Imaging beta-amyloid in middle age alcoholics as a mechanism that increases their risk for Alzheimer’s disease

长期以来，酒精使用障碍、认知障碍和 痴呆症的发展。研究表明，中年人大量饮酒 甚至在未被诊断为痴呆的患者中也损害认知功能（GiovanniPiumatti， 2018;凯瑟琳斯塔夫罗，2012）。传统上，对酗酒者神经认知障碍的研究 专注于硫胺素缺乏导致韦尼克脑病或韦尼克-科萨科夫 综合征最近，有证据表明酒精使用障碍与其他类型的疾病有关 包括阿尔茨海默氏症在内的痴呆症。最近的流行病学数据表明， 在酒精使用障碍的个体中，患阿尔茨海默病的比例高出2倍 与一般人群相比（Michael Schwarsinger，2018）。这种关系尤其 当酒精滥用被视为女性痴呆症发病的危险因素时， 中年人。这些流行病学数据表明，发展为痴呆症的"高危"时期 在酒精使用障碍的个体中转移到中年。与这个概念相一致 与对照组相比，酒精消耗啮齿类动物显示出几种蛋白质表达的增加， (such作为b-淀粉样前体蛋白，C-末端片段-b，酶b-分泌酶1，未成熟 nicastrin等）参与β-淀粉样蛋白斑（Ab）的合成。不过唯一的 对人类进行的尸检研究发现， 与对照组相比，酗酒者中Ab、过度磷酸化的β-突触核蛋白或β-突触核蛋白的聚集（Leena𝜏𝛼 Aho，2009）。鉴于尸检研究的回顾性性质以及它不能排除共同作用的事实， 病态医学、精神病学和药物滥用障碍，很难解释这些数据。有一个 非常需要体内研究来进一步研究酒精使用障碍，Ab， 和老年痴呆症正电子发射断层扫描（PET）放射性示踪剂[11 C] PiB， 在匹兹堡大学发现的是一个最广泛使用和验证良好的抗体 显像剂（Klunk等，2004年）。在这里，我们建议使用[11 C] PiB和PET来对比 40 - 65岁酗酒者和对照组的Ab阳性（+）（%）。我们假设， 与对照组相比，这样的发现表明Ab+的风险增加， 扩展解释了最近报道的酗酒者中阿尔茨海默氏痴呆症发病率的增加 流行病学研究。

There is a long-established relationship between alcohol use disorders, cognitive impairments, and the development of dementia. Studies have shown that heavy alcohol use in middle aged individuals impairs cognitive function even in patients who are not diagnosed with dementia (Giovanni Piumatti, 2018; Katherine Stavro, 2012). Traditionally, the study of neurocognitive impairments in alcoholics have focused on thiamine deficiency resulting in Wernicke encephalopathy or Wernicke-Korsakoff syndrome. More recently, evidence has begun to arise linking alcohol use disorders with other types of dementia including Alzheimer’s disease. Recent epidemiological data suggests that the hazard ratio to develop Alzheimer’s disease is 2-fold greater amongst individuals with alcohol use disorders compared to the general population (Michael Schwarsinger, 2018). This relationship is especially strong when alcohol abuse is examined as a risk factor for the onset of dementia in women and middle-aged adults. These epidemiological data suggest that the ‘at risk’ period to develop dementia is shifted to the middle-age years in individuals with alcohol use disorder. Consistent with this notion alcohol consuming rodents relative to controls show an increase in the expression of several proteins (such as b-amyloid precursor protein, C-terminal fragment-b, enzyme b-secretase 1, immature nicastrin, etc.,) that are involved in the synthesis of beta-amyloid plaques (Ab). However, the only post-mortem study that examined this issue in humans found no significant increase in the aggregation of Ab, hyperphosphorylated 𝜏, or 𝛼-synuclein in alcoholics compared to controls (Leena Aho, 2009). Given the retrospective nature of postmortem studies and the fact it cannot exclude co- morbid medical, psychiatric, and drug abuse disorders, it is difficult to interpret these data. There is a great need for in vivo studies to further investigate the relationship between alcohol use disorders, Ab, and Alzheimer’s disease. The positron emission tomography (PET) radiotracer [11C]PiB, which was discovered at the University of Pittsburgh is one of the most widely used and well validated Ab imaging agents (Klunk et al., 2004). Here, we propose to use [11C]PiB and PET to contrast the rate (%) of Ab positivity (+) in 40-65 year old alcoholics and controls. We hypothesize increased Ab+ in alcoholics compared to controls. Such a finding would suggest an increased risk of Ab+, and by extension explain the increased rates of Alzheimer’s dementia in alcoholics reported in recent epidemiological studies.