Amyloid beta (Aβ) peptide modulators and other current treatment strategies for Alzheimer's disease (AD).

Amyloid beta (Aβ) peptide modulators and other current treatment strategies for Alzheimer's disease (AD).
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DOI:
10.1517/14728214.2012.672559
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发表时间:
2012-03-23
影响因子:
3.4
通讯作者:
Lukiw WJ
Lukiw WJ
中科院分区:
医学3区
文献类型:
--
作者:
Lukiw WJ

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阿尔茨海默病(AD)是一种常见的进行性神经系统疾病,其发病率正达到流行病的比例。流行的“淀粉样蛋白级联假说"认为β-淀粉样蛋白前体蛋白(βAPP)异常蛋白水解为神经毒性淀粉样蛋白β(Aβ)-肽是AD发病机制的核心,继续主导着临床管理这种潜在疾病的药理学方法。本文综述了目前旨在下调Aβ42肽生成以改善AD悲剧的药理学策略的汇编和更新。本综述利用在线数据搜索各种开放的在线访问网站,包括阿尔茨海默病协会,阿尔茨海默病研究论坛;个别制药公司数据库;美国国立卫生研究院(NIH)Medline; Pharmaprojects数据库; Scopus;大学间的研究通信和未发表的研究数据。Aβ免疫、抗乙酰胆碱酯酶、β分泌酶、螯合、γ分泌酶、N-甲基D-天冬氨酸(NMDA)受体拮抗剂、他汀类药物和其他调节βAPP加工的策略已主导了针对AD型神经退行性病理学的药理学方法。这些努力的累积临床结果仍然非常令人失望,并且对AD的临床管理几乎没有总体影响。虽然许多新的方法正在考虑和开发中,但迄今为止,仍然没有有效的治疗或治愈这种不断扩大的医疗保健问题。
Alzheimer’s disease (AD) is a common, progressive neurological disorder whose incidence is reaching epidemic proportions. The prevailing ‘amyloid cascade hypothesis’, which maintains that the aberrant proteolysis of beta-amyloid precursor protein (βAPP) into neurotoxic amyloid beta (Aβ)-peptides is central to the etiopathology of AD, continues to dominate pharmacological approaches to the clinical management of this insidious disorder. This review is a compilation and update on current pharmacological strategies designed to down-regulate Aβ42-peptide generation in an effort to ameliorate the tragedy of AD. This review utilized on-line data searches at various open online-access websites including the Alzheimer Association, Alzheimer Research Forum; individual drug company databases; the National Institutes of Health (NIH) Medline; Pharmaprojects database; Scopus; inter-University research communications and unpublished research data. Aβ immunization-, anti-acetylcholinesterase-, β-secretase-, chelation-, γ-secretase-, N-methyl D-aspartate (NMDA) receptor antagonist-, statin-based and other strategies to modulate βAPP processing have dominated pharmacological approaches directed against AD-type neurodegenerative pathology. Cumulative clinical results of these efforts remain extremely disappointing, and have had little overall impact on the clinical management of AD. While a number of novel approaches are in consideration and development, to date there is still no effective treatment or cure for this expanding healthcare concern.
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