摘要
背景:临床前研究表明,锂减轻某些神经退行性疾病如阿尔茨海默氏病(AD),Huntigton病(HD),多系统萎缩症(MSA)和肌萎缩性侧索硬化症(ALS)的病理级联效应。关键的问题是,锂的这些药效学特性是否转化为减轻人类受试者的神经退行性疾病的影响。方法:我们回顾了2004年7月到2014年7月间所有英文的在PubMed、PsycINFO,EMBASE、Scopus、ISI-Web里发表的用锂治疗神经退行性疾病的临床对照试验。结果:证据显示锂对遗忘型轻度认知功能障碍(aMCI、1项研究)和AD(2项研究)患者的认知功能和生物标志物有积极的影响,即使用低于控制情绪稳定的剂量。锂治疗HD、MSA和CSI的研究没显示锂的益处。然而,由于方法的局限性和小样本的研究,这些研究可能是不确定的。ALS的研究表明持续的负面结果和呈现不利于锂治疗本病的证据。结论:在对任何神经退行性疾病的治疗没有减轻症状的情况下,事实上,至少有3项支持锂对aMCI / AD的影响的研究是值得关注的。未来的研究应致力于确定为神经保护作用所需的的剂量范围。
关键词: 锂和阿尔茨海默氏病,锂和轻度认知功能障碍,锂和肌萎缩侧索硬化症,锂和多系统萎缩,锂和神经退行性疾病,锂。
Current Alzheimer Research
Title:Lithium, a Therapy for AD: Current Evidence from Clinical Trials of Neurodegenerative Disorders
Volume: 13 Issue: 8
Author(s): Orestes V. Forlenza, Ivan Aprahamian, Vanessa J. de Paula, Tomas Hajek
Affiliation:
关键词: 锂和阿尔茨海默氏病,锂和轻度认知功能障碍,锂和肌萎缩侧索硬化症,锂和多系统萎缩,锂和神经退行性疾病,锂。
摘要: Background: Preclinical studies have shown that lithium modifies pathological cascades implicated in certain neurodegenerative disorders, such as Alzheimer’s disease (AD), Huntigton`s disease (HD), multiple system atrophy (MSA) and amyotrophic lateral sclerosis (ALS). A critical question is whether these pharmacodynamic properties of lithium translate into neurodegenerative diseases modifying effects in human subjects. Methods: We reviewed all English controlled clinical trials published in PubMed, PsycINFO, Embase, SCOPUS, ISI-Web with the use of lithium for the treatment of neurodegenerative disorders between July 2004 and July 2014. Results: Lithium showed evidence for positive effects on cognitive functions and biomarkers in amnestic mild cognitive impairment (aMCI, 1 study) and AD (2 studies), even with doses lower than those used for mood stabilisation. Studies of Li in HD, MSA and CSI did not show benefits of lithium. However, due to methodological limitations and small sample size, these studies may be inconclusive. Studies in ALS showed consistently negative results and presented evidence against the use of lithium for the treatment of this disease. Conclusion: In absence of disease modifying treatments for any neurodegenerative disorders, the fact that at least 3 studies supported the effect of lithium in aMCI/AD is noteworthy. Future studies should focus on defining the dose range necessary for neuroprotective effects to occur.
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Orestes V. Forlenza, Ivan Aprahamian, Vanessa J. de Paula, Tomas Hajek , Lithium, a Therapy for AD: Current Evidence from Clinical Trials of Neurodegenerative Disorders, Current Alzheimer Research 2016; 13 (8) . https://dx.doi.org/10.2174/1567205013666160219112854
DOI https://dx.doi.org/10.2174/1567205013666160219112854 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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