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白藜芦醇治疗阿尔茨海默病的临床疗效及作用机制研究进展。

Evidence of Clinical Efficacy and Pharmacological Mechanisms of Resveratrol in the Treatment of Alzheimer's Disease.

机构信息

Liaoning University of Traditional Chinese Medicine, Shenyang, 110000, China.

Shenyang Pharmaceutical University, Shenyang, 110000, China.

出版信息

Curr Alzheimer Res. 2023;20(8):588-602. doi: 10.2174/0115672050272577231120060909.

Abstract

BACKGROUND

To evaluate the efficacy and pharmacological mechanisms of resveratrol in Alzheimer's disease (AD) patients.

METHODS

We conducted a thorough exploration of existing randomized controlled trials concerning the treatment of Alzheimer's disease patients using resveratrol, utilizing accessible open databases. Quantitative variables were represented as a standardized mean difference (SMD), accompanied by a 95% confidence interval (CI). Additionally, we examined the potential targets and plausible pathways associated with the impact of resveratrol on Alzheimer's disease using network pharmacology techniques.

RESULTS

Our meta-analysis comprised five trials involving 271 AD patients, of whom 139 received resveratrol treatment and 132 received placebo treatment. Compared with placebo therapy, resveratrol treatment resulted in a significant improvement in Alzheimer's Disease Cooperative Study- Activities of Daily Living (ADAS-ADL) scores (SMD=0.51; 95% CI, 0.24 to 0.78) and cerebrospinal fluid (CSF) Aβ40 (SMD=0.84; 95% CI, 0.21 to 1.47) and plasma Aβ40 levels (SMD=0.43; 95% CI, 0.07 to 0.79). However, the improvement in the resveratrol-treated group compared with the placebo treatment group on the Mini-Mental State Examination (MMSE) score, CSF Aβ42 and plasma Aβ42 levels, and brain volume was not significant. There were no noteworthy statistical variances in the occurrence of adverse effects noted between the two groups. The outcomes of network pharmacology divulged that the principal enriched interaction pathway between resveratrol and Alzheimer's disease is primarily concentrated within the PI3K signaling pathways. Resveratrol's potential key targets for the treatment of AD include MAKP1, HRAS, EGFR, and MAPK2K1.

CONCLUSION

While having a high safety profile, resveratrol has efficacy in AD patients to a certain extent, and more data are required to validate the efficacy of resveratrol for the treatment of AD in the future. Suppression of the PI3K signaling pathways could hold significant importance in the treatment of AD patients using resveratrol.

摘要

背景

评估白藜芦醇治疗阿尔茨海默病(AD)患者的疗效和药理学机制。

方法

我们使用可公开获取的数据库,对使用白藜芦醇治疗阿尔茨海默病患者的随机对照试验进行了全面探索。定量变量表示为标准化均数差(SMD),并附有 95%置信区间(CI)。此外,我们使用网络药理学技术研究了白藜芦醇对阿尔茨海默病影响的潜在靶点和可能途径。

结果

我们的荟萃分析包括五项涉及 271 例 AD 患者的试验,其中 139 例接受白藜芦醇治疗,132 例接受安慰剂治疗。与安慰剂治疗相比,白藜芦醇治疗可显著改善阿尔茨海默病合作研究-日常生活活动(ADAS-ADL)评分(SMD=0.51;95%CI,0.24 至 0.78)和脑脊液(CSF)Aβ40(SMD=0.84;95%CI,0.21 至 1.47)和血浆 Aβ40 水平(SMD=0.43;95%CI,0.07 至 0.79)。然而,白藜芦醇治疗组与安慰剂治疗组在简易精神状态检查(MMSE)评分、CSF Aβ42 和血浆 Aβ42 水平以及脑容量方面的改善并不显著。两组不良反应发生率无显著统计学差异。网络药理学的结果表明,白藜芦醇与阿尔茨海默病之间主要的富集互作途径主要集中在 PI3K 信号通路内。白藜芦醇治疗 AD 的潜在关键靶点包括 MAPK1、HRAS、EGFR 和 MAPK2K1。

结论

白藜芦醇安全性高,在一定程度上对 AD 患者有效,未来需要更多数据来验证白藜芦醇治疗 AD 的疗效。抑制 PI3K 信号通路可能对白藜芦醇治疗 AD 患者具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a37d/10825797/19d91a072af6/CAR-20-588_F1.jpg

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