Ann Romney Center for Neurologic Diseases Brigham and Women's Hospital Harvard Medical School, Boston, MA, USA.
Nat Aging. 2024 Apr;4(4):453-463. doi: 10.1038/s43587-024-00611-5. Epub 2024 Apr 19.
Slowing neurodegenerative disorders of late life has lagged behind progress on other chronic diseases. But advances in two areas, biochemical pathology and human genetics, have now identified early pathogenic events, enabling molecular hypotheses and disease-modifying treatments. A salient example is the discovery that antibodies to amyloid ß-protein, long debated as a causative factor in Alzheimer's disease (AD), clear amyloid plaques, decrease levels of abnormal tau proteins and slow cognitive decline. Approval of amyloid antibodies as the first disease-modifying treatments means a gradually rising fraction of the world's estimated 60 million people with symptomatic disease may decline less or even stabilize. Society is entering an era in which the unchecked devastation of AD is no longer inevitable. This Perspective considers the impact of slowing AD and other neurodegenerative disorders on the trajectory of aging, allowing people to survive into late life with less functional decline. The implications of this moment for medicine and society are profound.
延缓晚年神经退行性疾病的进展落后于其他慢性疾病。但在生化病理学和人类遗传学两个领域的进展,现在已经确定了早期的致病事件,从而能够提出分子假说和治疗疾病的方法。一个突出的例子是发现针对淀粉样蛋白β-肽的抗体,长期以来一直被认为是阿尔茨海默病(AD)的致病因素,它可以清除淀粉样斑块,降低异常tau 蛋白的水平并减缓认知能力下降。淀粉样蛋白抗体被批准为第一种治疗疾病的方法,这意味着全球估计有 6000 万有症状的患者中,可能会有越来越多的患者病情下降幅度较小或甚至稳定。社会正进入一个阿尔茨海默病不受控制的破坏不再是不可避免的时代。本观点考虑了延缓 AD 和其他神经退行性疾病对衰老轨迹的影响,使人们能够在晚年生活中减少功能下降。这一时刻对医学和社会的影响是深远的。