科学家于本周二表示,绿茶中的化学物质已被证明能改善唐氏综合征患者的认知能力。经过一年的临床试验,研究人员发现绿茶可提高患者的记忆和行为能力,且试验结束后,该效应还能持续六个月。相关结果发表在《The Lancet Neurology》上。
脑部扫描显示,一种称为表没食子儿茶素没食子酸酯(epigallocatechin gallate)改变大脑中神经元之间的连接方式。本研究第一作者,巴塞罗那基因组调控研究中心Mara Dierssen表示,“该研究是首个显示绿茶治疗能改善唐氏综合征患者认知的研究。”然而,她在一份声明中补充道,“该研究结果不应该被解释为治疗,但它或许能作为一种改善唐氏综合征患者生活质量的途径”。此外,未参加该研究的专家也认为该结果令人兴奋,是一项重要的发现。但专家警告称,该结果还需更多的临床试验进行验证。
唐氏综合征是一种最常见的遗传性智力障碍,据世界卫生组织,大约每1000个人中有1个唐氏综合征患者。唐氏综合征也被称为21三体综合征,是由染色体异常(多了一条21号染色体)而导致的疾病。
健康人体通常有23对染色体,包含大约25000个蛋白的编码基因。而唐氏综合征患者额外的拷贝数导致21染色体上的基因过量表达,从而导致认知能力下降和其他健康问题。在早期的小鼠实验中,Dierssen发现抑制DYRK1A基因可改善大脑的功能和发展。
“大跃进”
然而,这种基因疗法对人类而言存在一定的困难,因而研究者们转向了绿茶化合物。在本次试验中,84名唐氏综合征年轻患者被分为两组,第一组给予不含咖啡因包含45%表没食子儿茶素没食子酸酯的绿茶补充物,并每周给予认知训练,第二组给予相同的认知训练,但以等量的安慰剂取代绿茶补充物。
受试者在试验3、6、12月后分别接受认知测试。两组患者在大多数特征上没有太大变化,但在一些记忆模式、回忆能力及适应行为中,绿茶组患者测试分数更高。此外,这些能力随时间推移而改善。
伦敦帝国理工学院神经药理学中心主任David Nutt对该研究评论道,“对唐氏综合征遗传神经生物学的理解为疾病的个性化治疗提供了可能”。巴黎大脑和脊椎研究所唐氏综合征专家Marie-Claude Potier说,“该研究结果是一个质的飞跃,但安全性和有效性有待确认”。然而,另外一些研究者警告说,尽管新研究有一定的重要性,但遗传仍不能说明一切,了解一个人的遗传条件、环境背景以及其他健康问题和受教育问题同样重要。
---------------英语原文-----------------
Down's syndrome 'treated' with green tea: study
A chemical in green tea has been shown to improve cognitive ability in persons with Down's syndrome, scientists and doctors said Tuesday.
In a year-long clinical trial, the treatment led to improved scores on memory and behaviour tests, they reported in a study, published in the The Lancet Neurology.
The positive impact remained six months after the trial ended.
Brain scans revealed that the compound, called epigallocatechin gallate, altered the way neurons in the brain connect with one another.
"This is the first time that a treatment has shown efficacy in the cognitive improvement of persons with this syndrome," said Mara Dierssen, senior author of the study and a researcher at the Centre for Genomic Regulation in Barcelona.
While significant, she added in a statement, the results should not be interpreted as a "cure".
"But it may be a tool to improve these individuals' quality of life."
Experts not involved in the study described it as "exciting" and "an important piece of work."
At the same time, they cautioned, the findings must be validated in additional trials.
Down's syndrome is the most common genetic form of intellectual disability, and afflicts approximately one in 1,000 people, according to the World Health Organization.
Also known as trisomy 21, the condition is caused by the presence of an extra, or third, copy of chromosome number 21.
Humans normally have 23 pairs of chromosomes, which together contain up to 25,000 protein-coding genes.
In Down's syndrome, the extra copy causes some of the genes in chromosome 21 to be "over-expressed", leading to reduced cognitive abilities and other health problems.
In earlier experiments with mice designed to mimic Down's, Dierssen had shown that inhibiting one of these genes, DYRK1A, improved function and development in the brain.
'A leap forward'
But the technique used—gene therapy—was not an option for humans, so the researchers turned to the green tea compound.
In the trials, 84 young adults with Down's syndrome were split into two groups.
One was given a decaffeinated green tea supplement containing 45 percent epigallocatechin gallate, along with weekly online cognitive training.
The second group had the same training, but ingested a look-alike placebo instead of the supplement.
The subjects took cognitive tests after three, six and 12 months.
There was little-to-no change in most categories, but in a few—the ability to remember patterns, verbal recall, adaptive behaviour—the "green tea" group scored significantly better.
Moreover, they improved over time.
"It's exciting that an understanding of the genetic neurobiology of Down's syndrome is leading to the possibility of disorder-specific treatments," said David Nutt, head of the Centre for Neuropsychopharmacology at Imperial College London, in commenting on the study.
Marie-Claude Potier, a Down's specialist at the Brain and Spine Institute in Paris, said the results were a "leap forward," but that safety and efficacy need to be confirmed.
Still genetics is not everything, cautioned another pair of researchers, even as they recognised the importance of the new study.
"We can no longer afford to view someone with Down's syndrome solely through the lens of trisomy 21," noted Fabian Fernandez and Jamie Edgin of the Evelyn F. McKnight Brain Institute at the University of Arizona in a commentary.
It is equally important to "understand each individual in light of their larger genetic and environmental background," as well as other health problems and access to education, they wrote in The Lancet Neurology.
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