对体液生物标志物在阿尔茨海默病中诊断作用的思考

The role of fluid biomarkers in the diagnosis of Alzheimer′s disease

阿尔茨海默病(AD)体液生物标志物研究的迅速发展,提高了AD诊断的准确性,促进了对疾病的早期诊断和干预,对疾病修饰疗法的评价研究也具有重要意义。自AT(N)生物标志物系统被提出以来,其在AD的临床和研究中发挥着越来越重要的作用。然而,AT(N)系统中的体液标志物尚不能充分反映AD错综复杂的病理生理过程,神经炎症、突触及血管功能障碍等重要机制相关的体液标志物应作为AT(N)的重要补充。近年来,外周血标志物的发展丰富了AD的体液标志物系统,有望极大地促进AD的早期筛查与诊断。文中简述了目前AT(N)及其相关的脑脊液研究、外周血液标志物的研究现状,提出应从多种病理生理的角度进行AD体液标志物的探索,以提高体液标志物在AD诊断中的效能。同时,文中还探讨了体液标志物在AD诊断中的局限性,并对AD体液标志物的未来发展进行展望。

The rapid advancement of biomarker research in Alzheimer′s disease(AD)has improved the accuracy of AD diagnosis,facilitated its early diagnosis and intervention,and has significant implications for disease-modifying therapy research and evaluation.Since its introduction,the AT(N)system has grown in importance in both the clinical and research aspects of AD.However,the fluid biomarkers in the AT(N)system do not yet adequately reflect the complex pathophysiology of AD.Other fluid biomarkers associated with neuroinflammation,synaptic dysfunction,and vascular dysfunction should be a valuable addition to the AT(N).In recent years,the development and application of peripheral blood biomarkers have greatly enriched the fluid biomarker system for AD and are expected to greatly facilitate early screening and diagnosis of the disease.Here,a brief overview of current research on AT(N)and other pathogenesis-related fluid biomarkers is presented,and the article proposes that fluid biomarkers for AD should be studied from a variety of pathophysiological perspectives in order to improve their role in disease diagnosis.This article also discusses the role and limitations of fluid biomarkers in the diagnosis of AD,as well as the future development and application of fluid biomarkers in AD.