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在中重度阿尔茨海默病海马模型中使用N-甲基-D-天冬氨酸(NMDA)拮抗剂美金刚进行虚拟治疗的计算机模拟试验

Virtual Therapy with the NMDA Antagonist Memantine in Hippocampal Models of Moderate to Severe Alzheimer's Disease, in Silico Trials.

作者信息

Świetlik Dariusz, Białowąs Jacek, Kusiak Aida, Krasny Marta

机构信息

Division of Biostatistics and Neural Networks, Medical University of Gdańsk, Dębinki 1, 80-211 Gdansk, Poland.

Division of Anatomy and Neurobiology, Medical University of Gdańsk, Dębinki 1, 80-211 Gdansk, Poland.

出版信息

Pharmaceuticals (Basel). 2022 Apr 28;15(5):546. doi: 10.3390/ph15050546.

Abstract

The variability in clinical trial results on memantine treatment of Alzheimer's disease remains incompletely explained. The aim of this in silico study is a virtual memantine therapy for Alzheimer's disease that provides a different perspective on clinical trials; An in silico randomised trial using virtual hippocampi to treat moderate to severe Alzheimer's disease with doses of memantine 3-30 µM compared to placebo. The primary endpoint was the number of impulses (spikes). Secondary endpoints included interspike interval and frequency; The number of virtual moderate-AD hippocampal spikes was significantly lower, at 1648.7 (95% CI, 1344.5-1952.9), versus those treated with the 3 µM dose, 2324.7 (95% CI, 2045.9-2603.5), and the 10 µM dose, 3607.0 (95% CI, 3137.6-4076.4). In contrast, the number of virtual spikes (spikes) of severe AD of the hippocampus was significantly lower, at 1461.8 (95% CI, 1196.2-1727.4), versus those treated with the 10 µM dose, at 2734.5 (95% CI, 2369.8-3099.2), and the 30 µM dose, at 3748.9 (95% CI, 3219.8-4278.0). The results of the analysis of secondary endpoints, interspike intervals and frequencies changed statistically significantly relative to the placebo; The results of the in silico study confirm that memantine monotherapy is effective in the treatment of moderate to severe Alzheimer's disease, as assessed by various neuronal parameters.

摘要

美金刚治疗阿尔茨海默病的临床试验结果存在的变异性仍未得到充分解释。这项计算机模拟研究的目的是对阿尔茨海默病进行虚拟美金刚治疗,为临床试验提供不同视角;一项使用虚拟海马体的计算机模拟随机试验,用3 - 30 µM剂量的美金刚与安慰剂相比治疗中度至重度阿尔茨海默病。主要终点是冲动(尖峰)数量。次要终点包括峰间间隔和频率;虚拟中度阿尔茨海默病海马体的尖峰数量显著更低,为1648.7(95%置信区间,1344.5 - 1952.9),而接受3 µM剂量治疗的为2324.7(95%置信区间,2045.9 - 2603.5),接受10 µM剂量治疗的为3607.0(95%置信区间,3137.6 - 4076.4)。相比之下,重度阿尔茨海默病海马体的虚拟尖峰数量显著更低,为1461.8(95%置信区间,1196.2 - 1727.4),而接受10 µM剂量治疗的为2734.5(95%置信区间,2369.8 - 3099.2),接受30 µM剂量治疗的为3748.9(95%置信区间,3219.8 - 4278.0)。次要终点峰间间隔和频率的分析结果相对于安慰剂有显著统计学变化;计算机模拟研究结果证实,通过各种神经元参数评估,美金刚单药治疗对中度至重度阿尔茨海默病有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1bb/9145937/fe11fda4a06e/pharmaceuticals-15-00546-g001.jpg

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