CSF biomarking for diagnosis and treatment assessment in neurodegeneration

摘要

Perhaps, the greatest medical challenge facing the developed world, and of increasing importance in the developing world, is the problem of late onset neurodegenerative disease. As life expectancies have increased, and smoking and cholesterol risk factors for heart disease and stroke have become understood and combatted, more and more of us are living to old age, where the scourge of neurodegenerative disease still remains. Most prevalent amongst these primary neurodegenerative diseases is Alzheimer's disease, but Lewy body dementia, frontotemporal lobar degeneration, motor neuron disease, progressive supranuclear palsy, prion disease and multiple system atrophy all afflict significant numbers of people. In all these cases, and in the ataxias and Huntington's disease, we have made enormous strides in understanding disease aetiologies - gene mutations have been found; cells have been transfected; transgenic mice have been made and, in some cases, these mice have developed 'symptoms' and pathologies and have had treatments tested upon them (Hardy and Gwinn-Hardy 1998). In no case, however, treatments based on these mechanistic understandings have yet yielded clinically useful treatments.