Regenerative therapy for Alzheimer's disease and cerebral amyloid angiopathy

痴呆症将成为全球最重要的健康问题之一。阿尔茨海默病的免疫治疗临床试验的令人沮丧的结果已经将科学的注意力从β淀粉样蛋白(Abeta)合成的机制转移到清除。动脉搏动可能是间质液体和溶质排出的动力。随着年龄的增长或其他共病因素，动脉变硬，搏动的幅度降低，血管周围Abeta的引流效率降低，不溶的Abeta沉积在引流途径中。因此，使用血管活性药物增强血管周围引流通路的通畅性的治疗策略可能会促进Abeta的清除，并有助于防止老年人的认知能力下降。基于这一新兴范式，我们将启动一项临床试验，以确定这种血流动力学策略作为一种先发制人的药物是否有效地阻止认知功能下降。

Dementia will become one of the most important health problems worldwide. The discouraging results of the immunotherapy clinical trials for Alzheimer's disease have shifted scientific attention from the mechanism underlying beta amyloid (Abeta) synthesis toward clearance. Arterial pulsations may be the motive force for the drainage of interstitial fluid and solutes. As arteries stiffen with age or with other co-morbid factors, the amplitude of pulsations is reduced, perivascular drainage of Abeta becomes less efficient, and insoluble Abeta is deposited in the drainage pathways. Therefore, therapeutic strategies that enhance the patency of this perivascular drainage pathway with vasoactive drugs may facilitate Abeta removal and help prevent cognitive decline in the elderly. Based on this emerging paradigm, we will start a clinical trial to determine whether such a hemodynamic strategy is effective to halt cognitive decline as a preemptive medicine.