阿尔茨海默病的诊断:实现准确性和可及性

Yan Mu, Ke-Xin Chang, Yu-Feng Chen, Ke Yan, Chun-Xiang Wang, Qian Hua
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摘要

阿尔茨海默病(AD)是一种严重困扰老年人群的痴呆症,以认知能力下降、淀粉样β斑块和神经纤维缠结为特征。老年痴呆症严重影响患者的生活质量,并给整个社会带来沉重负担。据估计,全球因渐变性痴呆、渐变性痴呆前兆和临床前渐变性痴呆导致的痴呆患者人数分别约为 320 万、6 900 万和 3.15 亿。目前的临床诊断以临床症状为基础,临床研究表明正电子发射断层扫描(PET)和脑脊液(CSF)生物标志物具有良好的诊断性能。然而,脑脊液生物标志物检测和正电子发射计算机断层扫描因其侵入性和高成本而限制了其应用。临床症状的出现意味着AD病理已发展多年,而目前仅有少数药物被批准用于AD的治疗。因此,早期诊断对于控制 AD 所造成的后果极其重要。在这篇综述中,我们概述了正在制定的临床诊断标准、临床研究中的诊断策略、正在开发的基于血液的生物标志物检测方法以及前景看好的基于纳米技术的检测方法。
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Diagnosis of Alzheimer's disease: Towards accuracy and accessibility
Alzheimer’s disease (AD) is a serious dementia afflicting aging population and is characterized by cognitive decline, amyloid-β plaques, and neurofibrillary tangles. AD substantially impairs the life quality of the victims and poses a heavy burden on the society at large. The number of people with dementia due to AD, prodromal AD, and preclinical AD is estimated to stand at roughly 3.2, 69, and 315 million worldwide, respectively. Current clinical diagnosis is based on clinical symptoms, and clinical research demonstrated that positron emission tomography (PET) and cerebrospinal fluid (CSF) biomarkers had excellent diagnostic performance. However, the application of CSF biomarker tests and PET are restricted by the invasiveness and high cost. The presence of clinical symptoms means that AD pathology has been progressing for many years, and only a few drugs have been approved for the traetemnt of AD. Therefore, early diagnosis is extremely important for controlling the outcomes caused by AD. In this review, we provided an overview of developing clinical diagnostic criteria, diagnostic strategies under clinical research, developing blood based-biomarker assays, and promising nanotechnologically-based assays.
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