争议的过去、辉煌的现在、不可预测的未来:阿尔茨海默病历史简述
Controversial Past, Splendid Present, Unpredictable Future: A Brief Review of Alzheimer Disease History.
作者信息
Bermejo-Pareja Félix, Del Ser Teodoro
机构信息
CIBERNED, Institute of Health Carlos III, 28029 Madrid, Spain.
Institute of Research i+12, University Hospital "12 de Octubre", 28041 Madrid, Spain.
出版信息
J Clin Med. 2024 Jan 17;13(2):536. doi: 10.3390/jcm13020536.
The concept of Alzheimer disease (AD)-since its histological discovery by Alzheimer to the present day-has undergone substantial modifications. We conducted a classical narrative review of this field with a bibliography selection (giving preference to Medline best match). The following subjects are reviewed and discussed: Alzheimer's discovery, Kraepelin's creation of a new disease that was a rare condition until the 1970's, the growing interest and investment in AD as a major killer in a society with a large elderly population in the second half of the 20th century, the consolidation of the AD clinicopathological model, and the modern AD nosology based on the dominant amyloid hypothesis among many others. In the 21st century, the development of AD biomarkers has supported a novel biological definition of AD, although the proposed therapies have failed to cure this disease. The incidence of dementia/AD has shown a decrease in affluent countries (possibly due to control of risk factors), and mixed dementia has been established as the most frequent etiology in the oldest old. The current concept of AD lacks unanimity. Many hypotheses attempt to explain its complex physiopathology entwined with aging, and the dominant amyloid cascade has yielded poor therapeutic results. The reduction in the incidence of dementia/AD appears promising but it should be confirmed in the future. A reevaluation of the AD concept is also necessary.
自阿尔茨海默从组织学上发现阿尔茨海默病(AD)至今,这一概念已发生了重大变化。我们通过文献筛选(优先选择与Medline最佳匹配的文献)对该领域进行了经典的叙述性综述。以下主题将被回顾和讨论:阿尔茨海默的发现、克雷佩林对一种新疾病的定义,这种疾病在20世纪70年代之前一直较为罕见、在20世纪下半叶,随着老年人口众多的社会中AD成为主要杀手,人们对其兴趣和投资不断增加、AD临床病理模型的巩固,以及基于众多假说中占主导地位的淀粉样蛋白假说的现代AD疾病分类学。在21世纪,AD生物标志物的发展支持了AD的一种新的生物学定义,尽管所提出的治疗方法未能治愈这种疾病。富裕国家的痴呆症/AD发病率有所下降(可能是由于危险因素得到控制),混合性痴呆已被确认为最年长者中最常见的病因。目前AD的概念缺乏一致性。许多假说试图解释其与衰老交织在一起的复杂病理生理学,而占主导地位的淀粉样蛋白级联反应产生的治疗效果不佳。痴呆症/AD发病率的下降似乎很有前景,但未来仍需证实。对AD概念进行重新评估也是必要的。