轻度认知障碍的生物学标志物研究进展

Research progress on biomarkers of mild cognitive impairment

轻度认知障碍(MCI)是介于正常衰老和痴呆之间的一种临床过渡状态,被认为是阿尔茨海默病(AD)的临床前阶段。由于阿尔茨海默病病程的不可逆性,且目前临床上尚无可改善病情或延缓疾病进程的有效疗法,因此,MCI的早期发现、早期诊断、早期干预治疗对降低AD的发病率、延缓进展至关重要。对于生物标志物的研究,一方面可以为揭示疾病的病理机制提供依据,另一方面可以为疾病的早期筛查和诊断提供客观证据支持。本文通过对MCI的生物标志物进行综述,以期为后续MCI确切病理机制的研究、有效治疗方案的探索以及病情客观临床指标的确定提供依据和帮助。本文分别从脑脊液、血液、遗传学等方面对MCI生物标志物的研究进展进行综述,重点对生物标志物(尤其是淀粉样蛋白、磷酸化tau蛋白)在脑脊液以及血液中的研究进展进行分析讨论。不同来源途径的生物学标志物研究各有优缺点,MCI血液生物标志物优势明显,临床转化意义大,具有较好的研究前景。生物标志物的标准化、规范化仍是目前MCI研究领域所需努力的一大方向。

Mild cognitive impairment(MCI)is a clinical transitional state between normal aging and dementia,which is considered to be the preclinical stage of Alzheimer's disease(AD).Due to the irreversible nature of the course of AD,and the lack of clinically available therapies to improve or delay the disease progression,the early detection,diagnosis and intervention of MCI are crucial in reducing the incidence of AD and delaying its progression.On one hand,research on biomarkers can serve as the foundation for elucidating the pathological mechanisms underlying the disease.On the other hand,it provides objective evidence for early screening and diagnosis.This paper reviewed the research progress of MCI biomarkers from the cerebrospinal fluid,blood and genetics perspectives with a focus on the analysis and discussion advancements in biomarkers(especially amyloid protein,phosphorylated tau protein)found in cerebrospinal fluid and blood.The study of biomarkers from different sources and pathways has their own advantages and disadvantages.MCI hematological biomarkers have significant potential for clinical translation with promising research prospects.The standardization of biomarkers is still a major direction in MCI research field.