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他汀类药物在血管性帕金森病中可能作用的新见解:需要假设性治疗。

New insight on the possible role of statins in Vascular Parkinsonism: A need for presumptive therapy.

机构信息

Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq.

Department of Applied Science, University of Technology, Iraq.

出版信息

Ageing Res Rev. 2024 Mar;95:102209. doi: 10.1016/j.arr.2024.102209. Epub 2024 Jan 28.

DOI:10.1016/j.arr.2024.102209
PMID:38286334
Abstract

Vascular Parkinsonism (VP) is clinical term represents a progressive ischemic changes and subcortical lacunar infarct leading to Parkinsonism mainly in the lower limbs so called lower body Parkinsonism. The VP neuropathology is differed from that of PD neuropathology which rarely associated with basal ganglion lesions. Dopamine transporters are normal in VP but are highly reduced in PD, and dopaminergic agonists had no effective role on VP. The neuropathological mechanisms of VP are related to vascular injury which induces the interruption of the neural connection between basal ganglion and cerebral cortex. Hyperlipidemia and other cardiometabolic risk factors augment VP risk and the related neuropathology. Targeting of these cardiometabolic disorders by lipid-lowering statins may be effective in the management of VP. Therefore, this mini-review aims to clarify the possible role of statins in the management of VP. Statins have neuroprotective effects against different neurodegenerative diseases by anti-inflammatory, antioxidant and antithrombotic effects with enhancement of endothelial function. In conclusion, statins can prevent and treat VP by inhibiting inflammatory and oxidative stress disorders, mitigating of white matter hyperintensities and improving of neuronal signaling pathways. Additional preclinical, clinical trials and prospective studies are warranted in this regard.

摘要

血管性帕金森病(VP)是一个临床术语,代表了一种进行性缺血性改变和皮质下腔隙性梗死导致的帕金森病,主要发生在下肢,也称为下半身帕金森病。VP 的神经病理学与 PD 的神经病理学不同,后者很少与基底节病变有关。多巴胺转运体在 VP 中正常,但在 PD 中高度减少,而多巴胺激动剂对 VP 没有作用。VP 的神经病理学机制与血管损伤有关,血管损伤会导致基底节和大脑皮层之间的神经连接中断。高血脂和其他心脏代谢危险因素会增加 VP 的风险和相关神经病理学。通过降低血脂的他汀类药物靶向这些心脏代谢紊乱可能对 VP 的治疗有效。因此,本篇综述旨在阐明他汀类药物在 VP 治疗中的可能作用。他汀类药物具有抗炎、抗氧化和抗血栓作用,可增强内皮功能,对多种神经退行性疾病具有神经保护作用。总之,他汀类药物可以通过抑制炎症和氧化应激紊乱、减轻白质高信号和改善神经元信号通路来预防和治疗 VP。在这方面需要进行更多的临床前、临床试验和前瞻性研究。

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Ageing Res Rev. 2024 Mar;95:102209. doi: 10.1016/j.arr.2024.102209. Epub 2024 Jan 28.
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[Vascular or "lower body Parkinsonism": rise and fall of a diagnosis].[血管性或“下肢帕金森综合征”:一种诊断的兴衰]
Ideggyogy Sz. 2011 Nov 30;64(11-12):385-93.
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Neurol Sci. 2022 Aug;43(8):4797-4802. doi: 10.1007/s10072-022-06035-6. Epub 2022 Mar 26.
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The effects of cholesterol and statins on Parkinson's neuropathology: a narrative review.胆固醇和他汀类药物对帕金森病神经病理学的影响:叙事性综述。
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