Alzheimer's disease.
Alzheimer's disease.
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阿尔茨海默氏症。
DOI：
10.1016/s0140-6736(20)32205-4
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发表时间：
2021-04-24
期刊：
影响因子：
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通讯作者：
van der Flier WM
中科院分区：
文献类型：
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作者：
Scheltens P;De Strooper B;Kivipelto M;Holstege H;Chételat G;Teunissen CE;Cummings J;van der Flier WM
在本次研讨会上，我们将重点介绍阿尔茨海默病领域的主要进展。最新数据表明，到2050年，痴呆症的患病率将在欧洲翻一番，在世界范围内翻三倍，如果根据阿尔茨海默病的生物学（而不是临床）定义，这一估计数字将高出三倍。阿尔茨海默病的早期阶段（细胞期）与β淀粉样蛋白的积累同时发生，诱导tau病理的扩散。阿尔茨海默病的风险有60-80%取决于遗传因素，目前已经确定了40多个与阿尔茨海默病相关的遗传风险位点，其中APOE等位基因与该疾病的相关性最强。新的生物标志物包括PET扫描和β淀粉样蛋白和磷酸化tau的血浆测定，它们在临床和研究中显示出巨大的前景。基于多领域生活方式的预防试验表明，痴呆风险增加的参与者的认知益处。生活方式因素不直接影响阿尔茨海默病的病理，但仍然可以促进阿尔茨海默病患者的积极结果。有前景的药物治疗处于临床试验的后期阶段，包括抗β淀粉样蛋白、抗tau蛋白和抗炎策略。
In this Seminar, we highlight the main developments in the field of Alzheimer’s disease. The most recent data indicate that, by 2050, the prevalence of dementia will double in Europe and triple worldwide, and that estimate is 3 times higher when based on a biological (rather than clinical) definition of Alzheimer’s disease. The earliest phase of Alzheimer’s disease (cellular phase) happens in parallel with accumulating amyloid β, inducing the spread of tau pathology. The risk of Alzheimer’s disease is 60–80% dependent on heritable factors, with more than 40 Alzheimer’s disease-associated genetic risk loci already identified, of which the APOE alleles have the strongest association with the disease. Novel biomarkers include PET scans and plasma assays for amyloid β and phosphorylated tau, which show great promise for clinical and research use. Multidomain lifestyle-based prevention trials suggest cognitive benefits in participants with increased risk of dementia. Lifestyle factors do not directly affect Alzheimer’s disease pathology, but can still contribute to a positive outcome in individuals with Alzheimer’s disease. Promising pharmacological treatments are poised at advanced stages of clinical trials and include anti-amyloid β, anti-tau, and anti-inflammatory strategies.