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超声打开血脑屏障与阿杜卡单抗治疗阿尔茨海默病:一项系统评价和荟萃分析

Ultrasound Blood-Brain Barrier Opening and Aducanumab in Alzheimer's Disease: A Systematic Review and Meta-Analysis.

作者信息

Aljehani Noha S, Al-Gunaid Seba T, Hobani Alhassan H, Alhinti Mohammad F, Khubrani Yahya A, Abu-Hamoud Lama M, Alrayes Aljawharah A, Alharbi Lama B, Sultan Ali A, Turkistani Doaa A, Naiser Seddiqa S, Albraik Leen, Alakel Amjad M, Alotaibi Muteb, Asiri Abdullah Y

机构信息

College of Medicine, Jazan University, Jazan, SAU.

College of Medicine, Syiah Kuala University, Banda Aceh, IDN.

出版信息

Cureus. 2024 Aug 28;16(8):e68008. doi: 10.7759/cureus.68008. eCollection 2024 Aug.

Abstract

The blood-brain barrier (BBB) presents a significant challenge in treating Alzheimer's disease, as it restricts the delivery of therapeutic medications to brain tissue. Reversible breaking of the BBB using low-intensity focused ultrasound guided by magnetic resonance imaging (MRI) may benefit patients with Alzheimer's disease and other neurological illnesses, such as brain tumors, amyotrophic lateral sclerosis, and Parkinson's disease. This systematic study and meta-analysis aimed to assess aducanumab and the ultrasonography of BBB opening in Alzheimer's patients. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the study was conducted by searching six digital repositories for relevant scholarly literature, focusing on English papers published between 2015 and 2024; the data was extracted using an Excel sheet, and data was analyzed using Revman 5.4.1 software. The study's findings indicate that the groups receiving ultrasound and aducanumab treatment benefited from it; however, overall, the effect was not statistically significant (P=0.29) at 95% CI 0.86 (0.75, 1.00). With regard to side effects, the results indicate that the treatment had fewer side effects compared to the control group; however, the difference was not statistically significant (p=0.94) at 95% CI 0.93 (0.70, 1.22). The study found a positive effect of ultrasound and aducanumab on the treatment groups, but it was not statistically significant. The control group had less side effects than the treatment group. Therefore, future studies should focus on the quantity or combination of the drug that yields more effective results.

摘要

血脑屏障(BBB)在治疗阿尔茨海默病方面构成了重大挑战,因为它限制了治疗药物向脑组织的递送。使用磁共振成像(MRI)引导的低强度聚焦超声可逆性破坏血脑屏障可能会使阿尔茨海默病患者以及其他神经系统疾病患者受益,如脑肿瘤、肌萎缩侧索硬化症和帕金森病。这项系统性研究和荟萃分析旨在评估阿杜卡单抗以及阿尔茨海默病患者血脑屏障开放的超声检查。根据系统评价和荟萃分析的首选报告项目(PRISMA),该研究通过在六个数字存储库中搜索相关学术文献来进行,重点关注2015年至2024年发表的英文论文;数据使用Excel表格提取,并使用Revman 5.4.1软件进行分析。研究结果表明,接受超声和阿杜卡单抗治疗的组从中受益;然而,总体而言,在95%置信区间0.86(0.75,1.00)时,效果无统计学意义(P = 0.29)。关于副作用,结果表明与对照组相比,该治疗的副作用更少;然而,在95%置信区间0.93(0.70,1.22)时,差异无统计学意义(p = 0.94)。该研究发现超声和阿杜卡单抗对治疗组有积极作用,但无统计学意义。对照组的副作用比治疗组少。因此,未来的研究应关注能产生更有效结果的药物剂量或联合用药。

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