Etiological factors of Alzheimer disease and recent advances of its treatment

OBJECTIVE： To investigate the etiological factors of Alzheimer disease （AD） and the advance in drug treatment. DATA SOURCES： Using the terms ＂Alzheimer disease, etiology, drug treatment＂, we searched Medline database for AD treatment-related English literatures which were published between January 1993 and September 2006. Other literatures were obtained by searching concrete magazines and papers by hand. STUDY SELECTION： The data were selected primarily. Epidemiologic study and randomized controlled clinical trials were selected, and those studies with repetitive or similar contents were excluded. DATA EXTRACTION： Totally 1 537 AD and its treatment-related literatures were collected, and 32 of them were involved. Altogether 1 505 non-randomized controlled clinical trials, repetitive studies and reviews were excluded. DATA SYNTHESIS： The restriction of curative effect is a progressive neural degenerative disease. Although the etiological hypothesis of this disease has been introduced, the etiological factors of this disease are still unclear. The current treatments mainly involve： preventing against A 13 formation and clearing A 13, application of antioxidant and free radical scavengers, application of anti-inflammatory preparation, application of cholinergic preparation, hormonal therapy, application of metabolic enhancer, application of neurotrophic factor and nerve protectant, gene therapy and so on. CONCLUSION： The etiological factors of AD are still unclear, and symptomatic treatment is much taken in clinical therapy. Therefore, the curative effects of AD are still not very ideal.

Role of cholinergic anti-inflammatory pathway in regulating host response and its interventional strategy for inflammatory diseases

The cholinergic anti-inflammatory pathway （CAP） is a neurophysiological mechanism that regulates the immune system. The CAP inhibits inflammation by suppressing cytokine synthesis via release of acetylcholine in organs of the reticuloendothelial system, including the lungs, spleen, liver, kidneys and gastrointestinal tract. Acetylcholine can interact with a 7 nicotinic acetylcholine receptors （ a 7 nAchR） expressed by macrophages and other cytokine producing cells, down-regulate pro-inflammatory cytokine synthesis and prevent tissue damage. Herein is a review of the neurophysiological mechanism in which the CAP regulates inflammatory response, as well as its potential interventional strategy for inflammatory diseases.