Снижение уровня ацетилхолина

В 1978 и 1979 гг. появились первые сообщения о нескольких случаях заметного улучшения состояния пациентов, страдавших болезнью Альцгеймера, после кратковременного лечения лецитином (в основном неочищенным). Но при более длительном (в течение нескольких недель) эксперименте в контролируемых условиях эти результаты не подтвердились. В последнее время делаются попытки выяснить, восстанавливаются ли умственные способности, или, по крайней мере, замедляется ли течение болезни при длительном лечении холиновыми препаратами (за период, достаточный для заметного ухудшения состояния у контрольных пациентов, не принимающих препараты). Пока закончено только одно продолжительное, тщательно выполненное исследование действия чистого лецитина. В эксперименте Р. Леви (медицинский факультет Лондонского университета) наблюдалось стабильное улучшение у 8 из 24 больных. Средний возраст этих 8 человек был 79 лет, тогда как средний возраст остальных, не испытавших улучшения, составлял 69 лет. Может быть, лечение оказалось успешным только у тех больных, у которых патологические изменения в мозгу были не так сильны и коснулись лишь холинэргических нейронов? Имеется ряд указаний на то, что существует несколько форм болезни Альцгеймера, причем у тех, кто заболевает в более преклонном возрасте, она обычно протекает в более легкой форме и ограничивается в основном поражением холинэргических нейронов.

Снижение уровня ацетилхолина в некоторых областях мозга при болезни Альцгеймера может дать ключ к разгадке ее патогенеза, т.е. механизма, посредством которого некий болезнетворный фактор вызывает изменения в поведении больного и в тканях его мозга. В частности, в результате какого процесса поражаются именно холинэргические нейроны, длинные аксоны которых простираются от базальной части мозга до гиппокампа и коры?




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