18-Month study of intravenous immunoglobulin for treatment of mild Alzheimer disease
18-Month study of intravenous immunoglobulin for treatment of mild Alzheimer disease
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DOI：
10.1016/j.neurobiolaging.2007.12.021
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发表时间：
2009-11-01
影响因子：
4.2
通讯作者：
Weksler, Marc E.
中科院分区：
文献类型：
--
作者：
Relkin, Norman R.;Szabo, Paul;Weksler, Marc E.
静脉注射免疫球蛋白（IVIg）已被认为是阿尔茨海默病（AD）免疫治疗的潜在药物，因为它含有抗β -淀粉样蛋白（a β）的抗体。我们在8名轻度AD患者中进行了一项开放标签剂量范围研究，在批准的AD治疗中添加IVIg 6个月，停药，然后再恢复9个月。注射总体耐受良好。AD患者血清中抗a β抗体与IVIg剂量成比例增加，且半衰期比抗肝炎抗体和总IgG短。每次输注后血浆A β水平短暂升高。脑脊液A β在6个月时显著下降，在洗脱后恢复到基线水平，在再次给予IVIg 9个月后再次下降。6个月后，迷你精神状态得分平均增加2.5分，在洗脱期间恢复到基线水平，并在随后的IVIg治疗期间保持稳定。我们的发现证实并扩展了Dodel等人的发现[Dodel， r.c., Du， Y., Depboylu， C., Hampel， H., Frolich， L., Haag， A., Hemmeter， U., Paulsen， S., Teipel, s.j., Brettschneider， S., Spottke， A., Nolker， C., Moller, h.j., Wei， X., Farlow， M., Sommer， N., Oertel， W.H., 2004]。静脉注射含有抗-淀粉样蛋白抗体的免疫球蛋白用于治疗阿尔茨海默病。j .神经。Neurosurg。精神病学75,1472-1474]来自5例AD患者的IVIg为期6个月的试验，并证明了IVIg治疗AD的进一步研究。(C) 2008爱思唯尔公司版权所有。
Intravenous immunoglobulin (IVIg) has been proposed as a potential agent for Alzheimer's disease (AD) immunotherapy because it contains antibodies against beta-amyloid (A beta). We carried out an open label dose-ranging study in 8 mild AD patients in which IVIg was added to approved AD therapies for 6 months, discontinued, and then resumed for another 9 months. Infusions were generally well-tolerated. Anti-A beta antibodies in the serum from AD patients increased in proportion to IVIg dose and had a shorter half-life than anti-hepatitis antibodies and total IgG. Plasma A beta levels increased transiently after each infusion. Cerebrospinal fluid A beta decreased significantly at 6 months, returned to baseline after washout and decreased again after IVIg was re-administered for an additional 9 months. Mini-mental state scores increased an average of 2.5 points after 6 months, returned to baseline during washout and remained stable during subsequent IVIg treatment. Our findings confirm and extend those obtained by Dodel et al. [Dodel, R.C., Du, Y., Depboylu, C., Hampel, H., Frolich, L., Haag, A., Hemmeter, U., Paulsen, S., Teipel, S.J., Brettschneider, S., Spottke, A., Nolker, C., Moller, H.J., Wei, X., Farlow, M., Sommer, N., Oertel, W.H., 2004. Intravenous immunoglobulins containing antibodies against beta-amyloid for the treatment of Alzheimer's disease. J. Neurol. Neurosurg. Psychiatry 75, 1472-1474] from a 6-month trial of IVIg in 5 AD patients and justify further studies of IVIg for treatment of AD. (C) 2008 Elsevier Inc. All rights reserved.