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首页> 外文期刊>The Internet Journal of Pharmacology >Pathophysiology and pharmacotherapy of Alzheimer's disease (AD)
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Pathophysiology and pharmacotherapy of Alzheimer's disease (AD)

机译：阿尔茨海默氏病（AD）的病理生理学和药物治疗

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Alzheimer's disease (AD) can be diagnosed with a considerable degree of accuracy. In some centers, clinical diagnosis predicts the autopsy diagnosis with 90% certainty in series reported from academic centers. The characteristic histopathologic changes at autopsy include neurofibrillary tangles, neuritic plaques, neuronal loss, and amyloid angiopathy. Mutations on chromosomes 21, 14, and 1 cause familial AD. Risk factors for AD include advanced age, lower intelligence, small head size, and history of head trauma; female gender may confer additional risks. Susceptibility genes do not cause the disease by themselves but, in combination with other genes or epigenetic factors, modulate the age of onset and increase the probability of developing AD. Among several putative susceptibility genes (on chromosomes 19, 12, and 6), the role of apolipoprotein E (ApoE) on chromosome 19 has been repeatedly confirmed. Protective factors include ApoE-2 genotype, history of estrogen replacement therapy in postmenopausal women, higher educational level, and history of use of nonsteroidal anti-inflammatory agents. The most proximal brain events associated with the clinical expression of dementia are progressive neuronal dysfunction and loss of neurons in specific regions of the brain... Advances in understanding the pathogenetic cascade of events that characterize AD provide a framework for early detection and therapeutic interventions, including transmitter replacement therapies, antioxidants, anti-inflammatory agents, estrogens, nerve growth factor, and drugs that prevent amyloid formation in the brain.
机译：阿尔茨海默氏病（AD）的诊断准确性很高。在一些中心，临床诊断可以预测从学术中心报告的90％的系列尸检诊断。尸检的典型组织病理学变化包括神经原纤维缠结，神经斑，神经元丢失和淀粉样血管病。 21、14和1号染色体上的突变会导致家族性AD。 AD的危险因素包括高龄，智力低下，头部较小和头部外伤史;女性可能会带来其他风险。易感基因本身不会引起疾病，但与其他基因或表观遗传因素结合，可调节发病年龄并增加发生AD的可能性。在几个假定的敏感性基因中（在19号，12号和6号染色体上），载脂蛋白E（ApoE）在19号染色体上的作用已得到反复确认。保护因素包​​括ApoE-2基因型，绝经后妇女的雌激素替代治疗史，较高的教育水平以及使用非甾体抗炎药的历史。与痴呆症的临床表达相关的最近端的大脑事件是进行性神经元功能障碍和大脑特定区域神经元的丧失。了解AD的特征性事件的病原学级联的进展为早期发现和治疗干预提供了框架，包括递质替代疗法，抗氧化剂，抗炎药，雌激素，神经生长因子以及防止大脑淀粉样蛋白形成的药物。

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