紅血球生成素之神經保護效果：應用於治療巴金森氏症失智為例

Neuronal Protection by Erythropoietin: A Possible Application in Parkinson’s Disease Dementia

目的：很高比例的巴金森氏症（Parkinson’s disease）患者在罹患此疾病後數年內，會合併出現失智症，稱為「巴金森氏症失智」（Parkinson’s disease dementia），目前尚無藥物可以根治此疾病，因此尋找可資運用之藥物具有臨床價值。方法：藉由檢索科學文獻，深入分析基礎研究證據與臨床報告，以指出具有潛力之藥物。結果：巴金森氏症雖然有典型的多巴胺神經退化現象，其病理機轉也涉及氧化壓力與麩胺酸興奮性毒性。紅血球生成素（erythropoietin）是腎臟所製造的賀爾蒙，臨床上主要用來治療缺血症狀。目前已知紅血球生成素可以增加抗氧化酵素glutathion peroxidase之製造量及活性、防止氧化壓力、減少興奮性毒性、促進神經新生並且改善認知功能。結論：紅血球生成素極有潛力可以應用於治療神經退化性疾病及相關之失智症。

Purposes: A high proportion of patients suffering from Parkinson's disease (PD) develop dementia, called 'Parkinson's disease dementia,' within a few years. To date, no medication has been found to treat this disease and it is important find an effective one. Methods: A literature survey of basic science and clinical data. The results would indicate a potential therapy. Results: Although PD is characterized by progressive dopaminergic degeneration, the pathogenesis also involves oxidative stress and glutamate excitotoxicity. Erythropoietin, a hormone secreted by the kidney, has been used clinically to treat anemia. Erythropoietin can enhance the production and activation of glutathion peroxidase, an antioxidant enzyme, which in turn, protects neurons from oxidative damage and excitotoxic cell death while boosting neurogenesis. Conclusions: Erythropoietin has great potential in the development of new therapeutic approaches to neurodegenerative diseases and related dementia disorders.