology. The track record of success in AD clinical trials thus far has been very poor. In part, this high failure rate has been related to the premature translation of highly successful results in animal models that mirror only limited aspects of AD pathology to humans. We highlight our recent efforts to increase use of human tissue to gain a better understanding of the AD pathogenesis subtype variety and to develop several distinct therapeutic approaches tailored to address this diversity. These therapeutic approaches include the blocking of the Aβ/apoE interaction, stimulation of innate immunity, and the simultaneous blocking of Aβ/tau oligomer toxicity. We believe that future successful therapeutic approaches will need to be combined to better reflect the complexity of the abnormal pathways triggered in AD pathogenesis.
越来越多的遗传和蛋白质组学数据强调了阿尔茨海默病(AD)发病机制的复杂性。越来越多的人认识到,更广泛地使用无偏“组学”方法对于未来开发有效的 AD 研究至关重要,因为这些方法需要更好地反映可能导致 AD 病理的多种不同途径异常。到目前为止,AD 临床试验的成功率非常低。部分原因是,由于过早地将动物模型中非常成功的结果转化为人类,而这些模型仅反映了 AD 病理的有限方面,导致临床试验的高失败率。我们强调了我们最近为增加使用人类组织以更好地了解 AD 发病机制亚型多样性并开发几种针对这种多样性的不同治疗方法所做的努力。这些治疗方法包括阻断 Aβ/apoE 相互作用、刺激先天免疫和同时阻断 Aβ/tau 寡聚物毒性。我们相信,未来成功的治疗方法需要结合起来,以更好地反映 AD 发病机制中触发的异常途径的复杂性。