Shahid Kamran, Tamene Yonas, Mody Shefali P, Sadiq Kaiser O, Shivakumar Yogamba M, Burra Eshwar, Ramphall Shivana
Internal Medicine/Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2023 Aug 23;15(8):e43984. doi: 10.7759/cureus.43984. eCollection 2023 Aug.
Amyloid-ß (Aß) plaques and Neurofibrillary tangles are hallmarks of Alzheimer's disease (AD) pathology. Recent advances to find a cure for AD have led to the exploration of Anti-Aß monoclonal antibodies and angiotensin-receptor blockers (ARBs). The antibodies can decrease plaque formation or remove already formed plaques. ARBs increase angiotensin II (AT2) levels and decrease the effect of AT2 on the AT1 receptor (AT1R). This systematic analysis reviews evidence of monoclonal antibodies (Aducanumab, Lecanemab, Donanemab, and Solanezumab) and ARBs in managing AD. An in-depth methodical search was conducted across PubMed, Science Direct, and Mendeley. PRISMA 2020 guidelines were followed for this study. Randomized control trials for antibodies and ARBs and one retrospective cohort study were included. The comparison was made among studies that shared similar measured outcomes. Antibodies were found to be more effective than ARBs, with Aducanumab and Lecanemab being the most effective. ARBs, on the other hand, were found to be the safer choice. Further trials of longer duration and larger sample sizes are needed to explore both groups' long-term safety and efficacy.
淀粉样β蛋白（Aβ）斑块和神经原纤维缠结是阿尔茨海默病（AD）病理学的标志。近期寻找AD治愈方法的进展促使人们对抗Aβ单克隆抗体和血管紧张素受体阻滞剂（ARB）进行探索。这些抗体可以减少斑块形成或清除已形成的斑块。ARB可提高血管紧张素II（AT2）水平，并降低AT2对AT1受体（AT1R）的作用。本系统分析回顾了单克隆抗体（阿杜卡努单抗、莱卡奈单抗、多纳奈单抗和索拉奈单抗）和ARB治疗AD的证据。通过PubMed、Science Direct和Mendeley进行了深入的系统检索。本研究遵循PRISMA 2020指南。纳入了抗体和ARB的随机对照试验以及一项回顾性队列研究。在具有相似测量结果的研究之间进行了比较。发现抗体比ARB更有效，其中阿杜卡努单抗和莱卡奈单抗最为有效。另一方面，ARB被认为是更安全的选择。需要进行持续时间更长、样本量更大的进一步试验，以探索两组药物的长期安全性和疗效。
