Lee Jong-Hoon, Choi Su-Hee, Lee Chul Joong, Oh Sang-Suk
Science and Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Obstetrics and Gynaecology, Seoul National University Hospital, Seoul, Republic of Korea.
Dement Geriatr Cogn Dis Extra. 2020 Jan 21;10(1):1-12. doi: 10.1159/000504880. eCollection 2020 Jan-Apr.
AIM/BACKGROUND: This research aims to prevent progression from mild cognitive impairment (MCI) to Alzheimer's disease. A Japanese study of leprosy patients revealed that the incidence of dementia in leprosy patients was lower than that in patients taking dapsone who had never been treated. But a similar study the following year refuted the finding of less dementia in leprosy patients taking dapsone. According to conflicting reports, was a factor in reducing the incidence of Alzheimer's disease. Thus, we formed a hypothesis that if dapsone is administered to patients without leprosy but with MCI and the prophylactic effect of dementia syndrome is observed over a long period of time, we can determine whether dapsone can prevent the progression of MCI to dementia syndrome. If dementia does not occur after treating inflammation in brain cells while dementia develops after a certain long-term period (usually within 2-3 years), brain cell inflammation can be demonstrated as the cause of dementia.
This is a prospective cohort research. We report on an elderly patient diagnosed with MCI from February 2008 to January 2019. The patient took dapsone 100 mg once a day from 2010 to 2015 for the treatment of MCI. Since 2016, the production of dapsone has ceased in Korea. In June 2018, the patient was diagnosed with Alzheimer's disease. The patient took Aricept for the treatment of Alzheimer's disease but complained of serious side effects. And dapsone was re-administered to the patient from November 2018.
The patient recovered to MCI and improved her daily life owing to the treatment with dapsone. The drug controls the inflammatory response in the brain, irrespective of whether proteins are deposited in neurons.
This finding means that dementia syndrome is an inflammatory disease. This research suggests that diagnostic criteria for Alzheimer's disease should be based on the presence or absence of inflammation in neurons. Because inflammation in neurons can occur in middle age due to various causes, we can treat inflammation in neurons and prevent and treat dementia syndrome, including Alzheimer's disease.
目的/背景：本研究旨在预防轻度认知障碍（MCI）进展为阿尔茨海默病。一项针对日本麻风病患者的研究表明，麻风病患者的痴呆发病率低于从未接受过治疗的服用氨苯砜的患者。但次年的一项类似研究反驳了服用氨苯砜的麻风病患者痴呆较少的这一发现。根据相互矛盾的报告，[此处原文缺失关键信息]是降低阿尔茨海默病发病率的一个因素。因此，我们形成了一个假设，即如果将氨苯砜给予无麻风病但患有MCI的患者，并在很长一段时间内观察到痴呆综合征的预防效果，我们就可以确定氨苯砜是否能预防MCI进展为痴呆综合征。如果在治疗脑细胞炎症后未发生痴呆，但在一定的长期（通常在2至3年内）后出现痴呆，那么脑细胞炎症可被证明是痴呆的病因。
这是一项前瞻性队列研究。我们报告了一名在2008年2月至2019年1月期间被诊断为MCI的老年患者。该患者在2010年至2015年期间每天服用100毫克氨苯砜以治疗MCI。自2016年以来，韩国已停止生产氨苯砜。2018年6月，该患者被诊断为阿尔茨海默病。该患者服用安理申治疗阿尔茨海默病，但出现了严重的副作用。2018年11月起再次给该患者服用氨苯砜。
由于服用氨苯砜进行治疗，该患者恢复到MCI状态，日常生活得到改善。该药物可控制大脑中的炎症反应，无论蛋白质是否沉积在神经元中。
这一发现意味着痴呆综合征是一种炎症性疾病。本研究表明，阿尔茨海默病的诊断标准应基于神经元中是否存在炎症。由于神经元炎症可因各种原因在中年时发生，我们可以治疗神经元炎症，预防和治疗包括阿尔茨海默病在内的痴呆综合征。
