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The Potential to use Chloroquine and other 4-Aminoquinoline Analogues to Modulate Persisting Inflammation in Old Age 使用氯喹和其他4-氨基喹啉类似物调节老年持续炎症的潜力
Pub Date : 1900-01-01 DOI: 10.36876/smggr.1020
S. Allen, D. Tiwari
Low-amplitude persisting systemic inflammation is frequently found in elderly people and is causally linked to several markers of frailty, including sarcopenia, low mood and higher dependency, as well as higher all-cause mortality. Older patients with such “inflammation” have raised baseline blood levels of several pro-inflammatory cytokines, such as tumor necrosis factor alpha and interleukin-1 beta, and chronically raised C-reactive protein. There is a clear need to identify interventions, including drugs that can ameliorate such inflammation by helping to re-set the innate immune system to a less inflamed baseline. Several classes of drugs have such properties. In this review the authors have summarized the background science with respect to the relationship between ageing, inflammation and frailty, then described the established role of methyl-xanthines, particularly theophylline, as immune modulating drugs before positing a case for the use of 4-aminoquinolines, such as chloroquine, in a similar role. The probable mechanisms of anti-inflammatory action for those classes of drugs are compared, leading to a proposal that formal clinical trials should be conducted of chloroquine as an adjunctive immune modulator for “inflammaging” and persisting post-acute inflammation in old age.
低幅度持续全身性炎症常见于老年人,并与几种虚弱的标志有因果关系,包括肌肉减少症、情绪低落、依赖性更高,以及更高的全因死亡率。患有这种“炎症”的老年患者血液中几种促炎细胞因子的基线水平升高,如肿瘤坏死因子α和白细胞介素-1 β,以及c反应蛋白的长期升高。很明显,有必要确定干预措施,包括通过帮助先天免疫系统重新设置炎症基线来改善这种炎症的药物。有好几类药物具有这种特性。在这篇综述中,作者总结了有关衰老、炎症和虚弱之间关系的背景科学,然后描述了甲基黄嘌呤,特别是茶碱,作为免疫调节药物的既定作用,然后提出了使用4-氨基喹啉类药物,如氯喹,具有类似作用的案例。这些药物抗炎作用的可能机制进行了比较,导致一项建议,应该进行正式的临床试验,氯喹作为“炎症”和持续的老年急性后炎症的辅助免疫调节剂。
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引用次数: 1
Towards a more Comprehensive Approach to Non-Pharmacological Therapies for Alzheimer’s Disease and other Dementias 迈向阿尔茨海默病和其他痴呆症的非药物治疗的更全面的方法
Pub Date : 1900-01-01 DOI: 10.36876/smggr.1019
R. Redolat, Mercedes Fernández-Ríos
The significant rise in life expectancy and the growing ageing of the world’s population are accompanied by an increase in the prevalence of neurodegenerative diseases. These disorders have a multidimensional impact on the quality of life for both patients and their caregivers and constitute a major challenge for social protection systems. Alzheimer’s Disease (AD) represents an increasing burden for patients, their caregivers and the society. For that reason, it is necessary to assess all the factors involved in the disease pathogenesis of AD in order to address a more comprehensive approach to the management of the disease. In the absence of diseasemodifying pharmacological treatments, interest for in non-pharmacological therapies has recently increased as a complement to other types of interventions in people with AD and other dementias. Non-pharmacological interventions for behavioral and psychological symptoms in dementia patients should take into account the caring environment as well as the support and education of the caregivers. Individualized and person-centered models tailored to the tastes and preferences of each patient could offer better results than the more traditional ones. Information and communication technologies can also provide assistance to people with dementia and to their caregivers. We can conclude that there is a need for developing pharmacological and non-pharmacological treatments aimed to different therapeutic targets and that can be applied in the early stages of the disease development. A more comprehensive approach to the management of AD and an increasing interest in dementia prevention could contribute to the development of new therapeutic strategies. These interventions are expected to have positive impact on the quality of life of people with AD and their caregivers.
在预期寿命显著延长和世界人口日益老龄化的同时,神经退行性疾病的发病率也在增加。这些疾病对患者及其照护者的生活质量产生多方面的影响,并对社会保护系统构成重大挑战。阿尔茨海默病(AD)对患者、护理人员和社会造成了越来越大的负担。因此,有必要评估阿尔茨海默病发病机制中涉及的所有因素,以解决更全面的疾病管理方法。在缺乏改善疾病的药物治疗的情况下,对非药物治疗的兴趣最近增加了,作为对阿尔茨海默病和其他痴呆症患者其他类型干预的补充。对痴呆患者行为和心理症状的非药物干预应考虑到护理环境以及护理人员的支持和教育。根据每个病人的口味和喜好量身定制的个性化和以人为本的模式可能比传统的模式提供更好的结果。信息和通信技术还可以为痴呆症患者及其照顾者提供帮助。我们可以得出结论,有必要开发针对不同治疗目标的药物和非药物治疗方法,这些方法可以应用于疾病发展的早期阶段。一个更全面的方法来管理阿尔茨海默氏症和对痴呆症预防的日益增加的兴趣可能有助于新的治疗策略的发展。预计这些干预措施将对阿尔茨海默病患者及其照顾者的生活质量产生积极影响。
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引用次数: 0
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