Tosi Giovanni, Pederzoli Francesca, Belletti Daniela, Vandelli Maria Angela, Forni Flavio, Duskey Jason Thomas, Ruozi Barbara
Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy; Istituto di Ricerca Pediatrico "Città della Speranza", Padova, Italy.
Prog Brain Res. 2019;245:57-88. doi: 10.1016/bs.pbr.2019.03.001. Epub 2019 Apr 2.
The treatment of Alzheimer's disease (AD) is up to today one of the most unsuccessful examples of biomedical science. Despite the high number of literature evidences detailing the multifactorial and complex etiopathology of AD, no cure is yet present on the market and the available treatments are only symptomatic. The reasons could be ascribed on two main factors: (i) lack of ability of the majority of drugs to cross the blood-brain barrier (BBB), thus excluding the brain for any successful therapy; (ii) lack of selectivity and specificity of drugs, decreasing the efficacy of even potent anti-AD drugs. The exploitation of specifically engineered nanomedicines planned to cross the BBB and to target the most "hot" site of action (i.e., β-amyloid) is one of the most interesting innovations in drug delivery and could reasonably represent an promising choice for possible treatments and even early-diagnosis of AD. In this chapter, we therefore outline the most talented approaches in AD treatment with a specific focus on the main advantages/drawbacks and future possible translation to clinic application.
直至今日,阿尔茨海默病(AD)的治疗仍是生物医学领域最不成功的案例之一。尽管有大量文献详细阐述了AD的多因素及复杂病因病理,但市面上仍无治愈方法,现有的治疗仅为对症治疗。原因可归结为两个主要因素:(i)大多数药物无法穿过血脑屏障(BBB),因此排除了脑部进行任何成功治疗的可能性;(ii)药物缺乏选择性和特异性,即使是强效抗AD药物的疗效也会降低。开发专门设计的纳米药物以穿过血脑屏障并靶向最“热门”的作用位点(即β-淀粉样蛋白)是药物递送领域最有趣的创新之一,并且有望成为AD可能治疗甚至早期诊断的有前途的选择。因此,在本章中,我们概述了AD治疗中最具潜力的方法,特别关注其主要优点/缺点以及未来转化为临床应用的可能性。