RESUMEN
Alzheimer's disease is a progressive neurodegenerative disorder that affects memory and cognitive abilities, affecting millions of people around the world. Current treatments focus on the management of symptoms, as no effective therapy has been approved to modify the underlying disease process. Gene therapy is a promising approach that can offer disease-modifying treatment for AD, targeting various aspects of the pathophysiology of the disease. This review presents a comprehensive overview of the current state of gene therapy research for AD, with a specific focus on clinical trials and preclinical studies that have used nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), apolipoprotein E2 (APOE2), and human telomerase reverse transcriptase (hTERT) as therapeutic gene therapy approaches. These gene targets have shown potential to alleviate the neuropathology of AD in animal studies and have demonstrated feasibility and safety in non-human primates. Despite the failure of the NGF gene therapy approach in clinical trials, we have reviewed and highlighted the reported findings and evaluations from the trials. Furthermore, the review included the conclusions of postmortem brain tissue analysis of AD patients who received NGF gene therapy. The goal is to learn from the failed trials and improve the approach in the future. Although gene therapy shows promise, it faces several challenges and limitations, including optimizing gene delivery methods, enhancing safety and efficacy profiles, and determining long-term results. This review contributes to the growing body of literature on innovative treatments for AD and highlights the need for more research and development to advance gene therapy as a viable treatment option for AD.
RESUMEN
Background: Adolescents' risk-taking behaviors can have profound impacts on their future health. Few studies have established a relationship between multiple social environmental factors and adolescent risk behaviors. We used structural equation modeling to examine the role of parental monitoring and environmental risks on adolescents' behavioral intentions and risk behaviors. Methods: Data were collected through the baseline survey of a national implementation project among 2205 Grade 6 students in 24 government schools in The Bahamas in 2019. Structural equation modeling examined relations among parental monitoring, environmental risk factors, behavioral intentions, and risk behaviors. Results: Students had engaged in various delinquent, substance use, and sexual risks. In the structural equation model, parental monitoring demonstrated direct negative (protective) effects on behavioral intentions and risk behaviors, whereas environmental risk factors had a direct positive effect on adolescent behavioral intentions and risk behaviors. The model had an R2 value of 0.57 for adolescent risk behaviors. Conclusion: Parental monitoring and environmental risk factors had strong influences on risk-taking behaviors of early adolescents. Future adolescent health behavior interventions should consider offering additional prevention resources to early adolescents who are exposed to multiple environmental risk factors.
