Grundman M, Corey-Bloom J, Thal L J
Department of Neurosciences, University of California, San Diego, USA.
J Neural Transm Suppl. 1998;53:255-75. doi: 10.1007/978-3-7091-6467-9_23.
Current treatment approaches in Alzheimer's disease are primarily symptomatic, with the major therapeutic strategy based on acetylcholinesterase inhibition. Alzheimer's disease research should advance over ensuing decade(s) to yield better symptomatic therapies, drugs designed to slow the rate of progression, and disease preventing agents. The next generation of cholinergic agents will include long acting cholinesterase inhibitors with a good safety profile and brain specific muscarinic agonists. The most critical advances in Alzheimer's disease treatment, however, will target slowing of disease progression and prevention of dementia. Therapeutic agents are being developed that interfere with the synthesis, deposition and aggregation of beta-amyloid protein. Clinical trials are presently being conducted with small molecules having nerve growth factor like activity (e.g. AIT-082, cerebrolysin). In addition, estrogen, anti-inflammatory agents (e.g. cyclooxygenase inhibitors) and antioxidant approaches (e.g. vitamin E) are currently being proposed or utilized in disease prevention trials.
目前治疗阿尔茨海默病的方法主要是对症治疗，主要治疗策略基于乙酰胆碱酯酶抑制。在接下来的十年里，阿尔茨海默病的研究应取得进展，以产生更好的对症治疗方法、旨在减缓疾病进展速度的药物以及疾病预防药物。下一代胆碱能药物将包括安全性良好的长效胆碱酯酶抑制剂和脑特异性毒蕈碱激动剂。然而，阿尔茨海默病治疗中最关键的进展将是针对减缓疾病进展和预防痴呆。正在研发干扰β-淀粉样蛋白合成、沉积和聚集的治疗药物。目前正在对具有神经生长因子样活性的小分子（如AIT-082、脑活素）进行临床试验。此外，雌激素、抗炎药（如环氧化酶抑制剂）和抗氧化方法（如维生素E）目前正在疾病预防试验中被提出或使用。
