Dávila C, Viteri C, de Castro P
Departamento de Neurología y Neurocirugía y Neurocirugía, Facultad de Medicina, Universidad de Navarra.
Rev Med Univ Navarra. 1997 Jan-Mar;41(1):58-64.
Significant changes in cholinergic neurotransmission have been described in Alzheimer's disease (AD). These findings led to consider cholinergic deficit as the main disturbance in AD, due to degeneration of presynaptic cholinergic neurons, and that replacement of acetylcholine could restore the cognitive alterations characteristic of AD. Although it was soon demonstrated that cholinergic deficit was not the only change, cholinergic hypothesis has allowed to set several possible therapeutic strategies for these severe disease, the most promising is administration of acetylcholinesterase inhibitors. Of all the compounds investigated, tacrine (tetrahydroamineacridine) has shown in several clinical trials a positive effect on memory in patients with symptoms of slight to moderate severity. Although not all studies have given successful result, probably due to methodological differences, global clinical impression has justified the introduction of tacrine as the first palliative therapy in AD.
阿尔茨海默病（AD）中胆碱能神经传递已被描述有显著变化。这些发现使得胆碱能缺陷被视为AD的主要紊乱，这是由于突触前胆碱能神经元的退化，并且认为乙酰胆碱的补充可以恢复AD特有的认知改变。尽管很快就证明胆碱能缺陷并非唯一的变化，但胆碱能假说已为这种严重疾病设定了几种可能的治疗策略，最有前景的是给予乙酰胆碱酯酶抑制剂。在所有研究的化合物中，他克林（四氢氨基吖啶）在多项临床试验中已显示对轻至中度症状患者的记忆有积极作用。尽管并非所有研究都取得了成功结果，可能是由于方法上的差异，但总体临床印象证明将他克林作为AD的首个姑息治疗药物引入是合理的。
