Medical Center Department of Dietetics and Nutrition, University of Kansas, Kansas City, KS 66160, USA.
Alzheimer's Disease Center, University of Kansas, Fairway, KS 66205, USA.
Nutrients. 2019 Aug 15;11(8):1910. doi: 10.3390/nu11081910.
Alzheimer's disease (AD) is a devastating neurodegenerative disease with growing prevalence as the global population ages. Currently available treatments for AD have minimal efficacy and there are no proven treatments for its prodrome, mild cognitive impairment (MCI). AD etiology is not well understood and various hypotheses of disease pathogenesis are currently under investigation. A consistent hallmark in patients with AD is reduced brain glucose utilization; however, evidence suggests that brain ketone metabolism remains unimpaired, thus, there is a great deal of increased interest in the potential value of ketone-inducing therapies for the treatment of AD (neuroketotherapeutics; NKT). The goal of this review was to discuss dietary NKT approaches and mechanisms by which they exert a possible therapeutic benefit, update the evidence available on NKTs in AD and consider a potential role of diet quality in the clinical use of dietary NKTs. Whether NKTs affect AD symptoms through the restoration of bioenergetics, the direct and indirect modulation of antioxidant and inflammation pathways, or both, preliminary positive evidence suggests that further study of dietary NKTs as a disease-modifying treatment in AD is warranted.
阿尔茨海默病（AD）是一种具有破坏性的神经退行性疾病，随着全球人口老龄化，其发病率不断上升。目前 AD 的治疗方法效果甚微，并且对于其前驱期即轻度认知障碍（MCI）也没有经过证实的治疗方法。AD 的病因尚不清楚，目前正在研究各种疾病发病机制的假说。AD 患者的一个一致特征是大脑葡萄糖利用率降低；然而，有证据表明大脑酮代谢仍然未受损，因此，酮类诱导疗法治疗 AD（神经酮治疗学；NKT）的潜在价值引起了极大的关注。本综述的目的是讨论饮食 NKT 方法及其发挥可能治疗益处的机制，更新 AD 中 NKT 的现有证据，并考虑饮食质量在 NKT 临床应用中的潜在作用。NKT 是否通过恢复生物能量、直接和间接调节抗氧化和炎症途径来影响 AD 症状，或者两者兼而有之，初步的积极证据表明，进一步研究饮食 NKT 作为 AD 的疾病修饰治疗方法是有必要的。
