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眼淀粉样变在阿尔茨海默病和年龄相关性黄斑变性的十字路口:对诊断和治疗的影响。

Ocular amyloid imaging at the crossroad of Alzheimer's disease and age-related macular degeneration: implications for diagnosis and therapy.

机构信息

Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Rd., DUMC 3802, Durham, NC, 27710, USA.

Department of Pathology, Duke University Medical Center, Durham, NC, USA.

出版信息

J Neurol. 2019 Jul;266(7):1566-1577. doi: 10.1007/s00415-018-9028-z. Epub 2018 Aug 28.

Abstract

Alzheimer's disease (AD) and age-related macular degeneration (AMD) are important disorders of aging, but significant challenges remain in diagnosis and therapy. Amyloid-beta (Aβ), found in the brain and a defining feature of AD, has also been observed in the retina in both AD and AMD. While current diagnostic modalities for detecting Aβ in the brain are costly or invasive, Aβ in the retina can be noninvasively and conveniently imaged using modern photonic imaging systems such as optical coherence tomography (OCT). Moreover, since many of these retinal changes occur before degenerative changes can be detected in the brain, ocular amyloid biomarkers could be utilized to detect AD as well as AMD in their earliest stages when therapy may be most effective in halting disease progression. Novel technologies to quantify retinal biomarkers have the potential to facilitate early diagnosis and noninvasive monitoring of disease progression with important therapeutic implications.

摘要

阿尔茨海默病(AD)和年龄相关性黄斑变性(AMD)是重要的衰老相关疾病,但在诊断和治疗方面仍存在重大挑战。淀粉样蛋白-β(Aβ)存在于大脑中,是 AD 的一个特征,也在 AD 和 AMD 的视网膜中被观察到。虽然目前用于检测大脑中 Aβ的诊断方法费用昂贵或具有侵入性,但可以使用现代光子成像系统(如光学相干断层扫描(OCT))非侵入性且方便地对视网膜中的 Aβ进行成像。此外,由于许多这些视网膜变化发生在大脑中退行性变化之前,因此眼部淀粉样蛋白生物标志物可用于在治疗效果最佳、可阻止疾病进展的早期阶段检测 AD 和 AMD。用于量化视网膜生物标志物的新技术有可能促进早期诊断和疾病进展的无创监测,具有重要的治疗意义。

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