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姜黄素治疗与年龄相关的认知衰退的疗效:临床前和临床研究的叙述性综述。

Efficacy of curcumin for age-associated cognitive decline: a narrative review of preclinical and clinical studies.

机构信息

Department of Pharmacology and Neuroscience, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, USA.

Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA.

出版信息

Geroscience. 2018 Apr;40(2):73-95. doi: 10.1007/s11357-018-0017-z. Epub 2018 Apr 21.

Abstract

Processes such as aberrant redox signaling and chronic low-grade systemic inflammation have been reported to modulate age-associated pathologies such as cognitive impairment. Curcumin, the primary therapeutic component of the Indian spice, Turmeric (Curcuma longa), has long been known for its strong anti-inflammatory and antioxidant activity attributable to its unique molecular structure. Recently, an interest in this polyphenol as a cognitive therapeutic for the elderly has emerged. The purpose of this paper is to critically review preclinical and clinical studies that have evaluated the efficacy of curcumin in ameliorating and preventing age-associated cognitive decline and address the translational progress of preclinical to clinical efficacy. PubMed, semantic scholar, and Google scholar searches were used for preclinical studies; and clinicaltrials.gov , the Australian and New Zealand clinical trials registry, and PubMed search were used to select relevant completed clinical studies. Results from preclinical studies consistently demonstrate curcumin and its analogues to be efficacious for various aspects of cognitive impairment and processes that contribute to age-associated cognitive impairment. Results of published clinical studies, while mixed, continue to show promise for curcumin's use as a therapeutic for cognitive decline but overall remain inconclusive at this time. Both in vitro and in vivo studies have found that curcumin can significantly decrease oxidative stress, systemic inflammation, and obstruct pathways that activate transcription factors that augment these processes. Future clinical studies would benefit from including evaluation of peripheral and cerebrospinal fluid biomarkers of dementia and behavioral markers of cognitive decline, as well as targeting the appropriate population.

摘要

已经有报道称,异常的氧化还原信号和慢性低度全身炎症等过程可以调节与年龄相关的病理学,如认知障碍。姜黄素是印度香料姜黄的主要治疗成分,长期以来因其独特的分子结构而具有很强的抗炎和抗氧化活性而闻名。最近,人们对这种多酚作为老年人认知治疗剂产生了兴趣。本文的目的是批判性地回顾评估姜黄素改善和预防与年龄相关的认知能力下降的功效的临床前和临床研究,并探讨临床前到临床疗效的转化进展。使用 PubMed、语义学者和 Google 学者搜索进行了临床前研究;使用 clinicaltrials.gov、澳大利亚和新西兰临床试验注册中心和 PubMed 搜索选择了相关的已完成的临床研究。临床前研究的结果一致表明,姜黄素及其类似物在认知障碍的各个方面以及导致与年龄相关的认知障碍的过程中都具有疗效。已发表的临床研究结果虽然参差不齐,但仍继续显示出姜黄素作为认知衰退治疗药物的应用前景,但目前总体上仍不确定。体外和体内研究都发现,姜黄素有能力显著降低氧化应激、全身炎症,并阻断激活转录因子的途径,从而增强这些过程。未来的临床研究将受益于包括对痴呆症的外周和脑脊液生物标志物以及认知衰退的行为标志物的评估,以及针对合适的人群。

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