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阿尔茨海默病转相时用局部辅酶 Q10 挽救视网膜神经节细胞:是否可行?

Salvage of the retinal ganglion cells in transition phase in Alzheimer's disease with topical coenzyme Q10: is it possible?

机构信息

Department of Ophthalmology, Ordu University School of Medicine, Ordu, Turkey.

Department of Neurology, Ordu University School of Medicine, Ordu, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2020 Feb;258(2):411-418. doi: 10.1007/s00417-019-04544-3. Epub 2019 Nov 28.

Abstract

PURPOSE

The evaluation of the short-term effect of topically applied coenzyme Q10 (CoQ10) on retina and choroid in Alzheimer's disease (AD) was aimed in this study.

METHODS

Randomized controlled study included a total of 93 patients, 62 of whom with AD. Thirty (32.3%) AD patients received treatment (Group 1), 32 (34.4%) AD patients observed without treatment (Group 2), and Group 3 included 31 (33.3%) healthy controls (HC). Neurological and ophthalmological examinations including optical coherence tomography (OCT) were executed.

RESULTS

Retinal nerve fiber layer (RNFL) thickness in all quadrants increased following CoQ10 treatment in Group 1; however significant rise yielded in average and temporal quadrant RNFL thickness. Average and superonasal sector ganglion cell-inner plexiform layer (GCIPL) thickness increased significantly following CoQ10 treatment. The correlation analysis between difference in pre- and posttreatment OCT values in Group 1 revealed that rise in average RNFL thickness was inversely correlated with duration of the disease and rise in average GCIPL thickness and superonasal sector thickness was inversely correlated with severity of the disease.

CONCLUSION

Short-term topical CoQ10 resulted in improvement in AD related retinal ganglion cell (RGC) loss which may reflect the salvage of some RGCs in the reversible transitional phase. More bioavailability through intravitreal route of administration and longer duration of effect with sustained release forms may possibly help enhalting the RGC loss, especially incipience of neurodegenerative diseases.

摘要

目的

本研究旨在评估局部应用辅酶 Q10(CoQ10)对阿尔茨海默病(AD)患者视网膜和脉络膜的短期疗效。

方法

这是一项随机对照研究,共纳入 93 例患者,其中 62 例为 AD 患者。30 例(32.3%)AD 患者接受治疗(第 1 组),32 例(34.4%)AD 患者未接受治疗(第 2 组),第 3 组包括 31 例健康对照者(HC)。所有患者均接受神经学和眼科检查,包括光学相干断层扫描(OCT)。

结果

第 1 组患者在 CoQ10 治疗后所有象限的视网膜神经纤维层(RNFL)厚度均增加;但平均和颞侧象限的 RNFL 厚度明显增加。平均和上方神经节细胞-内丛状层(GCIPL)厚度在 CoQ10 治疗后显著增加。第 1 组 OCT 治疗前后差值的相关性分析显示,平均 RNFL 厚度的增加与疾病持续时间呈负相关,平均 GCIPL 厚度和上方神经节细胞厚度的增加与疾病严重程度呈负相关。

结论

短期局部 CoQ10 可改善 AD 相关的视网膜节细胞(RGC)损失,这可能反映了在可逆的过渡阶段对一些 RGC 的挽救。通过玻璃体内给药途径增加生物利用度和通过持续释放形式延长作用时间可能有助于减轻 RGC 损失,特别是在神经退行性疾病的早期。

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