Potential therapeutic system for Alzheimer's disease: removal of blood Aβs by hemodialzyers and its effect on the cognitive functions of renal-failure patients
Potential therapeutic system for Alzheimer's disease: removal of blood Aβs by hemodialzyers and its effect on the cognitive functions of renal-failure patients
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DOI：
10.1007/s00702-012-0844-5
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发表时间：
2012-12-01
影响因子：
3.3
通讯作者：
Kitaguchi, Nobuya
中科院分区：
文献类型：
--
作者：
Kato, Masao;Kawaguchi, Kazunori;Kitaguchi, Nobuya
阿尔茨海默病的病理变化包括淀粉样β蛋白(Aβ)作为老年斑沉积在大脑中。我们推测，血液中AβS的快速排出可能起到脑部外周Aβ引流汇的作用。对57例血液透析患者(69.4+/-A3.8岁)、26例非血液透析肾功能衰竭患者(66.6+/-14.7岁)和17例年龄匹配的健康对照组(66.6+/-4.1岁)的血浆Aβ浓度和认知功能进行了研究。血浆AβS浓度随肾功能下降而升高。此外，未进行血液透析且肾功能较差的肾功能衰竭患者的认知功能较差。血浆Aβ(1-42)浓度与血肌酐(P<；0.001)和简易智力状态检查分数(P=0.017)相关。在血液透析过程中，透析器有效地清除了血液中的AβS。随着血液透析时间的延长，血浆Aβ浓度呈稳定或轻微下降趋势。在一次血液透析过程中，S清除的Aβ总量与S在血液和脑脊液中溶解的Aβ相当。维持性血液透析患者的MMSE评分随透析时间的延长无明显下降。因此，从血液中去除AβS治疗阿尔茨海默病的方法值得进一步研究，包括脑组织中AβS是否减少。
The pathological changes of Alzheimer's disease include the deposition of amyloid beta protein (A beta) as senile plaques in the brain. We hypothesized that the rapid removal of A beta s from the blood may act as a peripheral A beta drainage sink from the brain. In this study, the plasma A beta concentrations and the cognitive functions were investigated for in 57 patients on hemodailysis (69.4 +/- A 3.8 years), 26 renal-failure patients without hemodialysis (66.6 +/- 14.7 years), and 17 age-matched healthy controls (66.6 +/- 4.1 years). The concentrations of plasma A beta s increased along with the decline of renal functions. Moreover, the renal-failure patients without hemodialysis and with poorer renal functions showed lower cognitive functions. The plasma concentrations of A beta(1-42) correlated with serum creatinine (P < 0.001) and Mini-Mental-State Examination scores (P = 0.017). The dialyzers effectively removed A beta s in the blood during hemodialysis sessions. The plasma A beta concentrations showed steady or slightly decreasing along with duration of hemodialysis. The total amount of A beta s removed during a hemodialysis session was calculated to be comparable to the A beta s dissolved in the blood and the cerebrospinal fluid. The MMSE scores of the hemodialysis patients showed no clear decrease in longer hemodialysis duration. Therefore, the therapeutic approach for Alzheimer's disease by removing A beta s from the blood is worthy of further investigation, including whether or not A beta s in the brain decrease.