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阿尔茨海默病精准诊断和药物研发的焦点与挑战
程文彬,陈晓晗,孙文静,吴惠涓,庄建华,尹又*
0
(海军军医大学(第二军医大学)第二附属医院神经内科, 上海 200003
*通信作者)
摘要:
阿尔茨海默病(AD)是一种常见的中枢神经系统退行性疾病,其典型临床表现主要有认知功能进行性减退、记忆障碍、人格和行为改变、失语、失用、失认等,病理改变包括β淀粉样蛋白沉积形成的老年斑、Tau蛋白形成的神经纤维缠结、神经元及其突触的变性、胶质细胞激活增生等。该病是我国乃至全世界目前面临的巨大挑战。近年来随着全球人口老龄化,AD患者的数量也不断增加,对个人、家庭和社会都造成了极大的负担和损失。因此,对AD患者进行早期精准诊断从而尽早干预至关重要,研发用于缓解症状、延缓病情的药物也刻不容缓。本文综述了与AD精准诊断相关的诊断框架的发展历程、影像和体液生物标志物,以及目前AD治疗药物的研发进展。
关键词:  阿尔茨海默病  早期诊断  筛查  生物标志物  药物研发  β淀粉样蛋白
DOI:10.16781/j.CN31-2187/R.20230210
投稿时间:2023-04-17修订日期:2023-05-30
基金项目:上海市自然科学基金(22ZR147750),上海市科学技术委员会生物医药科技支撑项目(19441907500),海军军医大学(第二军医大学)第二附属医院创新型临床研究项目(2020YLCYJ-Y02),海军军医大学(第二军医大学)第二附属医院为军特色医疗服务项目(2020CZWJFW12).
Precision diagnosis and drug development for Alzheimer's disease: focus and challenges
CHENG Wenbin,CHEN Xiaohan,SUN Wenjing,WU Huijuan,ZHUANG Jianhua,YIN You*
(Department of Neurology, The Second Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200003, China
*Corresponding author)
Abstract:
Alzheimer's disease (AD) is a common neurodegenerative disease of the central nervous system. Its typical clinical manifestations include progressive cognitive decline, memory impairment, personality and behavioural changes, aphasia, dysfunction, and loss of recognition. Pathological changes include amyloid β protein (Aβ) deposition, neurofibrillary tangles formed by Tau protein, degeneration of neurons and their synapses, and glial cell activation and proliferation. The disease is a huge challenge in our country and the whole world at present. In recent years, with the gradual increase of the global aging population, the number of AD patients has been increasing, causing a great burden and loss to individuals, families, and society. Therefore, early and accurate diagnosis of AD patients is essential for early intervention, and the development of drugs to relieve symptoms and delay the disease is also greatly needed. This article reviews the development of diagnostic frameworks related to the precise diagnosis of AD, imaging and body fluid biomarkers, as well as current advances in drugs and treatments for AD.
Key words:  Alzheimer's disease  early diagnosis  screening  biomarkers  drug development  amyloid β protein