阿尔茨海默病的发病机制、表皮学、诊断和治疗综述

A. B. Chavan, Sachin Rangrao Patil, A. Patel, Shweta Vijay Chaugule, Sayali Krishnat Gharal
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引用次数: 6

摘要

阿尔茨海默病(AD)的全球影响是显著的。据估计,目前严重神经认知障碍的患病率约为4400万人。目前,美国约有620万人患有阿尔茨海默病(AD)痴呆症。值得强调的是,与阿尔茨海默病(AD)相关的死亡率超过乳腺癌和前列腺癌的总死亡率。根据国立老龄研究所的调查结果,65岁以后,阿尔茨海默病(AD)的发病率每5年增加2倍。此外,随着人口老龄化的不断进行,越来越多的人口受到这一特殊情况的影响。根据预测,预计到2021年,美国将因阿尔茨海默病(AD)而遭受3550亿美元的财务影响。此外,同样的预测表明,到2050年,这一数额预计将大大增加,超过1.5万亿美元。因此,这将给该国带来巨大的财政压力。阿尔茨海默病(AD)是一种神经退行性疾病,其特征是细胞外β淀粉样蛋白(a β)斑块和细胞内由过度磷酸化的τ蛋白组成的神经原纤维缠结的存在。上述异常特征主要表现在人类大脑的皮层和边缘区域。上述疾病的特点是存在记忆障碍和神经认知能力的进行性恶化。β-分泌酶和γ-分泌酶对淀粉样前体蛋白(APP)的非典型分裂导致a - β40和a - β42个体分子的产生,这些个体分子随后经历寡聚和聚集过程,最终形成老年斑。另外,包括人体免疫缺陷病毒(HIV)在内的病原微生物加重了上述疾病。此外,在疾病病理生理学的框架内,中枢神经系统内Aβ肽含量的增加诱导了小胶质细胞的浸润。目前,通过探索多种途径来全面了解阿尔茨海默病(Alzheimer's disease, AD)的病理本质是科学研究领域中一个值得关注的焦点。这些机制包括tau蛋白的异常代谢、β-淀粉样蛋白的存在、炎症反应以及胆碱能功能障碍和自由基引起的损伤。这项研究的最终目的是开发有效的治疗方法,可以有效地阻止或改变阿尔茨海默病的进展。本研究对阿尔茨海默病的病理生理机制进行了分析,并对其识别所采用的诊断方法进行了检查。此外,该综述探讨了目前用于管理这种神经退行性疾病的许多治疗方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Comprehensive Review on Alzheimer’s Disease its Pathogenesis, Epidermiology, Diagnostics and Treatment
The global impact of Alzheimer's disease (AD) is significant. The current prevalence of Major Neurocognitive Disorder is estimated to affect approximately 44 million individuals. Presently, the United States harbors a population of approximately 6.2 million individuals who are afflicted by Alzheimer's disease (AD) dementia. It is of significance to highlight that mortality associated with Alzheimer's disease (AD) exceeds the combined mortality rates of both breast cancer and prostate cancer. Based on the findings of the National Institute on Aging, the frequency of Alzheimer's disease (AD) exhibits a twofold rise every five years subsequent to attaining the age of 65. Furthermore, with the ongoing process of population aging, an increasingly substantial portion of the population is affected by this particular condition. Based on forecasts, it is anticipated that the United States will experience a financial impact of $355 billion in 2021 as a result of Alzheimer's disease (AD). Furthermore, same projections indicate that this amount is expected to increase significantly to over $1.5 trillion by the year 2050. As a result, this would place a significant financial strain on the country. Alzheimer's disease (AD) is a neurodegenerative condition that is distinguished by the existence of extracellular amyloid β (Aβ) plaques and intracellular neurofibrillary tangles consisting of hyperphosphorylated τ-protein. The aforementioned abnormal characteristics primarily present themselves inside the cortical and limbic regions of the human brain. The aforementioned ailment is characterized by the presence of memory impairment and a progressive deterioration of neurocognitive abilities. The atypical division of amyloid precursor protein (APP) by β-secretases and γ-secretases leads to the production of Aβ40 and Aβ42 individual molecules, which then undergo the process of oligomerization and aggregation, finally culminating in the formation of senile plaques. The aforementioned disease is additionally aggravated by pathogenic microorganisms, including the human immunodeficiency virus (HIV). Moreover, within the framework of disease pathophysiology, the presence of heightened amounts of Aβ peptides within the central nervous system induces the infiltration of microglial cells. Presently, there exists a notable focus within the realm of scientific inquiry on gaining a comprehensive understanding of the pathological nature of Alzheimer's disease (AD) by means of exploring diverse pathways. These mechanisms include the abnormal metabolism of tau proteins, the presence of β-amyloid, the inflammatory response, as well as the damage caused by cholinergic dysfunction and free radicals. The ultimate objective of this research is to develop efficacious treatments that can effectively halt or alter the progression of AD. The present study provides an analysis of the pathophysiological mechanisms underlying Alzheimer's disease, as well as an examination of the diagnostic methods employed in its identification. Furthermore, the review explores the many therapy modalities now utilized in managing this neurodegenerative disorder.
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