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他汀类药物在阿尔茨海默病中的应用:疯狂探索与叙述性综述的祸还是福

Statins Use in Alzheimer Disease: Bane or Boon from Frantic Search and Narrative Review.

作者信息

Alsubaie Nawal, Al-Kuraishy Hayder M, Al-Gareeb Ali I, Alharbi Bandar, De Waard Michel, Sabatier Jean-Marc, Saad Hebatallah M, Batiha Gaber El-Saber

机构信息

Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia.

Department of Pharmacology, Toxicology and Medicine, Medical Faculty, College of Medicine, Al-Mustansiriyah University, Baghdad P.O. Box 14132, Iraq.

出版信息

Brain Sci. 2022 Sep 24;12(10):1290. doi: 10.3390/brainsci12101290.

Abstract

Alzheimer's disease (AD) was used to describe pre-senile dementia to differentiate it from senile dementia, which develops in the adult age group of more than 65 years. AD is characterized by the deposition of amyloid beta (Aβ) plaque and tau-neurofibrillary tangles (TNTs) in the brain. The neuropathological changes in AD are related to the deposition of amyloid plaques, neurofibrillary tangles, and progression of neuroinflammation, neuronal mitochondrial dysfunction, autophagy dysfunction, and cholinergic synaptic dysfunction. Statins are one of the main cornerstone drugs for the management of cardiovascular disorders regardless of dyslipidemia status. Increasing the use of statins, mainly in the elderly groups for primary and secondary prevention of cardiovascular diseases, may affect their cognitive functions. Extensive and prolonged use of statins may affect cognitive functions in healthy subjects and dementia patients. Statins-induced cognitive impairments in both patients and health providers had been reported according to the post-marketing survey. This survey depends mainly on sporadic cases, and no cognitive measures were used. Evidence from prospective and observational studies gives no robust conclusion regarding the beneficial or detrimental effects of statins on cognitive functions in AD patients. Therefore, this study is a narrative review aimed with evidences to the beneficial, detrimental, and neutral effects of statins on AD.

摘要

阿尔茨海默病(AD)曾被用于描述早老性痴呆,以将其与老年痴呆区分开来,后者发生在65岁以上的成年人群中。AD的特征是大脑中β-淀粉样蛋白(Aβ)斑块和tau神经原纤维缠结(TNTs)的沉积。AD的神经病理学变化与淀粉样斑块的沉积、神经原纤维缠结以及神经炎症的进展、神经元线粒体功能障碍、自噬功能障碍和胆碱能突触功能障碍有关。他汀类药物是治疗心血管疾病的主要基石药物之一,无论血脂异常状况如何。他汀类药物使用的增加,主要是在老年人群中用于心血管疾病的一级和二级预防,可能会影响他们的认知功能。广泛和长期使用他汀类药物可能会影响健康受试者和痴呆患者的认知功能。根据上市后调查,已经报道了他汀类药物在患者和医疗服务提供者中引起的认知障碍。这项调查主要依赖于散发病例,并且没有使用认知测量方法。前瞻性和观察性研究的证据对于他汀类药物对AD患者认知功能的有益或有害影响没有给出确凿的结论。因此,本研究是一项叙述性综述,旨在提供他汀类药物对AD有益、有害和中性影响的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8ab/9599431/187976407880/brainsci-12-01290-g001.jpg

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