Poortvliet Peter C, O'Maley Karen, Silburn Peter A, Mellick George D
School of Environment and Science, Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD, Australia.
School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, QLD, Australia.
Front Neurol. 2020 Jul 8;11:686. doi: 10.3389/fneur.2020.00686. eCollection 2020.
We are gradually becoming aware that there is more to Parkinson's disease (PD) than meets the eye. Accumulating evidence has unveiled a disease complexity that has not (yet) been incorporated into ongoing efforts aimed at slowing, halting or reversing the course of PD, likely underlying their lack of success. There is a substantial latency between the actual onset of PD pathology and our ability to confirm diagnosis, during which accumulating structural and functional damage might be too advanced for effective modification or protection. Identification at the earliest stages of the disease course in the absence of Parkinsonism is crucial if we are to intervene when it matters most. Prognostic and therapeutic inferences can only be successful if we are able to accurately predict who is at risk for developing PD and if we can differentiate amongst the considerable clinicopathologic diversity. Biomarkers can greatly improve our identification and differentiation abilities if we are able to disentangle cause and effect.
我们逐渐意识到，帕金森病（PD）远比其表面所呈现的更为复杂。越来越多的证据揭示了一种疾病复杂性，而这种复杂性尚未被纳入旨在减缓、阻止或逆转帕金森病病程的现有努力中，这可能是这些努力缺乏成效的根本原因。帕金森病病理学实际发病与我们确认诊断的能力之间存在相当长的潜伏期，在此期间，不断累积的结构和功能损伤可能过于严重，以至于无法进行有效的改善或保护。如果我们要在最关键的时候进行干预，那么在帕金森综合征出现之前的疾病进程最早阶段进行识别至关重要。只有当我们能够准确预测谁有患帕金森病的风险，并且能够区分出相当大的临床病理多样性时，预后和治疗推断才可能成功。如果我们能够理清因果关系，生物标志物可以极大地提高我们的识别和区分能力。
