Amyloid-targeted therapeutics in Alzheimer's disease: use of human albumin in plasma exchange as a novel approach for Abeta mobilization.
Drug News Perspect. 2009 Jul-Aug;22(6):325-39.
Boada M, Ortiz P, Anaya F, Hernández I, Muñoz J, Núñez L, Olazarán J, Roca I, Cuberas G, Tárraga L, Buendia M, Pla RP, Ferrer I, Páez A.
ACE Foundation, Catalan Institute of Applied Neurosciences and the Neurology Service, University <leo_highlight style="border-bottom: 2px solid #ffff96; background: transparent none repeat scroll 0% 0%; cursor: pointer; display: inline;" id="leoHighlights_Underline_0" on-click="leoHighlightsHandleClick('leoHighlights_Underline_0')" on-mouseover="leoHighlightsHandleMouseOver('leoHighlights_Underline_0')" on-mouseout="leoHighlightsHandleMouseOut('leoHighlights_Underline_0')" leohighlights_keywords="general%20hospital" leohighlights_url_top="http%3A//shortcuts.thebrowserhighlighter.com/leonardo/plugin/highlights/3_1/tbh_highlightsTop.jsp?keywords%3Dgeneral%2520hospital%26domain%3Dwww.ncbi.nlm.nih.gov" leohighlights_url_bottom="http%3A//shortcuts.thebrowserhighlighter.com/leonardo/plugin/highlights/3_1/tbh_highlightsBottom.jsp?keywords%3Dgeneral%2520hospital%26domain%3Dwww.ncbi.nlm.nih.gov" leohighlights_underline="true">General Hospital Vall d'Hebron, Barcelona, Spain.
A clinical investigation program was carried out to replace endogenous albumin of patients with mild to moderate Alzheimer's disease (AD) with 5% Human Albumin Grifols(R) through a plasma exchange (PE) schedule, in order to alter the dynamic equilibrium between albumin-bound Abeta in plasma and Abeta in cerebrospinal fluid. In a pilot proof-of-concept study, 7 patients underwent 6 PE in 3 weeks and 1 year of follow-up. Plasma Abeta determinations demonstrated a variation pattern in levels in relation with the PEs. Cognitive status scores (MMSE and ADAS-Cog) were more stable than expected. In a phase II clinical trial, 29 patients were randomized into PEtreated and control groups with 1 year follow-up. Interim results point toward the occurrence of Abeta40 mobilization in the PE-treated patients, who scored better in cognitive tests (differences at 9 months: 2.5 in MMSE and 5.5 in ADAS-cog). These results suggest that a PE program with 5% Human Albumin Grifols may have a promising role in the treatment of mild to moderate AD. Copyright 2009 Prous Science, S.A.U. or its licensors. All rights reserved.