Alzheimer Hastalığı Tedavisi
Özet
Alzheimer Hastalığı (AH), patolojik olarak nöronal kayıp, amiloid-beta (Aβ) plaklarının ve hiperfosforile tau nörofibriler yumaklarının (NFY'ler) birikimiyle karakterize, ilerleyici bir nörodejeneratif bozukluktur. Mevcut farmakolojik yönetim, bilişsel işlevi artıran veya eksitotoksisiteyi azaltan asetilkolinesteraz inhibitörü Donepezil ve NMDA reseptör antagonisti Memantin gibi semptomatik tedavileri içermektedir. Son terapötik gelişmeler, temel patolojiyi hedefleyen hastalığı modifiye edici tedavilere (HMT'ler) odaklanmaktadır. Donanemab ve Lecanemab gibi monoklonal antikorlar, Aβ plaklarını temizleyerek erken evre AH'de klinik gerilemeyi önemli ölçüde yavaşlatarak etkinlik göstermektedir. Ancak, bu immünoterapiler, özellikle Amiloidle İlişkili Görüntüleme Anormallikleri (ARIA) gibi risklerle ilişkilidir. Gelişmekte olan stratejiler, uygun bir mikroçevreyi teşvik etmek, kaybedilen nöronları ikame etmek ve toksik agregatları temizlemek amacıyla Embriyonik, Mezenkimal, Nöral ve İndüklenmiş Pluripotent Kök Hücreleri (iPKH) kullanan kök hücre tedavilerini kapsamaktadır. Ayrıca, kapsamlı tedavi nöropsikiyatrik semptomları da ele almaktadır: ajitasyon, öncelikli olarak farmakolojik olmayan yöntemler veya Brexpiprazole ile, depresyon ise sıklıkla essitalopram gibi SSRI'lara yanıt vermektedir. Bu yeni tedavilerin sürdürülebilir etkinliğini ve güvenlik profillerini belirlemek için devam eden uzun vadeli çalışmalar hayati önem taşımaktadır.
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