title: Inflammation, Antiinflammatory Agents, and Alzheimer's Disease: The Last 22 Years.
abstract: Two basic discoveries spurred research into inflammation as a driving force in the pathogenesis of Alzheimer's disease (AD). The first was the identification of activated microglia in association with the lesions. The second was the discovery that rheumatoid arthritics, who regularly consume anti-inflammatory agents, were relatively spared from the disease. These findings led to an exploration of the inflammatory pathways that were involved in AD pathogenesis. A pivotal advance was the discovery that amyloid-β protein (Aβ) activated the complement system. This focused attention on anti-inflammatories as blockers of complement activation. More than 15 epidemiological studies have since showed a sparing effect of non-steroidal anti-inflammatory drugs (NSAIDs) in AD. A consistent finding has been that the longer the NSAIDs were used prior to clinical diagnosis, the greater the sparing effect. The reason has since emerged from studies of biomarkers such as amyloid-β (Aβ) levels in the cerebrospinal fluid and Aβ deposits in brain. They have established that the onset of AD commences at least a decade before cognitive decline permits clinical diagnosis. Such biomarker studies have revealed that a huge window of opportunity exists when application of NSAIDs, other anti-inflammatory agents, or complement activation blockers, could arrest further progress of AD, thus eliminating its manifestation. It can be anticipated that this principle will apply to many other chronic neurodegenerative diseases. Neuroinflammation, discovered in AD more than 30 years ago, has now become a major field of brain research today. Inhibiting it may be the key to successful treatment of many chronic neurological disorders.
authors.affiliation: Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver BC, Canada.
authors.forename: Patrick L
authors.initials: PL
authors.lastname: McGeer
authors.affiliation: Biosciences Division SRI International, Menlo Park, CA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Rogers
authors.affiliation: Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver BC, Canada.
authors.forename: Edith G
authors.initials: EG
authors.lastname: McGeer
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000378:metabolism*; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid / Q000378:metabolism; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use; D015415:Biomarkers / Q000134:cerebrospinal fluid / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000378:metabolism; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors / Q000134:cerebrospinal fluid / Q000378:metabolism*; D013997:Time Factors
chemical_list: D016229:Amyloid beta-Peptides; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D018836:Inflammation Mediators
keywords: Biomarkers; NSAID; complement; immunohistochemistry; membrane attack complex; reactive microglia