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Abstract(s)
O presente trabalho está dividido em dois capítulos que descrevem a minha experiência
profissionalizante para a obtenção de grau de Mestre em Ciências Farmacêuticas,
apresentando uma componente de investigação, bem como uma componente de estágio
realizado em Farmácia Comunitária. O primeiro capítulo é composto por uma revisão
sistemática de artigos em que foram comparados os níveis de pregnenolona e sulfato de
pregnenolona, em amostras biológicas de doentes com doença de Alzheimer e grupos
controlo sem apresentação de demência. A doença de Alzheimer é a causa mais comum
de demência globalmente e os únicos tratamentos aprovados, atualmente, visam
apenas a melhoria de sintomas, não possuindo a capacidade de alterar a deterioração
progressiva da doença nem o respetivo declínio cognitivo. A pregnenolona é um
esteróide derivado do colesterol com várias funções neuronais e, tal como o seu
conjugado sulfatado, exibe propriedades de neuroproteção e potenciação de memória.
Evidência crescente sobre a influência de uma desregulação de níveis endógenos de
esteróides neuroativos na patofisiologia da doença de Alzheimer poderá constituir uma
nova abordagem no tratamento e diagnóstico da doença. Desta forma, foi elaborada
uma pesquisa sobre o tópico em três bases de dados eletrónicas e incluídos cinco
artigos no estudo. Ainda que haja uma tendência para os níveis de pregnenolona e
sulfato de pregnenolona estarem aumentados em amostras de sangue, líquido
cefalorraquidiano, córtex pré-frontal e córtex temporal de doentes com Alzheimer, não
é possível fazer uma associação clara entre a alteração dos níveis destes
neuroesteróides e a presença da doença. Adicionalmente, foi demonstrada uma
correlação positiva entre os níveis de pregnenolona no córtex temporal e a severidade
do estágio neuropatológico da doença. A realização de ensaios clínicos controlados e
randomizados a larga escala poderá ser valiosa para avaliar a eficácia de um tratamento
com pregnenolona ou sulfato de pregnenolona face ao declínio cognitivo, assim como a
realização de estudos prospetivos para avaliar as alterações de concentração a longo
prazo destes neuroesteróides e a sua potencialidade como biomarcadores para
diagnóstico em estágios precoces da doença de Alzheimer. O segundo capítulo é
referente às competências adquiridas no decorrer do estágio em Farmácia Comunitária,
na Farmácia Gândara, em Vila Nova de Gaia. Durante o período de estágio curricular,
tive oportunidade de contactar com a realidade da profissão de farmacêutico
comunitário e desempenhar o papel de agente de saúde pública durante a pandemia
provocada pela doença Covid-19.
The present dissertation is divided into two chapters that describe my professional experience for obtaining a Master's degree in Pharmaceutical Sciences, presenting a research component, as well as an internship component carried out in Community Pharmacy. The first chapter consists of a systematic review of articles comparing the levels of pregnenolone and pregnenolone sulfate in biological samples from patients with Alzheimer's disease and cognitively intact control groups. Alzheimer's disease is the most common cause of dementia globally and the only treatments currently approved are aimed at improving symptoms, without the ability to alter the progressive deterioration of the disease or the corresponding cognitive decline. Pregnenolone is a cholesterol-derived steroid with several neuronal functions and, like its sulfated conjugate, exhibits neuroprotective and memory enhancing properties. Increasing evidence on the influence of endogenous levels of neuroactive steroids on the pathophysiology of Alzheimer's disease may constitute a new approach in the treatment and diagnosis of the disease. In this way, research on the topic was carried out in three electronic databases and five articles were included in the study. Although there is a tendency for pregnenolone and pregnenolone sulfate levels to be increased in blood, cerebrospinal fluid, prefrontal cortex and temporal cortex samples from Alzheimer's patients, it is not possible to make a clear association between the changes in the levels of these neurosteroids and the presence of Alzheimer’s. Additionally, a positive correlation has been demonstrated between pregnenolone levels in the temporal cortex and the severity of the neuropathological stage of the disease. Conducting large-scale controlled and randomized clinical trials may be valuable in assessing the effectiveness of a treatment with pregnenolone or pregnenolone sulfate against the cognitive decline, as well as conducting prospective studies to assess changes in the long-term concentration of these neurosteroids and their potential as biomarkers for diagnosis in early stages of Alzheimer's disease. The second chapter refers to the skills acquired during the internship in Community Pharmacy, at Farmácia Gândara, in Vila Nova de Gaia. During the internship period, I had the opportunity to get in touch with the reality of the community pharmacist profession and play the role of public health agent during the pandemic caused by the Covid-19 disease.
The present dissertation is divided into two chapters that describe my professional experience for obtaining a Master's degree in Pharmaceutical Sciences, presenting a research component, as well as an internship component carried out in Community Pharmacy. The first chapter consists of a systematic review of articles comparing the levels of pregnenolone and pregnenolone sulfate in biological samples from patients with Alzheimer's disease and cognitively intact control groups. Alzheimer's disease is the most common cause of dementia globally and the only treatments currently approved are aimed at improving symptoms, without the ability to alter the progressive deterioration of the disease or the corresponding cognitive decline. Pregnenolone is a cholesterol-derived steroid with several neuronal functions and, like its sulfated conjugate, exhibits neuroprotective and memory enhancing properties. Increasing evidence on the influence of endogenous levels of neuroactive steroids on the pathophysiology of Alzheimer's disease may constitute a new approach in the treatment and diagnosis of the disease. In this way, research on the topic was carried out in three electronic databases and five articles were included in the study. Although there is a tendency for pregnenolone and pregnenolone sulfate levels to be increased in blood, cerebrospinal fluid, prefrontal cortex and temporal cortex samples from Alzheimer's patients, it is not possible to make a clear association between the changes in the levels of these neurosteroids and the presence of Alzheimer’s. Additionally, a positive correlation has been demonstrated between pregnenolone levels in the temporal cortex and the severity of the neuropathological stage of the disease. Conducting large-scale controlled and randomized clinical trials may be valuable in assessing the effectiveness of a treatment with pregnenolone or pregnenolone sulfate against the cognitive decline, as well as conducting prospective studies to assess changes in the long-term concentration of these neurosteroids and their potential as biomarkers for diagnosis in early stages of Alzheimer's disease. The second chapter refers to the skills acquired during the internship in Community Pharmacy, at Farmácia Gândara, in Vila Nova de Gaia. During the internship period, I had the opportunity to get in touch with the reality of the community pharmacist profession and play the role of public health agent during the pandemic caused by the Covid-19 disease.
Description
Keywords
Doença de Alzheimer Farmácia Comunitária Neuroesteróides Pregnenolona Sulfato de Pregnenolona