A carregar...
Publicação
Olfato como marcador biológico
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 439.17 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Este trabalho tem como objetivo a compreensão, à luz da evidência mais recente, do papel atual do olfato enquanto marcador biológico de doença. Nesse sentido foram pesquisados artigos na MEDLINE através do PubMed com recurso aos termos MESH considerados mais relevantes, alcançando um total de 1140 resultados. Foram selecionados e revistos de forma narrativa os 136 resultados mais pertinentes.
O olfato é reconhecido atualmente como marcador diagnóstico de estadios precoces da doença de Alzheimer (DA) e doença de Parkinson (DP); marcador de diagnóstico diferencial entre a DP e outras doenças neurodegenerativas motoras; marcador da progressão do défice cognitivo ligeiro para a DA e DP; e possível marcador diagnóstico para certos subtipos de doenças do espetro do autismo e potencial marcador de formas da síndrome de Usher.
É ainda apontado como possível marcador de resposta terapêutica em doentes com DA sob Donepezilo e doentes com depressão major sob antidepressivos. É também um possível marcador de gravidade de doença e pior prognóstico na DP, esclerose lateral amiotrófica, depressão e esquizofrenia (para a qual não se verificou, até à data, utilidade diagnóstica enquanto marcador).
Algumas limitações da utilização do olfato enquanto marcador incluem: a existência de fatores de confusão culturais e sociais com impacto nos resultados dos testes olfativos padronizados atuais; a necessidade de validação clínica em estudos prospetivos otimizados para o efeito, bem como as questões éticas relacionadas com a aplicação de métodos de rastreio de doenças para as quais atualmente não existem ainda intervenções preventivas e curativas eficazes como é o caso das doenças neurodegenerativas em estudo.
Ainda assim, o olfato afigura-se como um marcador biológico de grande potencial pela grande acessibilidade e simplicidade da sua avaliação. Tal permite trazer, de modo custo-efetivo, maior especificidade e sensibilidade ao conjunto atual de métodos de rastreio e diagnóstico, levando a uma sinalização e referenciação dos doentes potencialmente mais precoces e atempadas.
This work aims to understand in the light of the latest evidence, which is the current role of olfaction as a biological marker of disease. Accordingly, articles were searched on MEDLINE through PubMed using the MESH terms considered more relevant coming to a total of 1140 results. The 136 most pertinent articles were reviewed in a narrative fashion. Olfaction is currently recognised as a diagnostic marker for early stages of Alzheimer’s disease (AD) and Parkinson’s disease (PD); a differential diagnosis marker between PD and other motor neurodegenerative disorders; a progression marker from mild cognitive impairment to both AD and PD; and a possible diagnostic marker for certain subtypes of the autism spectrum disorders and a potential marker for Usher syndrome subtypes. It is also suggested as a possible marker for therapeutic response in AD patients under Donepezil and major depression patients under antidepressant therapy. Likewise, it is a possible marker of disease severity and worse prognosis in PD, amyotrophic lateral sclerosis, depression and schizophrenia (in which there has been no proof of utility as a diagnosis marker thus far). Some limitations of the current use of olfaction as a marker include: the existence of confounding cultural and social factors to the application of the olfactory current tests with possible impact on results; the need to validate clinically its use in studies designed for that goal; and the ethical issues raised by the application of screening methods for early stages of diseases, for which there are still no effective preventive or curative strategies available. Still, olfaction appears to be a biological marker of great potential due to the marked accessibility and simplicity of its evaluation, bringing in a cost-effective way more specificity and sensibility to the current group of screening and diagnostic methods, leading to an earlier and timelier signalization and referral of patients.
This work aims to understand in the light of the latest evidence, which is the current role of olfaction as a biological marker of disease. Accordingly, articles were searched on MEDLINE through PubMed using the MESH terms considered more relevant coming to a total of 1140 results. The 136 most pertinent articles were reviewed in a narrative fashion. Olfaction is currently recognised as a diagnostic marker for early stages of Alzheimer’s disease (AD) and Parkinson’s disease (PD); a differential diagnosis marker between PD and other motor neurodegenerative disorders; a progression marker from mild cognitive impairment to both AD and PD; and a possible diagnostic marker for certain subtypes of the autism spectrum disorders and a potential marker for Usher syndrome subtypes. It is also suggested as a possible marker for therapeutic response in AD patients under Donepezil and major depression patients under antidepressant therapy. Likewise, it is a possible marker of disease severity and worse prognosis in PD, amyotrophic lateral sclerosis, depression and schizophrenia (in which there has been no proof of utility as a diagnosis marker thus far). Some limitations of the current use of olfaction as a marker include: the existence of confounding cultural and social factors to the application of the olfactory current tests with possible impact on results; the need to validate clinically its use in studies designed for that goal; and the ethical issues raised by the application of screening methods for early stages of diseases, for which there are still no effective preventive or curative strategies available. Still, olfaction appears to be a biological marker of great potential due to the marked accessibility and simplicity of its evaluation, bringing in a cost-effective way more specificity and sensibility to the current group of screening and diagnostic methods, leading to an earlier and timelier signalization and referral of patients.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Olfato Hiposmia Doenças neurodegenerativas Marcador diagnóstico Doenças psiquiátricas Otorrinolaringologia