Arafah Azher, Khatoon Saima, Rasool Iyman, Khan Andleeb, Rather Mashoque Ahmad, Abujabal Khaled Abdullah, Faqih Yazid Abdullilah Hassan, Rashid Hina, Rashid Shahzada Mudasir, Bilal Ahmad Sheikh, Alexiou Athanasios, Rehman Muneeb U
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.
Department of Medical Elementology and Toxicology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi 110062, India.
Biomedicines. 2023 Jan 25;11(2):335. doi: 10.3390/biomedicines11020335.
This decade has seen the beginning of ground-breaking conceptual shifts in the research of Alzheimer's disease (AD), which acknowledges risk elements and the evolving wide spectrum of complicated underlying pathophysiology among the range of diverse neurodegenerative diseases. Significant improvements in diagnosis, treatments, and mitigation of AD are likely to result from the development and application of a comprehensive approach to precision medicine (PM), as is the case with several other diseases. This strategy will probably be based on the achievements made in more sophisticated research areas, including cancer. PM will require the direct integration of neurology, neuroscience, and psychiatry into a paradigm of the healthcare field that turns away from the isolated method. PM is biomarker-guided treatment at a systems level that incorporates findings of the thorough pathophysiology of neurodegenerative disorders as well as methodological developments. Comprehensive examination and categorization of interrelated and convergent disease processes, an explanation of the genomic and epigenetic drivers, a description of the spatial and temporal paths of natural history, biological markers, and risk markers, as well as aspects about the regulation, and the ethical, governmental, and sociocultural repercussions of findings at a subclinical level all require clarification and realistic execution. Advances toward a comprehensive systems-based approach to PM may finally usher in a new era of scientific and technical achievement that will help to end the complications of AD.
在这十年中,阿尔茨海默病(AD)研究出现了开创性的概念转变,该转变认识到风险因素以及多种神经退行性疾病中复杂潜在病理生理学的不断演变的广泛范围。与其他几种疾病一样,开发和应用精准医学(PM)的综合方法可能会在AD的诊断、治疗和缓解方面带来显著改善。这一策略可能基于包括癌症在内的更复杂研究领域所取得的成果。精准医学需要将神经学、神经科学和精神病学直接整合到一个摒弃孤立方法的医疗保健领域范式中。精准医学是在系统层面上由生物标志物引导的治疗,它整合了神经退行性疾病的全面病理生理学研究结果以及方法学进展。对相互关联和趋同的疾病过程进行全面检查和分类、解释基因组和表观遗传驱动因素、描述自然史的时空路径、生物标志物和风险标志物,以及亚临床水平研究结果的调控方面、伦理、政府和社会文化影响等,都需要进行阐明并切实执行。朝着基于综合系统的精准医学方法迈进的进展最终可能会开创一个科学技术成就的新时代,这将有助于终结阿尔茨海默病的并发症。