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阿尔茨海默病(AD)血液生物标志物的研究进展:综述。

Advances in blood biomarkers for Alzheimer disease (AD): A review.

机构信息

Department of Neurology, Knight Alzheimer Disease Research Center (Knight ADRC), Washington University School of Medicine, St. Louis, Missouri, USA.

出版信息

Kaohsiung J Med Sci. 2024 Aug;40(8):692-698. doi: 10.1002/kjm2.12870. Epub 2024 Jun 18.

Abstract

Alzheimer disease (AD) and Alzheimer Disease and Related Dementias (AD/ADRD) are growing public health challenges globally affecting millions of older adults, necessitating concerted efforts to advance our understanding and management of these conditions. AD is a progressive neurodegenerative disorder characterized pathologically by amyloid plaques and tau neurofibrillary tangles that are the primary cause of dementia in older individuals. Early and accurate diagnosis of AD dementia is crucial for effective intervention and treatment but has proven challenging to accomplish. Although testing for AD brain pathology with cerebrospinal fluid (CSF) or positron emission tomography (PET) has been available for over 2 decades, most patients never underwent this testing because of inaccessibility, high out-of-pocket costs, perceived risks, and the lack of AD-specific treatments. However, in recent years, rapid progress has been made in developing blood biomarkers for AD/ADRD. Consequently, blood biomarkers have emerged as promising tools for non-invasive and cost-effective diagnosis, prognosis, and monitoring of AD progression. This review presents the evolving landscape of blood biomarkers in AD/ADRD and explores their potential applications in clinical practice for early detection, prognosis, and therapeutic interventions. It covers recent advances in blood biomarkers, including amyloid beta (Aβ) peptides, tau protein, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP). It also discusses their diagnostic and prognostic utility while addressing associated challenges and limitations. Future research directions in this rapidly evolving field are also proposed.

摘要

阿尔茨海默病(AD)和阿尔茨海默病及相关痴呆症(AD/ADRD)是全球日益严重的公共卫生挑战,影响着数以百万计的老年人,需要共同努力来提高我们对这些疾病的认识和管理。AD 是一种进行性神经退行性疾病,病理特征为淀粉样斑块和 tau 神经原纤维缠结,是老年人痴呆的主要原因。AD 痴呆的早期和准确诊断对于有效的干预和治疗至关重要,但事实证明这很难实现。尽管用脑脊液(CSF)或正电子发射断层扫描(PET)检测 AD 脑病理学已经有 20 多年的历史,但由于不可及性、高昂的自费费用、感知风险和缺乏 AD 特异性治疗,大多数患者从未接受过这种检测。然而,近年来,开发 AD/ADRD 血液生物标志物的进展迅速。因此,血液生物标志物已成为 AD 非侵入性和经济有效诊断、预后和监测进展的有前途的工具。本文介绍了 AD/ADRD 中血液生物标志物的发展现状,并探讨了它们在临床实践中用于早期检测、预后和治疗干预的潜在应用。涵盖了血液生物标志物的最新进展,包括淀粉样β(Aβ)肽、tau 蛋白、神经丝轻链(NfL)和胶质纤维酸性蛋白(GFAP)。还讨论了它们的诊断和预后效用,同时解决了相关的挑战和局限性。还提出了这个快速发展领域的未来研究方向。

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