来源：《福布斯》杂志2023年2月3月双月刊
Why is there no cure for Alzheimer’s—or why aren’t there medications that can at least substantially slow or meaningfully ameliorate the disease? It afflicts more than 6 million Americans, with that number on its way to doubling within a generation.
为什么没有治疗阿尔茨海默病的药物，或者为什么没有至少能显著减缓或有意义地改善这种疾病的药物？它折磨着600多万美国人，这一数字将在一代人内翻一番。
Alzheimer’s is a hideous ailment for both the sufferers and their families and friends. Yet even though the disease was first diagnosed by psychiatrist Alois Alzheimer in the early 1900s, progress in fighting it has been almost nonexistent. What’s scandalous is that for decades research has been almost entirely focused on the wrong hypothesis.
阿尔茨海默症对患者及其家人和朋友来说都是一种可怕的疾病。然而，尽管精神病学家阿洛伊斯·阿尔茨海默在20世纪初首次诊断出这种疾病，但在对抗该病方面几乎没有任何进展。令人愤慨的是，几十年来，研究几乎完全集中在错误的假设上。
Dr. Alzheimer noted in the patient’s brain with the disease that came to bear his name that it was densely loaded with two proteins called plaques and tangles. Unfortunately, the dominant thesis in research on the disease has been that attacking plaques, and to a lesser extent tangles, would cure the ailment and enable the brain to regain its health.
阿尔茨海默医生注意到，患有这种以他的名字命名的疾病的患者的大脑中密集地充斥着两种蛋白质，即斑块和缠结。不幸的是，关于该疾病的主要研究观点是，攻击斑块，以及在较小程度上攻击缠结，将治愈疾病，并使大脑恢复健康。
Alzheimer himself warned about focusing too much on plaques and tangles as causes. In fact, some sufferers of Alzheimer’s have proved to have had little in the way of plaques, while others who had plaques didn’t have the disease.
阿尔茨海默自己也警告说，不要把过多的注意力放在斑块和缠结上。事实上，一些阿尔茨海默症患者被证明几乎没有斑块，而另一些有斑块的患者则没有这种疾病。
Nonetheless, despite constant failures—some 20 drugs have been developed that ended up as flops—and the expenditure of tens of billions of dollars, the main thrust of research remains focused on fighting plaques.
然而，尽管不断的失败——已经开发了大约20种药物，但都以失败告终——花费了数百亿美元，研究的主要方向仍然集中在对抗斑块上。
The obsession with this dead-end approach has been crazy, almost cultlike. Researchers who want to pursue more promising avenues have faced serious obstacles. Rarely has chronic failure resisted correction on something so important.
对这种死路一条的痴迷是疯狂的，几乎如邪教般狂热。想要寻求更有前景的途径的研究人员面临着严重的障碍。很少有在如此重要的事情上，长期的失败却得不到纠正。
You may have heard of a new drug called lecanemab, which is being heralded as a fantastic breakthrough. But lecanemab is based on the wrongheaded plaques hypothesis. As noted health policy journalist Joanne Silberner sadly points out, “At best, lecanemab might slightly slow a patient’s inevitable decline for a few months.”
你可能听说过一种叫做lecanemab的新药，它被誉为一项了不起的突破。但是lecanemab是基于错误的斑块假说。正如著名卫生政策记者乔安娜·西尔伯纳悲哀地指出的那样，“lecanemab充其量只能在几个月内略微减缓患者不可避免的衰退。”
This research scandal shows the danger of groupthink, particularly when there’s a powerful government agency such as the National Institutes of Health halting grants for nonconsensus projects. A classic case of similar groupthink involved the cause of stomach ulcers. The once-prevailing view was that stress and lifestyle were the cause, and drugs and regimens were developed on that belief.
这一研究丑闻表明了团体迷思的危险，尤其是当国立卫生研究院这样强大的政府机构停止对非共识项目的拨款时。类似团体迷思的一个经典案例涉及胃溃疡的起因。曾经流行的观点是，压力和生活方式是病因，药物和治疗方案是在这种信念的基础上开发的。
This dogma was challenged by two Australian physicians, Robin Warren and Barry Marshall. They posited that the villain was bacteria and that antibiotics were the answer for a permanent cure. When not ignored, their discoveries were derided. Only after many years and constant, sometimes unorthodox advocacy, especially by Dr. Marshall, did the medical world accept their truths. The two were eventually awarded the Nobel Prize in Medicine.
这一教条受到了两位澳大利亚医生罗宾·沃伦和巴里·马歇尔的挑战。他们认为罪魁祸首是细菌，而抗生素是永久治愈的答案。要不是被忽视，他们的发现可能会遭到嘲笑。经过多年不断的，有时是非正统的宣传，尤其是马歇尔医生，医学界才接受了他们的真理。两人最终都获得了诺贝尔医学奖。
In the case of Alzheimer’s, the rigid research mentality has begun to soften, but only slightly. To attack this deadly rigidity, Congress should hold hearings on the subject, starting with the leaders at the National Institutes of Health.
对于阿尔茨海默症，僵化的研究心态已经开始软化，但只是略微软化。为了打击这种致命的僵化，国会应该就这个问题举行听证会，首先从国立卫生研究院的领导人开始。