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阿尔茨海默病的新型治疗策略:抗淀粉样蛋白疗法及其他疗法的陷阱与挑战

Novel Therapeutic Strategies in Alzheimer's Disease: Pitfalls and Challenges of Anti-Amyloid Therapies and Beyond.

作者信息

Tondo Giacomo, De Marchi Fabiola, Bonardi Francesca, Menegon Federico, Verrini Gaia, Aprile Davide, Anselmi Matteo, Mazzini Letizia, Comi Cristoforo

机构信息

Neurology Unit, Department of Translational Medicine, Maggiore della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy.

Neurology Unit, Department of Translational Medicine, Sant'Andrea Hospital, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy.

出版信息

J Clin Med. 2024 May 25;13(11):3098. doi: 10.3390/jcm13113098.

Abstract

Alzheimer's disease (AD) causes a significant challenge to global healthcare systems, with limited effective treatments available. This review examines the landscape of novel therapeutic strategies for AD, focusing on the shortcomings of traditional therapies against amyloid-beta (Aβ) and exploring emerging alternatives. Despite decades of research emphasizing the role of Aβ accumulation in AD pathogenesis, clinical trials targeting Aβ have obtained disappointing results, highlighting the complexity of AD pathophysiology and the need for investigating other therapeutic approaches. In this manuscript, we first discuss the challenges associated with anti-Aβ therapies, including limited efficacy and potential adverse effects, underscoring the necessity of exploring alternative mechanisms and targets. Thereafter, we review promising non-Aβ-based strategies, such as tau-targeted therapies, neuroinflammation modulation, and gene and stem cell therapy. These approaches offer new avenues for AD treatment by addressing additional pathological hallmarks and downstream effects beyond Aβ deposition.

摘要

阿尔茨海默病(AD)给全球医疗系统带来了重大挑战,目前有效的治疗方法有限。本综述审视了AD新型治疗策略的格局,着重探讨传统抗淀粉样β蛋白(Aβ)疗法的不足,并探索新出现的替代方法。尽管数十年来的研究都强调Aβ积累在AD发病机制中的作用,但针对Aβ的临床试验结果却令人失望,这凸显了AD病理生理学的复杂性以及研究其他治疗方法的必要性。在本手稿中,我们首先讨论抗Aβ疗法相关的挑战,包括疗效有限和潜在的不良反应,强调探索替代机制和靶点的必要性。此后,我们综述了有前景的非Aβ策略,如靶向tau蛋白的疗法、神经炎症调节以及基因和干细胞疗法。这些方法通过解决Aβ沉积之外的其他病理特征和下游效应,为AD治疗提供了新途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9875/11172489/afca43613d5c/jcm-13-03098-g001.jpg

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