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Oosthoek M, Vermunt L, de Wilde A, Bongers B, Antwi-Berko D, Scheltens P, van Bokhoven P, Vijverberg EGB, Teunissen CE. Utilization of fluid-based biomarkers as endpoints in disease-modifying clinical trials for Alzheimer's disease: a systematic review. Alzheimers Res Ther 2024; 16:93. [PMID: 38678292 PMCID: PMC11055304 DOI: 10.1186/s13195-024-01456-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/12/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Clinical trials in Alzheimer's disease (AD) had high failure rates for several reasons, including the lack of biological endpoints. Fluid-based biomarkers may present a solution to measure biologically relevant endpoints. It is currently unclear to what extent fluid-based biomarkers are applied to support drug development. METHODS We systematically reviewed 272 trials (clinicaltrials.gov) with disease-modifying therapies starting between 01-01-2017 and 01-01-2024 and identified which CSF and/or blood-based biomarker endpoints were used per purpose and trial type. RESULTS We found that 44% (N = 121) of the trials employed fluid-based biomarker endpoints among which the CSF ATN biomarkers (Aβ (42/40), p/tTau) were used most frequently. In blood, inflammatory cytokines, NFL, and pTau were most frequently employed. Blood- and CSF-based biomarkers were used approximately equally. Target engagement biomarkers were used in 26% (N = 72) of the trials, mainly in drugs targeting inflammation and amyloid. Lack of target engagement markers is most prominent in synaptic plasticity/neuroprotection, neurotransmitter receptor, vasculature, epigenetic regulators, proteostasis and, gut-brain axis targeting drugs. Positive biomarker results did not always translate to cognitive effects, most commonly the small significant reductions in CSF tau isoforms that were seen following anti-Tau treatments. On the other hand, the positive anti-amyloid trials results on cognitive function were supported by clear effect in most fluid markers. CONCLUSIONS As the field moves towards primary prevention, we expect an increase in the use of fluid-based biomarkers to determine disease modification. Use of blood-based biomarkers will rapidly increase, but CSF markers remain important to determine brain-specific treatment effects. With improving techniques, new biomarkers can be found to diversify the possibilities in measuring treatment effects and target engagement. It remains important to interpret biomarker results in the context of the trial and be aware of the performance of the biomarker. Diversifying biomarkers could aid in the development of surrogacy biomarkers for different drug targets.
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Affiliation(s)
- Marlies Oosthoek
- Department of Laboratory Medicine, Neurochemistry Laboratory, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Lisa Vermunt
- Department of Laboratory Medicine, Neurochemistry Laboratory, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Arno de Wilde
- EQT Life Sciences, Johannes Vermeersplein 9, 1071 DV, Amsterdam, The Netherlands
| | - Bram Bongers
- Department of Laboratory Medicine, Neurochemistry Laboratory, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Daniel Antwi-Berko
- Department of Laboratory Medicine, Neurochemistry Laboratory, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Philip Scheltens
- EQT Life Sciences, Johannes Vermeersplein 9, 1071 DV, Amsterdam, The Netherlands
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | | | - Everard G B Vijverberg
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Department of Laboratory Medicine, Neurochemistry Laboratory, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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Nehra G, Promsan S, Yubolphan R, Chumboatong W, Vivithanaporn P, Maloney BJ, Lungkaphin A, Bauer B, Hartz AMS. Cognitive decline, Aβ pathology, and blood-brain barrier function in aged 5xFAD mice. Fluids Barriers CNS 2024; 21:29. [PMID: 38532486 PMCID: PMC10967049 DOI: 10.1186/s12987-024-00531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Patients with Alzheimer's disease (AD) develop blood-brain barrier dysfunction to varying degrees. How aging impacts Aβ pathology, blood-brain barrier function, and cognitive decline in AD remains largely unknown. In this study, we used 5xFAD mice to investigate changes in Aβ levels, barrier function, and cognitive decline over time. METHODS 5xFAD and wild-type (WT) mice were aged between 9.5 and 15.5 months and tested for spatial learning and reference memory with the Morris Water Maze (MWM). After behavior testing, mice were implanted with acute cranial windows and intravenously injected with fluorescent-labeled dextrans to assess their in vivo distribution in the brain by two-photon microscopy. Images were processed and segmented to obtain intravascular intensity, extravascular intensity, and vessel diameters as a measure of barrier integrity. Mice were sacrificed after in vivo imaging to isolate brain and plasma for measuring Aβ levels. The effect of age and genotype were evaluated for each assay using generalized or cumulative-linked logistic mixed-level modeling and model selection by Akaike Information Criterion (AICc). Pairwise comparisons were used to identify outcome differences between the two groups. RESULTS 5xFAD mice displayed spatial memory deficits compared to age-matched WT mice in the MWM assay, which worsened with age. Memory impairment was evident in 5xFAD mice by 2-threefold higher escape latencies, twofold greater cumulative distances until they reach the platform, and twice as frequent use of repetitive search strategies in the pool when compared with age-matched WT mice. Presence of the rd1 allele worsened MWM performance in 5xFAD mice at all ages but did not alter the rate of learning or probe trial outcomes. 9.5-month-old 15.5-month-old 5xFAD mice had twofold higher brain Aβ40 and Aβ42 levels (p < 0.001) and 2.5-fold higher (p = 0.007) plasma Aβ40 levels compared to 9.5-month-old 5xFAD mice. Image analysis showed that vessel diameters and intra- and extravascular dextran intensities were not significantly different in 9.5- and 15.5-month-old 5xFAD mice compared to age-matched WT mice. CONCLUSION 5xFAD mice continue to develop spatial memory deficits and increased Aβ brain levels while aging. Given in vivo MP imaging limitations, further investigation with smaller molecular weight markers combined with advanced imaging techniques would be needed to reliably assess subtle differences in barrier integrity in aged mice.
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Affiliation(s)
- Geetika Nehra
- Sanders-Brown Center On Aging, University of Kentucky, 760 Press Ave, 124 HKRB, Lexington, KY, 40536-0679, USA
| | - Sasivimon Promsan
- Sanders-Brown Center On Aging, University of Kentucky, 760 Press Ave, 124 HKRB, Lexington, KY, 40536-0679, USA
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ruedeemars Yubolphan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Faculty of Medicine Ramathibodi Hospital, Chakri Naruebodindra Medical Institute, Mahidol University, Nakhon Pathom, Thailand
| | - Wijitra Chumboatong
- Sanders-Brown Center On Aging, University of Kentucky, 760 Press Ave, 124 HKRB, Lexington, KY, 40536-0679, USA
| | - Pornpun Vivithanaporn
- Faculty of Medicine Ramathibodi Hospital, Chakri Naruebodindra Medical Institute, Mahidol University, Nakhon Pathom, Thailand
| | - Bryan J Maloney
- Sanders-Brown Center On Aging, University of Kentucky, 760 Press Ave, 124 HKRB, Lexington, KY, 40536-0679, USA
| | - Anusorn Lungkaphin
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Bjoern Bauer
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, USA
| | - Anika M S Hartz
- Sanders-Brown Center On Aging, University of Kentucky, 760 Press Ave, 124 HKRB, Lexington, KY, 40536-0679, USA.
- Department of Pharmacology and Nutritional Sciences, College of Medicine, University of Kentucky, Lexington, USA.
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Fang L, Li J, Cheng H, Liu H, Zhang C. Dual fluorescence images, transport pathway, and blood-brain barrier penetration of B-Met-W/O/W SE. Int J Pharm 2024; 652:123854. [PMID: 38280499 DOI: 10.1016/j.ijpharm.2024.123854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 01/07/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
Borneol is an aromatic traditional Chinese medicine that can improve the permeability of the blood-brain barrier (BBB), enter the brain, and promote the brain tissue distribution of many other drugs. In our previous study, borneol-metformin hydrochloride water/oil/water composite submicron emulsion (B-Met-W/O/W SE) was prepared using borneol and SE to promote BBB penetration, which significantly increased the brain distribution of Met. However, the dynamic images, transport pathway (uptake and efflux), promotion of BBB permeability, and mechanisms of B-Met-W/O/W SE before and after entering cells have not been clarified. In this study, rhodamine B and coumarin-6 were selected as water-soluble and oil-soluble fluorescent probes to prepare B-Met-W/O/W dual-fluorescent SE (B-Met-W/O/W DFSE) with concentric circle imaging. B-Met-W/O/W SE can be well taken up by brain microvascular endothelial cells (BMECs). The addition of three inhibitors (chlorpromazine hydrochloride, methyl-β-cyclodextrin, and amiloride hydrochloride) indicated that its main pathway may be clathrin-mediated and fossa protein-mediated endocytosis. Meanwhile, B-Met-W/O/W SE was obviously shown to inhibit the efflux of BMECs. Next, BMECs were cultured in the Transwell chamber to establish a BBB model, and Western blot was employed to detect the protein expressions of Occludin, Zona Occludens 1 (ZO-1), and p-glycoprotein (P-gp) after B-Met-W/O/W SE treatment. The results showed that B-Met-W/O/W SE significantly down-regulated the expression of Occludin, ZO-1, and P-gp, which increased the permeability of BBB, promoted drug entry into the brain through BBB, and inhibited BBB efflux. Furthermore, 11 differentially expressed genes (DEGs) and 7 related signaling pathways in BMECs treated with B-W/O/W SE were detected by transcriptome sequencing and verified by quantitative real-time polymerase chain reaction (qRT-PCR). These results provide a scientific experimental basis for the dynamic monitoring, transmembrane transport mode, and permeation-promoting mechanism of B-Met-W/O/W SE as a new brain-targeting drug delivery system.
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Affiliation(s)
- Liang Fang
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei 230012, Anhui, China; School of Pharmacy, Institute of Pharmacokinetics, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Anhui Genuine Chinese Medicinal Materials Quality Improvement Collaborative Innovation Center, Hefei 230012, Anhui, China; Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Junying Li
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei 230012, Anhui, China; School of Pharmacy, Institute of Pharmacokinetics, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Anhui Genuine Chinese Medicinal Materials Quality Improvement Collaborative Innovation Center, Hefei 230012, Anhui, China; Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Hongyan Cheng
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei 230012, Anhui, China; School of Pharmacy, Institute of Pharmacokinetics, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Anhui Genuine Chinese Medicinal Materials Quality Improvement Collaborative Innovation Center, Hefei 230012, Anhui, China; Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Huanhuan Liu
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei 230012, Anhui, China; School of Pharmacy, Institute of Pharmacokinetics, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Anhui Genuine Chinese Medicinal Materials Quality Improvement Collaborative Innovation Center, Hefei 230012, Anhui, China; Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Caiyun Zhang
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei 230012, Anhui, China; School of Pharmacy, Institute of Pharmacokinetics, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China; Anhui Genuine Chinese Medicinal Materials Quality Improvement Collaborative Innovation Center, Hefei 230012, Anhui, China; Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230012, China.
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Dubbelman MA, Hendriksen HMA, Harrison JE, Vijverberg EGB, Prins ND, Kroeze LA, Ottenhoff L, Van Leeuwenstijn MMSSA, Verberk IMW, Teunissen CE, van de Giessen EM, Van Harten AC, Van Der Flier WM, Sikkes SAM. Cognitive and Functional Change Over Time in Cognitively Healthy Individuals According to Alzheimer Disease Biomarker-Defined Subgroups. Neurology 2024; 102:e207978. [PMID: 38165338 PMCID: PMC10962908 DOI: 10.1212/wnl.0000000000207978] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/04/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES It is unclear to what extent cognitive outcome measures are sensitive to capture decline in Alzheimer disease (AD) prevention trials. We aimed to analyze the sensitivity to changes over time of a range of neuropsychological tests in several cognitively unimpaired, biomarker-defined patient groups. METHODS Cognitively unimpaired individuals from the Amsterdam Dementia Cohort and the SCIENCe project with available AD biomarkers, obtained from CSF, PET scans, and plasma at baseline, were followed over time (4.5 ± 3.1 years, range 0.6-18.9 years). Based on common inclusion criteria for clinical trials, we defined groups (amyloid, phosphorylated tau [p-tau], APOE ε4). Linear mixed models, adjusted for age, sex, and education, were used to estimate change over time in neuropsychological tests, a functional outcome, and 2 cognitive composite measures. Standardized regression coefficients of time in years (βtime) were reported as outcome of interest. We analyzed change over time with full follow-up, as well as with follow-up limited to 1.5 and 3 years. RESULTS We included 387 individuals (aged 61.7 ± 8.6 years; 44% female) in the following (partly overlapping) biomarker groups: APOE ε4 carriers (n = 212), amyloid-positive individuals (n = 109), amyloid-positive APOE ε4 carriers (n = 66), CSF p-tau-positive individuals (n = 127), plasma p-tau-positive individuals (n = 71), and amyloid and CSF p-tau-positive individuals (n = 50), or in a control group (normal biomarkers; n = 65). An executive functioning task showed most decline in all biomarker groups (βtime range -0.30 to -0.71), followed by delayed word list recognition (βtime range -0.18 to -0.50). Functional decline (βtime range -0.17 to -0.63) was observed in all, except the CSF and plasma tau-positive groups. Both composites showed comparable amounts of change (βtime range -0.12 to -0.62) in all groups, except plasma p-tau-positive individuals. When limiting original follow-up duration, many effects disappeared or even flipped direction. DISCUSSION In conclusion, functional, composite, and neuropsychological outcome measures across all cognitive domains detect changes over time in various biomarker-defined groups, with changes being most evident among individuals with more AD pathology. AD prevention trials should use sufficiently long follow-up duration and/or more sensitive outcome measures to optimally capture subtle cognitive changes over time.
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Affiliation(s)
- Mark A Dubbelman
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Heleen M A Hendriksen
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - John E Harrison
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Everard G B Vijverberg
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Niels D Prins
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lior A Kroeze
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lois Ottenhoff
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Mardou M S S A Van Leeuwenstijn
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Inge M W Verberk
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Elsmarieke M van de Giessen
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Argonde C Van Harten
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Wiesje M Van Der Flier
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Sietske A M Sikkes
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
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Odenkirk MT, Zheng X, Kyle JE, Stratton KG, Nicora CD, Bloodsworth KJ, Mclean CA, Masters CL, Monroe ME, Doecke JD, Smith RD, Burnum-Johnson KE, Roberts BR, Baker ES. Deciphering ApoE Genotype-Driven Proteomic and Lipidomic Alterations in Alzheimer's Disease Across Distinct Brain Regions. J Proteome Res 2024. [PMID: 38236019 DOI: 10.1021/acs.jproteome.3c00604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease with a complex etiology influenced by confounding factors such as genetic polymorphisms, age, sex, and race. Traditionally, AD research has not prioritized these influences, resulting in dramatically skewed cohorts such as three times the number of Apolipoprotein E (APOE) ε4-allele carriers in AD relative to healthy cohorts. Thus, the resulting molecular changes in AD have previously been complicated by the influence of apolipoprotein E disparities. To explore how apolipoprotein E polymorphism influences AD progression, 62 post-mortem patients consisting of 33 AD and 29 controls (Ctrl) were studied to balance the number of ε4-allele carriers and facilitate a molecular comparison of the apolipoprotein E genotype. Lipid and protein perturbations were assessed across AD diagnosed brains compared to Ctrl brains, ε4 allele carriers (APOE4+ for those carrying 1 or 2 ε4s and APOE4- for non-ε4 carriers), and differences in ε3ε3 and ε3ε4 Ctrl brains across two brain regions (frontal cortex (FCX) and cerebellum (CBM)). The region-specific influences of apolipoprotein E on AD mechanisms showcased mitochondrial dysfunction and cell proteostasis at the core of AD pathophysiology in the post-mortem brains, indicating these two processes may be influenced by genotypic differences and brain morphology.
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Affiliation(s)
- Melanie T Odenkirk
- Department of Chemistry, North Carolina State University, Raleigh, North Carolina 27606, United States of America
| | - Xueyun Zheng
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - Jennifer E Kyle
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - Kelly G Stratton
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - Carrie D Nicora
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - Kent J Bloodsworth
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - Catriona A Mclean
- Anatomical Pathology, Alfred Hospital, Prahran, Victoria 3181, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Colin L Masters
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Matthew E Monroe
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - James D Doecke
- CSIRO Health and Biosecurity, Herston, Queensland 4029, Australia
| | - Richard D Smith
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - Kristin E Burnum-Johnson
- Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington 99354, United States of America
| | - Blaine R Roberts
- Department of Biochemistry, Emory University, Atlanta, Georgia 30322, United States of America
- Department of Neurology, Emory University, Atlanta, Georgia 30322, United States of America
| | - Erin S Baker
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, United States of America
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6
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Isik AT, Kaya D, Gokden M. Brain Banking in Dementia Studies. Methods Mol Biol 2024; 2785:287-295. [PMID: 38427200 DOI: 10.1007/978-1-0716-3774-6_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
It is now well-established practice in dementia that one clinical entity may be caused by various neurodegenerative disorders, each with different histopathological findings, whereas neuropathologically confirmed patients may have different, unusual, and atypical clinical manifestations.This inconsistency in dementia patients leads to neuropathological examination of cases, and neuropathological examination seems to be an inevitable part of dementia practice, at least until all clinical entities are properly identified for humans.Additionally, the development of disease-modifying therapies and confirmation of the actual accurate diagnosis of the neurodegenerative disease that the drug is thought to modify or act upon are of great importance for neuropathological evaluation in brain banks.Neuropathological processes coexisting among patients diagnosed with established clinical criteria or international guidelines have provided a new perspective in the context of drug development.Here, we review our routinely used methodology in the context of the brain banking process.
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Affiliation(s)
- Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Derya Kaya
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Murat Gokden
- Division of Neuropathology, Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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7
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Daly T. Improving Clinical Trials of Antioxidants in Alzheimer's Disease. J Alzheimers Dis 2024; 99:S171-S181. [PMID: 37781800 DOI: 10.3233/jad-230308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Maintaining diversity in drug development in research into Alzheimer's disease (AD) is necessary to avoid over-reliance on targeting AD neuropathology. Treatments that reduce or prevent the generation of oxidative stress, frequently cited for its causal role in the aging process and AD, could be useful in at-risk populations or diagnosed AD patients. However, in this review, it is argued that clinical research into antioxidants in AD could provide more useful feedback as to the therapeutic value of the oxidative stress theory of AD. Improving comparability between randomized controlled trials (RCTs) is vital from a waste-reduction and priority-setting point of view for AD clinical research. For as well as attempting to improve meaningful outcomes for patients, RCTs of antioxidants in AD should strive to maximize the extraction of clinically useful information and actionable feedback from trial outcomes. Solutions to maximize information flow from RCTs of antioxidants in AD are offered here in the form of checklist questions to improve ongoing and future trials centered around the following dimensions: adhesion to reporting guidelines like CONSORT, biomarker enrichment, simple tests of treatment, and innovative trial design.
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Affiliation(s)
- Timothy Daly
- Science Norms Democracy UMR 8011, Sorbonne Université, Paris, France
- Bioethics Program, FLACSO Argentina, Buenos Aires, Argentina
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8
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Anderson C, Bucholc M, McClean PL, Zhang SD. The Potential of a Stratified Approach to Drug Repurposing in Alzheimer's Disease. Biomolecules 2023; 14:11. [PMID: 38275752 PMCID: PMC10813465 DOI: 10.3390/biom14010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
Alzheimer's disease (AD) is a complex neurodegenerative condition that is characterized by the build-up of amyloid-beta plaques and neurofibrillary tangles. While multiple theories explaining the aetiology of the disease have been suggested, the underlying cause of the disease is still unknown. Despite this, several modifiable and non-modifiable factors that increase the risk of developing AD have been identified. To date, only eight AD drugs have ever gained regulatory approval, including six symptomatic and two disease-modifying drugs. However, not all are available in all countries and high costs associated with new disease-modifying biologics prevent large proportions of the patient population from accessing them. With the current patient population expected to triple by 2050, it is imperative that new, effective, and affordable drugs become available to patients. Traditional drug development strategies have a 99% failure rate in AD, which is far higher than in other disease areas. Even when a drug does reach the market, additional barriers such as high cost and lack of accessibility prevent patients from benefiting from them. In this review, we discuss how a stratified medicine drug repurposing approach may address some of the limitations and barriers that traditional strategies face in relation to drug development in AD. We believe that novel, stratified drug repurposing studies may expedite the discovery of alternative, effective, and more affordable treatment options for a rapidly expanding patient population in comparison with traditional drug development methods.
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Affiliation(s)
- Chloe Anderson
- Personalised Medicine Centre, School of Medicine, Altnagelvin Hospital Campus, Ulster University, Glenshane Road, Derry/Londonderry BT47 6SB, UK;
| | - Magda Bucholc
- School of Computing, Engineering and Intelligent Systems, Magee Campus, Ulster University, Northland Road, Derry/Londonderry BT48 7JL, UK
| | - Paula L. McClean
- Personalised Medicine Centre, School of Medicine, Altnagelvin Hospital Campus, Ulster University, Glenshane Road, Derry/Londonderry BT47 6SB, UK;
| | - Shu-Dong Zhang
- Personalised Medicine Centre, School of Medicine, Altnagelvin Hospital Campus, Ulster University, Glenshane Road, Derry/Londonderry BT47 6SB, UK;
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9
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Doherty T, Yao Z, Khleifat AAL, Tantiangco H, Tamburin S, Albertyn C, Thakur L, Llewellyn DJ, Oxtoby NP, Lourida I, Ranson JM, Duce JA. Artificial intelligence for dementia drug discovery and trials optimization. Alzheimers Dement 2023; 19:5922-5933. [PMID: 37587767 DOI: 10.1002/alz.13428] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/26/2023] [Accepted: 07/05/2023] [Indexed: 08/18/2023]
Abstract
Drug discovery and clinical trial design for dementia have historically been challenging. In part these challenges have arisen from patient heterogeneity, length of disease course, and the tractability of a target for the brain. Applying big data analytics and machine learning tools for drug discovery and utilizing them to inform successful clinical trial design has the potential to accelerate progress. Opportunities arise at multiple stages in the therapy pipeline and the growing availability of large medical data sets opens possibilities for big data analyses to answer key questions in clinical and therapeutic challenges. However, before this goal is reached, several challenges need to be overcome and only a multi-disciplinary approach can promote data-driven decision-making to its full potential. Herein we review the current state of machine learning applications to clinical trial design and drug discovery, while presenting opportunities and recommendations that can break down the barriers to implementation.
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Affiliation(s)
- Thomas Doherty
- Eisai Europe Ltd, Hatfield, UK
- University of Westminster, London, UK
| | | | - Ahmad A L Khleifat
- Institute of Psychiatry, Psychology & Neuroscience, Department of Basic and Clinical Neuroscience, King's College London, London, UK
| | | | - Stefano Tamburin
- University of Verona, Department of Neurosciences, Biomedicine & Movement Sciences, Verona, Italy
| | - Chris Albertyn
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lokendra Thakur
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David J Llewellyn
- University of Exeter Medical School, Exeter, UK
- Alan Turing Institute, London, UK
| | - Neil P Oxtoby
- UCL Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | | | | | - James A Duce
- The ALBORADA Drug Discovery Institute, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
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10
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Simard MA, Kozlowski D, Segal J, Messer M, Ocay DD, Saari T, Ferland CE, Larivière V. Trends in Brain Research: A Bibliometric Analysis. Can J Neurol Sci 2023:1-11. [PMID: 37933094 DOI: 10.1017/cjn.2023.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
BACKGROUND Bibliometrics methods have allowed researchers to assess the popularity of brain research through the ever-growing number of brain-related research papers. While many topics of brain research have been covered by previous studies, there is no comprehensive overview of the evolution of brain research and its various specialties and funding practices over a long period of time. OBJECTIVE This paper aims to (1) determine how brain research has evolved over time in terms of number of papers, (2) countries' relative and absolute positioning in terms of papers and impact, and (3) how those various trends vary by area. METHODS Using a list of validated keywords, we extracted brain-related articles and journals indexed in the Web of Science over the 1991-2020 period, for a total of 2,467,708 papers. We used three indicators to perform: number of papers, specialization, and research impact. RESULTS Our results show that over the past 30 years, the number of brain-related papers has grown at a faster pace than science in general, with China being at the forefront of this growth. Different patterns of specialization among countries and funders were also underlined. Finally, the NIH, the European Commission, the National Natural Science Foundation of China, the UK Medical Research Council, and the German Research Foundation were found to be among the top funders. CONCLUSION Despite data-related limitations, our findings provide a large-scope snapshot of the evolution of brain research and its funding, which may be used as a baseline for future studies on these topics.
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Affiliation(s)
- Marc-André Simard
- École de bibliothéconomie et des sciences de l'information, Université de Montréal, Montréal, QC, Canada
| | - Diego Kozlowski
- École de bibliothéconomie et des sciences de l'information, Université de Montréal, Montréal, QC, Canada
| | - Julia Segal
- Brain Canada Foundation, Montréal, QC, Canada
| | - Mia Messer
- Brain Canada Foundation, Montréal, QC, Canada
| | | | - Toni Saari
- Department of Neurology, University of Eastern Finland, Kuopio, Finland
- NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | | | - Vincent Larivière
- École de bibliothéconomie et des sciences de l'information, Université de Montréal, Montréal, QC, Canada
- Observatoire des sciences et des technologies, Université du Québec à Montréal, Montréal, QC, Canada
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11
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Boxer AL, Sperling R. Accelerating Alzheimer's therapeutic development: The past and future of clinical trials. Cell 2023; 186:4757-4772. [PMID: 37848035 PMCID: PMC10625460 DOI: 10.1016/j.cell.2023.09.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/03/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
Alzheimer's disease (AD) research has entered a new era with the recent positive phase 3 clinical trials of the anti-Aβ antibodies lecanemab and donanemab. Why did it take 30 years to achieve these successes? Developing potent therapies for reducing fibrillar amyloid was key, as was selection of patients at relatively early stages of disease. Biomarkers of the target pathologies, including amyloid and tau PET, and insights from past trials were also critical to the recent successes. Moving forward, the challenge will be to develop more efficacious therapies with greater efficiency. Novel trial designs, including combination therapies and umbrella and basket protocols, will accelerate clinical development. Better diversity and inclusivity of trial participants are needed, and blood-based biomarkers may help to improve access for medically underserved groups. Incentivizing innovation in both academia and industry through public-private partnerships, collaborative mechanisms, and the creation of new career paths will be critical to build momentum in these exciting times.
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Affiliation(s)
- Adam L Boxer
- Memory and Aging Center, Department of Neurology, Weill Institute of Neuroscience, University of California, San Francisco, San Francisco, CA, USA.
| | - Reisa Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, MassGeneral Brigham, Harvard Medical School, Boston, MA, USA
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12
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Scheijbeler EP, de Haan W, Stam CJ, Twisk JWR, Gouw AA. Longitudinal resting-state EEG in amyloid-positive patients along the Alzheimer's disease continuum: considerations for clinical trials. Alzheimers Res Ther 2023; 15:182. [PMID: 37858173 PMCID: PMC10585755 DOI: 10.1186/s13195-023-01327-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND To enable successful inclusion of electroencephalography (EEG) outcome measures in Alzheimer's disease (AD) clinical trials, we retrospectively mapped the progression of resting-state EEG measures over time in amyloid-positive patients with mild cognitive impairment (MCI) or dementia due to AD. METHODS Resting-state 21-channel EEG was recorded in 148 amyloid-positive AD patients (MCI, n = 88; dementia due to AD, n = 60). Two or more EEG recordings were available for all subjects. We computed whole-brain and regional relative power (i.e., theta (4-8 Hz), alpha1 (8-10 Hz), alpha2 (10-13 Hz), beta (13-30 Hz)), peak frequency, signal variability (i.e., theta permutation entropy), and functional connectivity values (i.e., alpha and beta corrected amplitude envelope correlation, theta phase lag index, weighted symbolic mutual information, inverted joint permutation entropy). Whole-group linear mixed effects models were used to model the development of EEG measures over time. Group-wise analysis was performed to investigate potential differences in change trajectories between the MCI and dementia subgroups. Finally, we estimated the minimum sample size required to detect different treatment effects (i.e., 50% less deterioration, stabilization, or 50% improvement) on the development of EEG measures over time, in hypothetical clinical trials of 1- or 2-year duration. RESULTS Whole-group analysis revealed significant regional and global oscillatory slowing over time (i.e., increased relative theta power, decreased beta power), with strongest effects for temporal and parieto-occipital regions. Disease severity at baseline influenced the EEG measures' rates of change, with fastest deterioration reported in MCI patients. Only AD dementia patients displayed a significant decrease of the parieto-occipital peak frequency and theta signal variability over time. We estimate that 2-year trials, focusing on amyloid-positive MCI patients, require 36 subjects per arm (2 arms, 1:1 randomization, 80% power) to detect a stabilizing treatment effect on temporal relative theta power. CONCLUSIONS Resting-state EEG measures could facilitate early detection of treatment effects on neuronal function in AD patients. Their sensitivity depends on the region-of-interest and disease severity of the study population. Conventional spectral measures, particularly recorded from temporal regions, present sensitive AD treatment monitoring markers.
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Affiliation(s)
- Elliz P Scheijbeler
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands.
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands.
| | - Willem de Haan
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
| | - Cornelis J Stam
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
| | - Alida A Gouw
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
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13
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Cummings JL, Gonzalez MI, Pritchard MC, May PC, Toledo-Sherman LM, Harris GA. The therapeutic landscape of tauopathies: challenges and prospects. Alzheimers Res Ther 2023; 15:168. [PMID: 37803386 PMCID: PMC10557207 DOI: 10.1186/s13195-023-01321-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
Tauopathies are a group of neurodegenerative disorders characterized by the aggregation of the microtubule-associated protein tau. Aggregates of misfolded tau protein are believed to be implicated in neuronal death, which leads to a range of symptoms including cognitive decline, behavioral change, dementia, and motor deficits. Currently, there are no effective treatments for tauopathies. There are four clinical candidates in phase III trials and 16 in phase II trials. While no effective treatments are currently approved, there is increasing evidence to suggest that various therapeutic approaches may slow the progression of tauopathies or improve symptoms. This review outlines the landscape of therapeutic drugs (indexed through February 28, 2023) that target tau pathology and describes drug candidates in clinical development as well as those in the discovery and preclinical phases. The review also contains information on notable therapeutic programs that are inactive or that have been discontinued from development.
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Affiliation(s)
- Jeffrey L Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas (UNLV), Henderson, NV, USA
| | | | | | - Patrick C May
- ADvantage Neuroscience Consulting LLC, Fort Wayne, IN, USA
| | | | - Glenn A Harris
- Rainwater Charitable Foundation, 777 Main Street, Suite 2250, Fort Worth, TX, 76102, USA.
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14
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Forno G, Parra MA, Thumala D, Villagra R, Cerda M, Zitko P, Ibañez A, Lillo P, Slachevsky A. The "when" matters: Evidence from memory markers in the clinical continuum of Alzheimer's disease. Neuropsychology 2023; 37:753-768. [PMID: 37227845 PMCID: PMC10522796 DOI: 10.1037/neu0000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE Cognitive assessment able to detect impairments in the early neuropathological stages of Alzheimer's disease (AD) is urgently needed. The visual short-term memory binding task (VSTMBT) and the Free and Cued Selective Reminding Test (FCSRT) have been recommended by the neurodegenerative disease working group as promising tests to aid in the early detection of AD. In this study, we investigated their complementary value across the clinical stages of the AD continuum. METHOD One hundred and seventeen older adults with subjective cognitive complaint (SCC), 79 with mild cognitive impairment (MCI), 31 patients with AD dementia (ADD), and 37 cognitively unimpaired (CU) subjects, underwent assessment with the VSTMBT and the picture version of the Spanish FCSRT. RESULTS After controlling for multiple comparisons, significant differences were found across groups. The VSTMBT was the only test that "marginally" differentiated between CU and SCC (d = 0.47, p = .052). Moreover, whereas the FCSRT showed a gradient (CU = SCC) > MCI > ADD, the VSTMBT gradient was CU > SCC > (MCI = ADD) suggesting that conjunctive binding deficits assessed by the latter may be sensitive to the very early stages of the disease. CONCLUSIONS Our results suggest that the VSTMBT and the FCSRT are sensitive to the clinical continuum of AD. Whereas the former detects changes in the early prodromal stages, the latter is more sensitive to the advanced prodromal stages of AD. These novel tests can aid in the early detection, monitor disease progression and response to treatment, and thus support drug development programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Gonzalo Forno
- School of Psychology, Universidad de los Andes, Santiago, Chile
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Daniela Thumala
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Psychology Department, Faculty of Social Sciences, University of Chile, Santiago, Chile
- Interuniversity Center on Healthy Aging (Plan to Strengthen State Universities, Chilean Ministry of Education RED21993). Santiago, Chile
| | - Roque Villagra
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Centro de Parkinson (CENPAR), Santiago, Chile
| | - Mauricio Cerda
- Programa de Biología Integrativa, Instituto de Ciencias Biomédicas y Centro de Informática Médica y Telemedicina, Facultad de Medicina, Universidad de Chile
| | - Pedro Zitko
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Departamento de Salud Global, Escuela de Salud Pública, Universidad de Chile
- Department of Health Services & Population Research, IoPPN, King’s College London
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, and National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), California, US; & Trinity College Dublin (TCD), Dublin, Ireland
| | - Patricia Lillo
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - Andrea Slachevsky
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Institute of Biomedical Science (ICBM), Neuroscience and East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador, SSMO & Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
- East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
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15
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Fay SM, García-Toro M, Henao LH, Villegas ÁA, Lopera F. Creativity During COVID-19: Evaluating an Online TimeSlips Storytelling Program for People Living With Dementia During Quarantine in Colombia. THE GERONTOLOGIST 2023; 63:1279-1288. [PMID: 36660858 DOI: 10.1093/geront/gnac191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Since its first implementation in 1998, evidence has been presented of the positive impact of the TimeSlips storytelling method for people with dementia in long-term care (LTC) settings. This article extends this evidence in important new directions: it is the longest TimeSlips study to date and the first to evaluate the feasibility of online delivery of the method (in response to the coronavirus disease 2019 [COVID-19] quarantine) and the impact of this on the personhood, quality of life, and psychological well-being of Spanish-speaking participants in non-LTC settings in the Global South. RESEARCH DESIGN AND METHODS Trained facilitators provided weekly, 1-hr TimeSlips sessions via Zoom over 32 consecutive weeks to 8 participants with dementia. Semistructured interviews of participants and care partners were conducted within 1 week of the final intervention. Thematic analysis evaluated the resultant qualitative data. RESULTS This online implementation of the TimeSlips creative expression (CE) method reinforced key facets of participants' personhood (self-expression and self-perception, which led in turn to increased care partner appreciation), had a positive impact on key domains of quality of life (mood, energy levels, and cognitive function), and stimulated a key aspect of psychological well-being (the formation and maintenance of social ties). DISCUSSION AND IMPLICATIONS The online delivery of the TimeSlips method to participants who remain in their own homes is feasible and effective. Future research should compare the benefits of online versus face-to-face delivery of this CE method.
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Affiliation(s)
- Stephen M Fay
- Faculty of Arts and Social Sciences, School of Literature and Languages, University of Surrey, Guildford, UK
| | - Maritza García-Toro
- Facultad de Ciencias de la Salud, Grupo de Investigación en Neurociencias y Envejecimiento (GISAM), Corporación Universitaria Remington, Medellín, Colombia
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
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16
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Daly T. Amyloid-β, vitamin D: why we should triangulate conclusions about therapeutic targets in Alzheimer's disease. Neurol Sci 2023; 44:3321-3322. [PMID: 37145228 DOI: 10.1007/s10072-023-06840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/02/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Timothy Daly
- Science Norms Democracy UMR 8011, Sorbonne Université, Paris, France.
- Bioethics Program, FLACSO Argentina, Buenos Aires, Argentina.
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17
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Wang C, Shao S, Li N, Zhang Z, Zhang H, Liu B. Advances in Alzheimer's Disease-Associated Aβ Therapy Based on Peptide. Int J Mol Sci 2023; 24:13110. [PMID: 37685916 PMCID: PMC10487952 DOI: 10.3390/ijms241713110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
Alzheimer's disease (AD) urgently needs innovative treatments due to the increasing aging population and lack of effective drugs and therapies. The amyloid fibrosis of AD-associated β-amyloid (Aβ) that could induce a series of cascades, such as oxidative stress and inflammation, is a critical factor in the progression of AD. Recently, peptide-based therapies for AD are expected to be great potential strategies for the high specificity to the targets, low toxicity, fast blood clearance, rapid cell and tissue permeability, and superior biochemical characteristics. Specifically, various chiral amino acids or peptide-modified interfaces draw much attention as effective manners to inhibit Aβ fibrillation. On the other hand, peptide-based inhibitors could be obtained through affinity screening such as phage display or by rational design based on the core sequence of Aβ fibrosis or by computer aided drug design based on the structure of Aβ. These peptide-based therapies can inhibit Aβ fibrillation and reduce cytotoxicity induced by Aβ aggregation and some have been shown to relieve cognition in AD model mice and reduce Aβ plaques in mice brains. This review summarizes the design method and characteristics of peptide inhibitors and their effect on the amyloid fibrosis of Aβ. We further describe some analysis methods for evaluating the inhibitory effect and point out the challenges in these areas, and possible directions for the design of AD drugs based on peptides, which lay the foundation for the development of new effective drugs in the future.
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Affiliation(s)
- Cunli Wang
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Lingshui Road, Dalian 116024, China; (C.W.); (S.S.); (N.L.); (Z.Z.); (H.Z.)
| | - Shuai Shao
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Lingshui Road, Dalian 116024, China; (C.W.); (S.S.); (N.L.); (Z.Z.); (H.Z.)
- Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Dalian 116024, China
| | - Na Li
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Lingshui Road, Dalian 116024, China; (C.W.); (S.S.); (N.L.); (Z.Z.); (H.Z.)
- Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Dalian 116024, China
| | - Zhengyao Zhang
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Lingshui Road, Dalian 116024, China; (C.W.); (S.S.); (N.L.); (Z.Z.); (H.Z.)
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin 124221, China
| | - Hangyu Zhang
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Lingshui Road, Dalian 116024, China; (C.W.); (S.S.); (N.L.); (Z.Z.); (H.Z.)
- Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Dalian 116024, China
| | - Bo Liu
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Lingshui Road, Dalian 116024, China; (C.W.); (S.S.); (N.L.); (Z.Z.); (H.Z.)
- Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Dalian 116024, China
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18
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Simon PYR, Bus J, David R. [Alzheimer's disease, amyloid-b peptides and ubiquitin-proteasome system: Therapeutic perspectives]. Med Sci (Paris) 2023; 39:643-649. [PMID: 37695154 DOI: 10.1051/medsci/2023094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
The Alzheimer's disease - an age-related neurodegenerative disorder leading to a progressive cognitive impairment - is characterized by an intracerebral accumulation of soluble β-amyloid (Aβ) oligomers, followed by the appearance of abnormally ubiquitinylated neurofibrillary tangles - a process associated with a chronic inflammation. The systematic presence of ubiquitinylated inclusions reflects a decrease in the proteasome activity due to (and contributing to) the presence of Aβ oligomers - a central dysfunction in the etiology of the disease. The involvement of the ubiquitin-proteasome system opens new therapeutic perspectives for both prevention and treatment.
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Affiliation(s)
| | - Johanna Bus
- Communication, hôpital d'instruction des armées Sainte-Anne, 83800 Toulon, France
| | - Renaud David
- Centre hospitalier universitaire de Nice, hôpital Cimiez, 06000 Nice, France
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19
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Comi G, Leocani L, Tagliavini F. Preserving the brain: forum on neurodegenerative diseases. Neurol Sci 2023; 44:2613-2616. [PMID: 37002504 PMCID: PMC10257600 DOI: 10.1007/s10072-023-06721-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Giancarlo Comi
- Department of Neurorehabilitation Sciences, Casa Di Cura Igea, Milan, Italy.
| | - Letizia Leocani
- University Vita-Salute San Raffaele and Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), Scientific Institute San Raffaele, Milan, Italy
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20
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Verdi S, Rutherford S, Fraza C, Tosun D, Altmann A, Raket LL, Schott JM, Marquand AF, Cole JH. Personalising Alzheimer's Disease progression using brain atrophy markers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.15.23291418. [PMID: 37398392 PMCID: PMC10312850 DOI: 10.1101/2023.06.15.23291418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Neuroanatomical normative modelling can capture individual variability in Alzheimer's Disease (AD). We used neuroanatomical normative modelling to track individuals' disease progression in people with mild cognitive impairment (MCI) and patients with AD. METHODS Cortical thickness and subcortical volume neuroanatomical normative models were generated using healthy controls (n~58k). These models were used to calculate regional Z-scores in 4361 T1-weighted MRI time-series scans. Regions with Z-scores <-1.96 were classified as outliers and mapped on the brain, and also summarised by total outlier count (tOC). RESULTS Rate of change in tOC increased in AD and in people with MCI who converted to AD and correlated with multiple non-imaging markers. Moreover, a higher annual rate of change in tOC increased the risk of MCI progression to AD. Brain Z-score maps showed that the hippocampus had the highest rate of atrophy change. CONCLUSIONS Individual-level atrophy rates can be tracked by using regional outlier maps and tOC.
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Affiliation(s)
- Serena Verdi
- Centre for Medical Image Computing, University College London, London, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Saige Rutherford
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, 6525EN, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, 6525EN, the Netherlands
| | - Charlotte Fraza
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, 6525EN, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, 6525EN, the Netherlands
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Andre Altmann
- Centre for Medical Image Computing, University College London, London, UK
| | - Lars Lau Raket
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Andre F Marquand
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, 6525EN, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, 6525EN, the Netherlands
| | - James H Cole
- Centre for Medical Image Computing, University College London, London, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
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21
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Mehta RI, Carpenter JS, Mehta RI, Haut MW, Wang P, Ranjan M, Najib U, D'Haese PF, Rezai AR. Ultrasound-mediated blood-brain barrier opening uncovers an intracerebral perivenous fluid network in persons with Alzheimer's disease. Fluids Barriers CNS 2023; 20:46. [PMID: 37328855 DOI: 10.1186/s12987-023-00447-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Focused ultrasound (FUS)-mediated blood-brain barrier (BBB) opening is under investigation as a therapeutic modality for neurodegeneration, yet its effects in humans are incompletely understood. Here, we assessed physiologic responses to FUS administered in multifocal brain sites of persons with Alzheimer's disease (AD). METHODS At a tertiary neuroscience institute, eight participants with AD (mean age 65, 38% F) enrolled in a phase 2 clinical trial underwent three successive targeted BBB opening procedures at 2 week intervals using a 220 kHz FUS transducer in combination with systemically administered microbubbles. In all, 77 treatment sites were evaluated and encompassed hippocampal, frontal, and parietal brain regions. Post-FUS imaging changes, including susceptibility effects and spatiotemporal gadolinium-based contrast agent enhancement patterns, were analyzed using serial 3.0-Tesla MRI. RESULTS Post-FUS MRI revealed expected intraparenchymal contrast extravasation due to BBB opening at all targeted brain sites. Immediately upon BBB opening, hyperconcentration of intravenously-administered contrast tracer was consistently observed around intracerebral veins. Following BBB closure, within 24-48 h of FUS intervention, permeabilization of intraparenchymal veins was observed and persisted for up to one week. Notably, extraparenchymal meningeal venous permeabilization and associated CSF effusions were also elicited and persisted up to 11 days post FUS treatment, prior to complete spontaneous resolution in all participants. Mild susceptibility effects were detected, however no overt intracranial hemorrhage or other serious adverse effects occurred in any participant. CONCLUSIONS FUS-mediated BBB opening is safely and reproducibly achieved in multifocal brain regions of persons with AD. Post-FUS tracer enhancement phenomena suggest the existence of a brain-wide perivenous fluid efflux pathway in humans and demonstrate reactive physiological changes involving these conduit spaces in the delayed, subacute phase following BBB disruption. The delayed reactive venous and perivenous changes are consistent with a dynamic, zonal exudative response to upstream capillary manipulation. Further preclinical and clinical investigations of these FUS-related imaging phenomena and of intracerebral perivenous compartment changes are needed to elucidate physiology of this pathway as well as biological effects of FUS administered with and without adjuvant neurotherapeutics. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03671889, registered 9/14/2018.
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Affiliation(s)
- Rashi I Mehta
- Department of Neuroradiology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA.
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA.
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA.
| | - Jeffrey S Carpenter
- Department of Neuroradiology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
| | - Rupal I Mehta
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Marc W Haut
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, 26506, USA
- Department of Neurology, West Virginia University, Morgantown, WV, 26506, USA
| | - Peng Wang
- Department of Neuroradiology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
| | - Manish Ranjan
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
- Department of Neurosurgery, West Virginia University, Morgantown, WV, 26506, USA
| | - Umer Najib
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
- Department of Neurology, West Virginia University, Morgantown, WV, 26506, USA
| | | | - Ali R Rezai
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
- Department of Neurosurgery, West Virginia University, Morgantown, WV, 26506, USA
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22
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Rudge JD. The Lipid Invasion Model: Growing Evidence for This New Explanation of Alzheimer's Disease. J Alzheimers Dis 2023:JAD221175. [PMID: 37302030 PMCID: PMC10357195 DOI: 10.3233/jad-221175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Lipid Invasion Model (LIM) is a new hypothesis for Alzheimer's disease (AD) which argues that AD is a result of external lipid invasion to the brain, following damage to the blood-brain barrier (BBB). The LIM provides a comprehensive explanation of the observed neuropathologies associated with the disease, including the lipid irregularities first described by Alois Alzheimer himself, and accounts for the wide range of risk factors now identified with AD, all of which are also associated with damage to the BBB. This article summarizes the main arguments of the LIM, and new evidence and arguments in support of it. The LIM incorporates and extends the amyloid hypothesis, the current main explanation of the disease, but argues that the greatest cause of late-onset AD is not amyloid-β (Aβ) but bad cholesterol and free fatty acids, let into the brain by a damaged BBB. It suggests that the focus on Aβ is the reason why we have made so little progress in treating the disease in the last 30 years. As well as offering new perspectives for further research into the diagnosis, prevention, and treatment of AD, based on protecting and repairing the BBB, the LIM provides potential new insights into other neurodegenerative diseases such as Parkinson's disease and amyotrophic lateral sclerosis/motor neuron disease.
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23
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Wang C, Yang Y, Zhang X, Shi Z, Gao H, Zhong M, Fan Y, Zhang H, Liu B, Qing G. Secreted endogenous macrosomes reduce Aβ burden and ameliorate Alzheimer's disease. SCIENCE ADVANCES 2023; 9:eade0293. [PMID: 37235655 DOI: 10.1126/sciadv.ade0293] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 04/21/2023] [Indexed: 05/28/2023]
Abstract
Innovative therapeutic strategies are urgently needed for Alzheimer's disease (AD) due to the increasing size of the aging population and the lack of effective drug treatment. Here, we report the therapeutic effects of extracellular vesicles (EVs) secreted by microglia, including macrosomes and small EVs, on AD-associated pathology. Macrosomes strongly inhibited β-amyloid (Aβ) aggregation and rescued cells from Aβ misfolding-induced cytotoxicity. Furthermore, macrosome administration reduced Aβ plaques and ameliorated cognitive impairment in mice with AD. In contrast, small EVs slightly promoted Aβ aggregation and did not improve AD pathology. Proteomic analysis of small EVs and macrosomes revealed that macrosomes harbor several important neuroprotective proteins that inhibit Aβ misfolding. In particular, the small integral membrane protein 10-like protein 2B in macrosomes has been shown to inhibit Aβ aggregation. Our observations provide an alternative therapeutic strategy for the treatment of AD over conventional ineffective drug treatments.
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Affiliation(s)
- Cunli Wang
- School of Biomedical Engineering, Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Lingshui Road, Dalian 116024, P. R. China
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 457 Zhongshan Road, Dalian 116023, P. R. China
| | - Yiming Yang
- School of Biomedical Engineering, Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Lingshui Road, Dalian 116024, P. R. China
| | - Xiaoyu Zhang
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 457 Zhongshan Road, Dalian 116023, P. R. China
| | - Zhenqiang Shi
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 457 Zhongshan Road, Dalian 116023, P. R. China
| | - Huiling Gao
- College of Life and Health Sciences, Northeastern University, Shenyang 110819, P. R. China
| | - Manli Zhong
- College of Life and Health Sciences, Northeastern University, Shenyang 110819, P. R. China
| | - Yonggang Fan
- Health Sciences Institute, Key Laboratory of Major Chronic Diseases of Nervous System, China Medical University, Shenyang, 110122, P. R. China
| | - Hongyan Zhang
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 457 Zhongshan Road, Dalian 116023, P. R. China
| | - Bo Liu
- School of Biomedical Engineering, Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Lingshui Road, Dalian 116024, P. R. China
| | - Guangyan Qing
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 457 Zhongshan Road, Dalian 116023, P. R. China
- Key Laboratory of Nano-Bio Interface, Suzhou Institute of Nano-Tech and Nano-Bionics, Chinese Academy of Sciences, Suzhou, 215123, P. R. China
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24
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Han Y, Liu D, Cheng Y, Ji Q, Liu M, Zhang B, Zhou S. Maintenance of mitochondrial homeostasis for Alzheimer's disease: Strategies and challenges. Redox Biol 2023; 63:102734. [PMID: 37159984 DOI: 10.1016/j.redox.2023.102734] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/11/2023] Open
Abstract
Alzheimer's disease (AD) is one of the most common neurodegenerative diseases, and its early onset is closely related to mitochondrial energy metabolism. The brain is only 2% of body weight, but consumes 20% of total energy needs. Mitochondria are responsible for providing energy in cells, and maintaining their homeostasis ensures an adequate supply of energy to the brain. Mitochondrial homeostasis is constituted by mitochondrial quantity and quality control, which is dynamically regulated by mitochondrial energy metabolism, mitochondrial dynamics and mitochondrial quality control. Impaired energy metabolism of brain cells occurs early in AD, and maintaining mitochondrial homeostasis is a promising therapeutic target in the future. We summarized the mechanism of mitochondrial homeostasis in AD, its influence on the pathogenesis of early AD, strategies for maintaining mitochondrial homeostasis, and mitochondrial targeting strategies. This review concludes with the authors' opinions on future research and development for mitochondrial homeostasis of early AD.
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Affiliation(s)
- Ying Han
- Department of Pharmaceutics, School of Pharmacy, Air Force Medical University, Changle West Road 169, Xi'an, 710032, Shaanxi, China
| | - Daozhou Liu
- Department of Pharmaceutics, School of Pharmacy, Air Force Medical University, Changle West Road 169, Xi'an, 710032, Shaanxi, China
| | - Ying Cheng
- Department of Pharmaceutics, School of Pharmacy, Air Force Medical University, Changle West Road 169, Xi'an, 710032, Shaanxi, China
| | - Qifeng Ji
- Department of Pharmaceutics, School of Pharmacy, Air Force Medical University, Changle West Road 169, Xi'an, 710032, Shaanxi, China
| | - Miao Liu
- Department of Pharmaceutics, School of Pharmacy, Air Force Medical University, Changle West Road 169, Xi'an, 710032, Shaanxi, China
| | - Bangle Zhang
- Department of Pharmaceutics, School of Pharmacy, Air Force Medical University, Changle West Road 169, Xi'an, 710032, Shaanxi, China
| | - Siyuan Zhou
- Department of Pharmaceutics, School of Pharmacy, Air Force Medical University, Changle West Road 169, Xi'an, 710032, Shaanxi, China.
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Aghamohammad S, Hafezi A, Rohani M. Probiotics as functional foods: How probiotics can alleviate the symptoms of neurological disabilities. Biomed Pharmacother 2023; 163:114816. [PMID: 37150033 DOI: 10.1016/j.biopha.2023.114816] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/25/2023] [Accepted: 04/30/2023] [Indexed: 05/09/2023] Open
Abstract
Neurological disorders are diseases of the central nervous system with progressive loss of nervous tissue. One of the most difficult problems associated with neurological disorders is that there is no clear treatment for these diseases. In this review, the physiopathology of some neurodegenerative diseases, etiological causes, drugs used and their side effects, and finally the role of probiotics in controlling the symptoms of these neurodegenerative diseases are presented. Recently, researchers have focused more on the microbiome and the gut-brain axis, which may play a critical role in maintaining brain health. Probiotics are among the most important bacteria that have positive effects on the balance of homeostasis via influencing the microbiome. Other important functions of probiotics in alleviating symptoms of neurological disorders include anti-inflammatory properties, short-chain fatty acid production, and the production of various neurotransmitters. The effects of probiotics on the control of abnormalities seen in neurological disorders led to probiotics being referred to as "psychobiotic. Given the important role of the gut-brain axis and the imbalance of the gut microbiome in the etiology and symptoms of neurological disorders, probiotics could be considered safe agents that positively affect the balance of the microbiome as complementary treatment options for neurological disorders.
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Affiliation(s)
| | - Asal Hafezi
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Mahdi Rohani
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
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26
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Yang SJ, Wang JJ, Cheng P, Chen LX, Hu JM, Zhu GQ. Ginsenoside Rg1 in neurological diseases: From bench to bedside. Acta Pharmacol Sin 2023; 44:913-930. [PMID: 36380226 PMCID: PMC10104881 DOI: 10.1038/s41401-022-01022-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Ginseng has been used in China as a superior medicinal material for thousands of years that can nourish the five internal organs, calm the mind and benefit wisdom. Due to its anti-inflammatory, antioxidant and neuroprotective activities, one of the active components of ginseng, ginsenoside Rg1, has been extensively investigated in the remedy of brain disorders, especially dementia and depression. In this review, we summarized the research progress on the action mechanisms of Rg1 ameliorating depression-like behaviors, including inhibition of hyperfunction of hypothalamic-pituitary-adrenal (HPA) axis, regulation of synaptic plasticity and gut flora. Rg1 may alleviate Alzheimer's disease in the early phase, as well as in the middle-late phases through repairing dendrite, axon and microglia- and astrocyte-related inflammations. We also proposed that Rg1 could regulate memory state (the imbalance of working and aversive memory) caused by distinct stimuli. These laboratory studies would further the clinical trials on Rg1. From the prospective of drug development, we discussed the limitations of the present investigations and proposed our ideas to increase permeability and bioavailability of Rg1. Taken together, Rg1 has the potential to treat neuropsychiatric disorders, but a future in-depth investigation of the mechanisms is still required. In addition, drug development will benefit from the clinical trials in one specific neuropsychiatric disorder.
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Affiliation(s)
- Shao-Jie Yang
- Key Laboratory of Xin'an Medicine, the Ministry of Education and Key Laboratory of Molecular Biology (Brain diseases), Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Jing-Ji Wang
- The Second Affiliation Hospital of Anhui University of Chinese Medicine, Hefei, 230061, China.
| | - Ping Cheng
- Key Laboratory of Xin'an Medicine, the Ministry of Education and Key Laboratory of Molecular Biology (Brain diseases), Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Li-Xia Chen
- Key Laboratory of Xin'an Medicine, the Ministry of Education and Key Laboratory of Molecular Biology (Brain diseases), Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Jia-Min Hu
- Key Laboratory of Xin'an Medicine, the Ministry of Education and Key Laboratory of Molecular Biology (Brain diseases), Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Guo-Qi Zhu
- Key Laboratory of Xin'an Medicine, the Ministry of Education and Key Laboratory of Molecular Biology (Brain diseases), Anhui University of Chinese Medicine, Hefei, 230012, China.
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27
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Cummings J, Zhou Y, Lee G, Zhong K, Fonseca J, Cheng F. Alzheimer's disease drug development pipeline: 2023. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12385. [PMID: 37251912 PMCID: PMC10210334 DOI: 10.1002/trc2.12385] [Citation(s) in RCA: 64] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 05/31/2023]
Abstract
Introduction Drugs that prevent the onset, slow progression, or improve cognitive and behavioral symptoms of Alzheimer's disease (AD) are needed. Methods We searched ClinicalTrials.gov for all current Phase 1, 2 and 3 clinical trials for AD and mild cognitive impairment (MCI) attributed to AD. We created an automated computational database platform to search, archive, organize, and analyze the derived data. The Common Alzheimer's Disease Research Ontology (CADRO) was used to identify treatment targets and drug mechanisms. Results On the index date of January 1, 2023, there were 187 trials assessing 141 unique treatments for AD. Phase 3 included 36 agents in 55 trials; 87 agents were in 99 Phase 2 trials; and Phase 1 had 31 agents in 33 trials. Disease-modifying therapies were the most common drugs comprising 79% of drugs in trials. Twenty-eight percent of candidate therapies are repurposed agents. Populating all current Phase 1, 2, and 3 trials will require 57,465 participants. Discussion The AD drug development pipeline is advancing agents directed at a variety of target processes. HIGHLIGHTS There are currently 187 trials assessing 141 drugs for the treatment of Alzheimer's disease (AD).Drugs in the AD pipeline address a variety of pathological processes.More than 57,000 participants will be required to populate all currently registered trials.
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Affiliation(s)
- Jeffrey Cummings
- Department of Brain HealthChambers‐Grundy Center for Transformative NeuroscienceSchool of Integrated Health SciencesUniversity of Nevada, Las Vegas (UNLV)Las VegasNevadaUSA
- Department of Computer ScienceHoward R. Hughes College of EngineeringUniversity of Nevada, Las Vegas (UNLV)Las VegasNevadaUSA
| | - Yadi Zhou
- Genomic Medicine InstituteLerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Garam Lee
- Department of Brain HealthSchool of Integrated Health SciencesUniversity of Nevada, Las Vegas (UNLV)Las VegasNevadaUSA
| | - Kate Zhong
- Department of Brain HealthChambers‐Grundy Center for Transformative NeuroscienceSchool of Integrated Health SciencesUniversity of Nevada, Las Vegas (UNLV)Las VegasNevadaUSA
- Department of Computer ScienceHoward R. Hughes College of EngineeringUniversity of Nevada, Las Vegas (UNLV)Las VegasNevadaUSA
| | - Jorge Fonseca
- Department of Molecular MedicineCleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Feixiong Cheng
- Genomic Medicine InstituteLerner Research InstituteCleveland ClinicClevelandOhioUSA
- Department of Molecular MedicineCleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandOhioUSA
- Case Comprehensive Cancer CenterCase Western Reserve University School of MedicineClevelandOhioUSA
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Allué JA, Pascual‐Lucas M, Sarasa L, Castillo S, Sarasa M, Sáez ME, Abdel‐Latif S, Rissman RA, Terencio J. Clinical utility of an antibody-free LC-MS method to detect brain amyloid deposition in cognitively unimpaired individuals from the screening visit of the A4 Study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12451. [PMID: 37274930 PMCID: PMC10236000 DOI: 10.1002/dad2.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/08/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION This study explored the ability of plasma amyloid beta (Aβ)42/Aβ40 to identify brain amyloid deposition in cognitively unimpaired (CU) individuals. METHODS Plasma Aβ was quantified with an antibody-free high-performance liquid chromatography tandem mass spectrometry method from Araclon Biotech (ABtest-MS) in a subset of 731 CU individuals from the screening visit of the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) Study, to assess associations of Aβ42/Aβ40 with Aβ positron emission tomography (PET). RESULTS A model including Aβ42/Aβ40, age, apolipoprotein E ε4, and recruitment site identified Aβ PET status with an area under the curve of 0.88 and an overall accuracy of 81%. A plasma-based pre-screening step could save up to 42% of the total number of Aβ PET scans. DISCUSSION ABtest-MS accurately identified brain amyloid deposition in a population of CU individuals, supporting its implementation in AD secondary prevention trials to reduce recruitment time and costs. Although a certain degree of heterogeneity is inherent to large and multicentric trials, ABtest-MS could be more robust to pre-analytical bias compared to other immunoprecipitation mass spectrometry methods. HIGHLIGHTS Plasma amyloid beta (Aβ)42/Aβ40 accurately identified brain Aβ deposition in cognitively unimpaired individuals from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) Study.The inclusion of the recruitment site in the predictive models has a non-negligible effect.A plasma biomarker-based model could reduce recruitment costs in Alzheimer's disease secondary prevention trials.Antibody-free liquid chromatography mass spectrometry methods may be more robust to pre-analytical variability than other platforms.
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Affiliation(s)
| | | | | | | | | | | | - Sara Abdel‐Latif
- Alzheimer's Therapeutic Research Institute, Keck School of MedicineUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Robert A. Rissman
- Alzheimer's Therapeutic Research Institute, Keck School of MedicineUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
- Department of NeurosciencesUniversity of CaliforniaSan Diego, La JollaCaliforniaUSA
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Martins MM, Branco PS, Ferreira LM. Enhancing the Therapeutic Effect in Alzheimer's Disease Drugs: The role of Polypharmacology and Cholinesterase inhibitors. ChemistrySelect 2023. [DOI: 10.1002/slct.202300461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- M. Margarida Martins
- Department of Chemistry NOVA School of Science and Technology Campus da Caparica 2825-149 Caparica Portugal
| | - Paula S. Branco
- Department of Chemistry NOVA School of Science and Technology Campus da Caparica 2825-149 Caparica Portugal
| | - Luísa M. Ferreira
- Department of Chemistry NOVA School of Science and Technology Campus da Caparica 2825-149 Caparica Portugal
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Marshall LJ, Bailey J, Cassotta M, Herrmann K, Pistollato F. Poor Translatability of Biomedical Research Using Animals - A Narrative Review. Altern Lab Anim 2023; 51:102-135. [PMID: 36883244 DOI: 10.1177/02611929231157756] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
The failure rate for the translation of drugs from animal testing to human treatments remains at over 92%, where it has been for the past few decades. The majority of these failures are due to unexpected toxicity - that is, safety issues revealed in human trials that were not apparent in animal tests - or lack of efficacy. However, the use of more innovative tools, such as organs-on-chips, in the preclinical pipeline for drug testing, has revealed that these tools are more able to predict unexpected safety events prior to clinical trials and so can be used for this, as well as for efficacy testing. Here, we review several disease areas, and consider how the use of animal models has failed to offer effective new treatments. We also make some suggestions as to how the more human-relevant new approach methodologies might be applied to address this.
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Affiliation(s)
- Lindsay J Marshall
- Animal Research Issues, 94219The Humane Society of the United States, Gaithersburg, MD, USA
| | - Jarrod Bailey
- 380235Cruelty Free International, London, UK; 542332Animal Free Research UK, London, UK
| | | | - Kathrin Herrmann
- Johns Hopkins Bloomberg School of Public Health, 457389Center for Alternatives to Animal Testing, Baltimore, MD, USA; Senate Department for the Environment, Urban Mobility, Consumer Protection and Climate Action, Berlin, Germany
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Maheux E, Koval I, Ortholand J, Birkenbihl C, Archetti D, Bouteloup V, Epelbaum S, Dufouil C, Hofmann-Apitius M, Durrleman S. Forecasting individual progression trajectories in Alzheimer's disease. Nat Commun 2023; 14:761. [PMID: 36765056 PMCID: PMC9918533 DOI: 10.1038/s41467-022-35712-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 12/19/2022] [Indexed: 02/12/2023] Open
Abstract
The anticipation of progression of Alzheimer's disease (AD) is crucial for evaluations of secondary prevention measures thought to modify the disease trajectory. However, it is difficult to forecast the natural progression of AD, notably because several functions decline at different ages and different rates in different patients. We evaluate here AD Course Map, a statistical model predicting the progression of neuropsychological assessments and imaging biomarkers for a patient from current medical and radiological data at early disease stages. We tested the method on more than 96,000 cases, with a pool of more than 4,600 patients from four continents. We measured the accuracy of the method for selecting participants displaying a progression of clinical endpoints during a hypothetical trial. We show that enriching the population with the predicted progressors decreases the required sample size by 38% to 50%, depending on trial duration, outcome, and targeted disease stage, from asymptomatic individuals at risk of AD to subjects with early and mild AD. We show that the method introduces no biases regarding sex or geographic locations and is robust to missing data. It performs best at the earliest stages of disease and is therefore highly suitable for use in prevention trials.
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Affiliation(s)
- Etienne Maheux
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Igor Koval
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Juliette Ortholand
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Colin Birkenbihl
- Department of bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, 53115, Germany
| | - Damiano Archetti
- IRCCS Instituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Vincent Bouteloup
- Université de Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
- Centre Hospitalier Universitaire (CHU) de Bordeaux, pôle de neurosciences cliniques, centre mémoire de ressources et de recherche, Bordeaux, France
| | - Stéphane Epelbaum
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Institut de la mémoire et de la maladie d'Alzheimer (IM2A), center of excellence of neurodegenerative diseases (CoEN), department of Neurology, DMU Neurosciences, Paris, France
| | - Carole Dufouil
- Université de Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
- Centre Hospitalier Universitaire (CHU) de Bordeaux, pôle de neurosciences cliniques, centre mémoire de ressources et de recherche, Bordeaux, France
| | - Martin Hofmann-Apitius
- Department of bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, 53115, Germany
| | - Stanley Durrleman
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.
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Parra MA, Orellana P, Leon T, Victoria CG, Henriquez F, Gomez R, Avalos C, Damian A, Slachevsky A, Ibañez A, Zetterberg H, Tijms BM, Yokoyama JS, Piña-Escudero SD, Cochran JN, Matallana DL, Acosta D, Allegri R, Arias-Suárez BP, Barra B, Behrens MI, Brucki SMD, Busatto G, Caramelli P, Castro-Suarez S, Contreras V, Custodio N, Dansilio S, De la Cruz-Puebla M, de Souza LC, Diaz MM, Duque L, Farías GA, Ferreira ST, Guimet NM, Kmaid A, Lira D, Lopera F, Meza BM, Miotto EC, Nitrini R, Nuñez A, O'neill S, Ochoa J, Pintado-Caipa M, de Paula França Resende E, Risacher S, Rojas LA, Sabaj V, Schilling L, Sellek AF, Sosa A, Takada LT, Teixeira AL, Unaucho-Pilalumbo M, Duran-Aniotz C. Biomarkers for dementia in Latin American countries: Gaps and opportunities. Alzheimers Dement 2023; 19:721-735. [PMID: 36098676 PMCID: PMC10906502 DOI: 10.1002/alz.12757] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/29/2022] [Accepted: 06/14/2022] [Indexed: 12/13/2022]
Abstract
Limited knowledge on dementia biomarkers in Latin American and Caribbean (LAC) countries remains a serious barrier. Here, we reported a survey to explore the ongoing work, needs, interests, potential barriers, and opportunities for future studies related to biomarkers. The results show that neuroimaging is the most used biomarker (73%), followed by genetic studies (40%), peripheral fluids biomarkers (31%), and cerebrospinal fluid biomarkers (29%). Regarding barriers in LAC, lack of funding appears to undermine the implementation of biomarkers in clinical or research settings, followed by insufficient infrastructure and training. The survey revealed that despite the above barriers, the region holds a great potential to advance dementia biomarkers research. Considering the unique contributions that LAC could make to this growing field, we highlight the urgent need to expand biomarker research. These insights allowed us to propose an action plan that addresses the recommendations for a biomarker framework recently proposed by regional experts.
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Affiliation(s)
- Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde. Glasgow, United Kingdom
| | - Paulina Orellana
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
| | - Tomas Leon
- Global Brain Health Institute, Trinity College. Dublin, Ireland
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador y Facultad de Medicina, Universidad de Chile. Santiago, Chile
| | - Cabello G. Victoria
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Unit of Brain Health, Department of Neurology and Neurosurgery, Faculty of Medicine, Universidad de Chile. Santiago, Chile
| | - Fernando Henriquez
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO). Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile. Santiago, Chile
| | - Rodrigo Gomez
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador y Facultad de Medicina, Universidad de Chile. Santiago, Chile
- Graduate School, Faculty of Medicine, Universidad Mayor, Chile - Centro de Apoyo Comunitario a personas con Demencia Kintun. Santiago, Chile
| | - Constanza Avalos
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
| | - Andres Damian
- Centro Uruguayo de Imagenología Molecular (CUDIM) - Centro de Medicina Nuclear e Imagenología Molecular, Hospital de Clínicas, Universidad de la República. Montevideo, Uruguay
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador y Facultad de Medicina, Universidad de Chile. Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO). Santiago, Chile
- Department of Neurology and Psyquiatry, Clínica Alemana-Universidad del Desarrollo. Santiago, Chile
| | - Agustin Ibañez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
- Global Brain Health Institute, Trinity College. Dublin, Ireland
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET). Buenos Aires, Argentina
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg. Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital. Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology. Queen Square, London, UK
- UK Dementia Research Institute at UCL. London, UK
- Hong Kong Center for Neurodegenerative Diseases. Clear Water Bay, Hong Kong, China
| | - Betty M. Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience. Amsterdam UMC, The Netherlands
| | - Jennifer S. Yokoyama
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Department of Neurology, Memory and Aging Center, UCSF. San Francisco, USA
| | - Stefanie D. Piña-Escudero
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
| | | | - Diana L Matallana
- Medical School, Aging Institute and Psychiatry Department, Neuroscience PhD Program, Pontificia Universidad Javeriana. Bogotá,Colombia
- Memory and Cognition Center, Intellectus, Hospital Universitario San Ignacio. Bogotá, Colombia
- Psychiatry Department, Hospital Universitario Santa Fe de Bogotá. Bogotá, Colombia
| | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Urena (UNPHU). Santo Domingo, República Dominicana
| | - Ricardo Allegri
- Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni. Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa. Barranquilla, Colombia
| | - Bianca P. Arias-Suárez
- Faculty of Human Medicine, Postgraduate Section, National University of San Marcos. Lima, Perú
| | - Bernardo Barra
- Mental Health Service, Clínica Universidad de los Andes. Santiago, Chile
- Department of Psychiatry, Medicine School, Andrés Bello University of Santiago (UNAB). Santiago, Chile
| | - Maria Isabel Behrens
- Department of Neurology and Psyquiatry, Clínica Alemana-Universidad del Desarrollo. Santiago, Chile
- Center for Advanced Clinical Research (CICA). Department of Neurology & Neurosurgery and Neuroscience Department, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Department of Neurology and Neurosurgery, Hospital Clínico Universidad de Chile. Santiago, Chile
- Department of Neurocience, Faculty of Medicine, Universidad de Chile. Santiago, Chile
| | - Sonia M. D. Brucki
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Geraldo Busatto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP. São Paulo, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte, Brazil
| | - Sheila Castro-Suarez
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Instituto Nacional de Ciencias Neurológicas. Lima, Perú
| | | | - Nilton Custodio
- Unit of diagnosis of cognitive impairment and dementia prevention, Instituto Peruano de Neurociencias.Lima, Perú
| | - Sergio Dansilio
- Department of Neuropsychology, Institut of Neurology, Hospital de Clínicas, Faculty of Medicine,Universidad de la República. Montevideo, Uruguay
| | - Myriam De la Cruz-Puebla
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute. Barcelona, Spain
- Department of Cellular Biology, Physiology and Immunology, Neuroscience Institute, Autonomous University of Barcelona. Barcelona, Spain
- Department of Internal Medicine, Health Sciences Faculty, Technical University of Ambato. Tungurahua, Ecuador
| | - Leonardo Cruz de Souza
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP. São Paulo, Brazil
- Neurology Service, School of Medicine, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill. North Carolina, USA
- School of Public Health, Universidad Peruana Cayetano Heredia. Lima, Peru
| | - Lissette Duque
- Unit of Cognitive diseases, Neuromedicenter. Quito, Ecuador
| | - Gonzalo A. Farías
- Center for Advanced Clinical Research (CICA). Department of Neurology & Neurosurgery and Neuroscience Department, Faculty of Medicine, Universidad de Chile. Santiago, Chile
| | - Sergio T. Ferreira
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro. Rio de Janeiro, Brazil
| | - Nahuel Magrath Guimet
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni. Buenos Aires, Argentina
| | - Ana Kmaid
- Unit of Cognitive evaluation. Department of Geriatry ang Gerentology. Hospital de Clínicas. Faculty of Medicine. Universidad de la República. Montevideo, Uruguay
| | - David Lira
- Unit of diagnosis of cognitive impairment and dementia prevention, Instituto Peruano de Neurociencias.Lima, Perú
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine. Medellín, Colombia
| | - Beatriz Mar Meza
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Department of Geriatry ang Gerentology, Hospital Central de la Fuerza Aérea del Perú. Lima, Perú
| | - Eliane C Miotto
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Alberto Nuñez
- Unit of Cognitive diseases, Neuromedicenter. Quito, Ecuador
| | - Santiago O'neill
- Neurosciences Institute, Favaloro Foundation University Hospital. Buenos Aires, Argentina
| | - John Ochoa
- Group of Neuropsychology and behavior, Universidad de Antioquia, School of Medicine. Medellín, Colombia
| | - Maritza Pintado-Caipa
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Unit of diagnosis of cognitive impairment and dementia prevention, Instituto Peruano de Neurociencias.Lima, Perú
| | - Elisa de Paula França Resende
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte, Brazil
- Neurology Service, School of Medicine, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Brain Institute of Rio Grande do Sul, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte, Brazil
| | - Shannon Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana Alzheimer’s Disease Research Center, Department of Neurology, Indiana University School of Medicine. Indianapolis, USA
| | - Luz Angela Rojas
- Research Group, MI Dneuropsy, Universidad Surcolombiana. Neiva, Colombia
| | - Valentina Sabaj
- Unit of Neuropsychogeriatry, Instituto Nacional de Geriatría. Santiago, Chile
| | - Lucas Schilling
- Neurology Service, School of Medicine, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Brain Institute of Rio Grande do Sul, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Graduate Program in Biomedical Gerontology, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
| | | | - Ana Sosa
- Instituto Nacional de Neurología y Neurocirugía (INNN), Manuel Velasco Suarez. Ciudad de México, México
| | - Leonel T. Takada
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Antonio L. Teixeira
- Faculdade Santa Casa BH. Belo Horizonte, Brazil
- Neuropsychiatry Program, University of Texas Health Science Center at Houston. Houston, USA
| | - Martha Unaucho-Pilalumbo
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Departamento de Neurología, Hospital Universidad Técnica Particular de Loja. Loja, Ecuador
| | - Claudia Duran-Aniotz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
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Jutten RJ, Papp KV, Hendrix S, Ellison N, Langbaum JB, Donohue MC, Hassenstab J, Maruff P, Rentz DM, Harrison J, Cummings J, Scheltens P, Sikkes SAM. Why a clinical trial is as good as its outcome measure: A framework for the selection and use of cognitive outcome measures for clinical trials of Alzheimer's disease. Alzheimers Dement 2023; 19:708-720. [PMID: 36086926 PMCID: PMC9931632 DOI: 10.1002/alz.12773] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/29/2022] [Accepted: 07/22/2022] [Indexed: 11/11/2022]
Abstract
A crucial aspect of any clinical trial is using the right outcome measure to assess treatment efficacy. Compared to the rapidly evolved understanding and measurement of pathophysiology in preclinical and early symptomatic stages of Alzheimer's disease (AD), relatively less progress has been made in the evolution of clinical outcome assessments (COAs) for those stages. The current paper aims to provide a benchmark for the design and evaluation of COAs for use in early AD trials. We discuss lessons learned on capturing cognitive changes in predementia stages of AD, including challenges when validating novel COAs for those early stages and necessary evidence for their implementation in clinical trials. Moving forward, we propose a multi-step framework to advance the use of more effective COAs to assess clinically meaningful changes in early AD, which will hopefully contribute to the much-needed consensus around more appropriate outcome measures to assess clinical efficacy of putative treatments. HIGHLIGHTS: We discuss lessons learned on capturing cognitive changes in predementia stages of AD. We propose a framework for the design and evaluation of performance based cognitive tests for use in early AD trials. We provide recommendations to facilitate the implementation of more effective cognitive outcome measures in AD trials.
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Affiliation(s)
- Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Michael C. Donohue
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, California, USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Paul Maruff
- Cogstate Ltd., Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - John Harrison
- Metis Cognition Ltd., Kilmington, UK
- Department of Psychiatry, Psychology & Neuroscience, King’s College London, UK
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada, USA
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Movement and Behavioral Sciences, VU University, Amsterdam, The Netherlands
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Three-dimensional chromatin architecture datasets for aging and Alzheimer's disease. Sci Data 2023; 10:51. [PMID: 36693875 PMCID: PMC9873630 DOI: 10.1038/s41597-023-01948-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023] Open
Abstract
Recently, increasing studies are indicating a close association between dysregulated enhancers and neurodegenerative diseases, such as Alzheimer's disease (AD). However, their contributions were poorly defined for lacking direct links to disease genes. To bridge this gap, we presented the Hi-C datasets of 4 AD patients, 4 dementia-free aged and 3 young subjects, including 30 billion reads. As applications, we utilized them to link the AD risk SNPs and dysregulated epigenetic marks to the target genes. Combining with epigenetic data, we observed more detailed interactions among regulatory regions and found that many known AD risk genes were under long-distance promoter-enhancer interactions. For future AD and aging studies, our datasets provide a reference landscape to better interpret findings of association and epigenetic studies for AD and aging process.
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Gait Indicators Contribute to Screening Cognitive Impairment: A Single- and Dual-Task Gait Study. Brain Sci 2023; 13:brainsci13010154. [PMID: 36672137 PMCID: PMC9856295 DOI: 10.3390/brainsci13010154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/23/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Screening cognitive impairment is complex and not an appliance for early screening. Gait performance is strongly associated with cognitive impairment. Objectives: We aimed to explore gait indicators that could potentially screen cognitive dysfunction. Methods: A total of 235 subjects were recruited from June 2021 to June 2022. Four gait tasks, including the walking test, the timed “Up & Go” test (TUG), foot pressure balance (FPB), and one-legged standing with eyes closed test (OLS-EC), were performed. Moreover, in the walking test, participants were instructed to walk at their usual pace for the single-gait test. For the dual-task tests, participants walked at their usual pace while counting backward from 100 by 1s. The data were analyzed by the independent sample t-test, univariate and multivariate logistic regression, a linear trend, stratified and interaction analysis, the receiver operating characteristic (ROC) curve, and Pearson’s correlations. Results: Among the 235 participants, 81 (34.5%) were men and 154 (65.5%) were women. The mean age of participants was 72 ± 7.836 years. The control, MCI, mild AD, and severe AD groups had means of 71, 63, 71, and 30, respectively. After adjusting for age, sex, education, and body mass index (BMI), the dual-task toe-off-ground angle (TOA) (odds ratio (OR) = 0.911, 95% confidence interval (CI): 0.847, 0.979), single-task TOA (OR = 0.904, 95% CI: 0.841−0.971), and the timed “Up & Go” time (TUGT) (OR = 1.515, 95% CI: 1.243−1.846) were significantly associated with an increased risk of cognitive impairment. In addition, the trend test and stratified analysis results had no significant differences (all p > 0.05). The area under the roc curve (AUC) values of TOA in the dual-task and TUGT were 0.812 and 0.847, respectively. Additionally, TOA < 36.75° in the dual-task, TOA < 38.90° in the single-task, and TUGT > 9.83 seconds (s) are likely to indicate cognitive impairment. The cognitive assessment scale scores were significantly correlated with TOA (all r > 0.3, p < 0.001) and TUGT (all r > 0.2), respectively. Conclusion: TOA and TUGT scores are, in some circumstances, associated with cognitive impairment; therefore, they can be used as simple initial screenings to identify patients at risk.
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Fosse V, Oldoni E, Bietrix F, Budillon A, Daskalopoulos EP, Fratelli M, Gerlach B, Groenen PMA, Hölter SM, Menon JML, Mobasheri A, Osborne N, Ritskes-Hoitinga M, Ryll B, Schmitt E, Ussi A, Andreu AL, McCormack E, Demotes J, Garcia P, Gerardi C, Glaab E, Haro JM, Hulstaert F, Miguel LS, Mirete JS, Niubo AS, Porcher R, Rauschenberger A, Rodriguez MC, Superchi C, Torres T. Recommendations for robust and reproducible preclinical research in personalised medicine. BMC Med 2023; 21:14. [PMID: 36617553 PMCID: PMC9826728 DOI: 10.1186/s12916-022-02719-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Personalised medicine is a medical model that aims to provide tailor-made prevention and treatment strategies for defined groups of individuals. The concept brings new challenges to the translational step, both in clinical relevance and validity of models. We have developed a set of recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine. METHODS These recommendations have been developed following four main steps: (1) a scoping review of the literature with a gap analysis, (2) working sessions with a wide range of experts in the field, (3) a consensus workshop, and (4) preparation of the final set of recommendations. RESULTS Despite the progress in developing innovative and complex preclinical model systems, to date there are fundamental deficits in translational methods that prevent the further development of personalised medicine. The literature review highlighted five main gaps, relating to the relevance of experimental models, quality assessment practices, reporting, regulation, and a gap between preclinical and clinical research. We identified five points of focus for the recommendations, based on the consensus reached during the consultation meetings: (1) clinically relevant translational research, (2) robust model development, (3) transparency and education, (4) revised regulation, and (5) interaction with clinical research and patient engagement. Here, we present a set of 15 recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine. CONCLUSIONS Appropriate preclinical models should be an integral contributor to interventional clinical trial success rates, and predictive translational models are a fundamental requirement to realise the dream of personalised medicine. The implementation of these guidelines is ambitious, and it is only through the active involvement of all relevant stakeholders in this field that we will be able to make an impact and effectuate a change which will facilitate improved translation of personalised medicine in the future.
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Affiliation(s)
- Vibeke Fosse
- Department of Clinical Science, Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway.
| | - Emanuela Oldoni
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Florence Bietrix
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Alfredo Budillon
- Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | | | - Maddalena Fratelli
- Department of Biochemistry and Molecular Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Björn Gerlach
- PAASP GmbH, Guarantors of EQIPD e.V., Central Institute for Mental Health in Mannheim, Mannheim, Germany
| | | | | | - Julia M L Menon
- Preclinicaltrials.eu, Netherlands Heart Institute, Utrecht, The Netherlands
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, 90570, Oulu, Finland.,Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-08406, Vilnius, Lithuania.,Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.,Departments of Orthopedics, Rheumatology and Clinical Immunology, University Medical Center Utrecht, 508, GA, Utrecht, The Netherlands.,World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Université de Liège, B-4000, Liège, Belgium
| | | | - Merel Ritskes-Hoitinga
- Department of Population Health Sciences, IRAS, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Clinical Medicine, AUGUST, Aarhus University, Aarhus, Denmark
| | - Bettina Ryll
- Melanoma Patient Network Europe, Uppsala, Sweden
| | - Elmar Schmitt
- Global Regulatory Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany
| | - Anton Ussi
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Antonio L Andreu
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Emmet McCormack
- Department of Clinical Science, Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway.,Department of Clinical Science, Centre for Pharmacy, The University of Bergen, Bergen, Norway
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Andrade S, Nunes D, Dabur M, Ramalho MJ, Pereira MC, Loureiro JA. Therapeutic Potential of Natural Compounds in Neurodegenerative Diseases: Insights from Clinical Trials. Pharmaceutics 2023; 15:pharmaceutics15010212. [PMID: 36678841 PMCID: PMC9860553 DOI: 10.3390/pharmaceutics15010212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/01/2023] [Accepted: 01/04/2023] [Indexed: 01/10/2023] Open
Abstract
Neurodegenerative diseases are caused by the gradual loss of neurons' function. These neurological illnesses remain incurable, and current medicines only alleviate the symptoms. Given the social and economic burden caused by the rising frequency of neurodegenerative diseases, there is an urgent need for the development of appropriate therapeutics. Natural compounds are gaining popularity as alternatives to synthetic drugs due to their neuroprotective properties and higher biocompatibility. While natural compounds' therapeutic effects for neurodegenerative disease treatment have been investigated in numerous in vitro and in vivo studies, only few have moved to clinical trials. This article provides the first systematic review of the clinical trials evaluating natural compounds' safety and efficacy for the treatment of the five most prevalent neurodegenerative disorders: Alzheimer's disease, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, and Huntington's disease.
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Affiliation(s)
- Stéphanie Andrade
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Débora Nunes
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Meghna Dabur
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Maria J. Ramalho
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Maria C. Pereira
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- Correspondence: (M.C.P.); (J.A.L.)
| | - Joana A. Loureiro
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- Correspondence: (M.C.P.); (J.A.L.)
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English BA, Ereshefsky L. Experimental Medicine Approaches in Early-Phase CNS Drug Development. ADVANCES IN NEUROBIOLOGY 2023; 30:417-455. [PMID: 36928860 DOI: 10.1007/978-3-031-21054-9_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Traditionally, Phase 1 clinical trials were largely conducted in healthy normal volunteers and focused on collection of safety, tolerability, and pharmacokinetic data. However, in the CNS therapeutic area, with more drugs failing in later phase development, Phase 1 trials have undergone an evolution that includes incorporation of novel approaches involving novel study designs, inclusion of biomarkers, and early inclusion of patients to improve the pharmacologic understanding of novel CNS-active compounds early in clinical development with the hope of improving success in later phase pivotal trials. In this chapter, the authors will discuss the changing landscape of Phase 1 clinical trials in CNS, including novel trial methodology, inclusion of pharmacodynamic biomarkers, and experimental medicine approaches to inform early decision-making in clinical development.
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Bachman SL, Blankenship JM, Busa M, Serviente C, Lyden K, Clay I. Capturing Measures That Matter: The Potential Value of Digital Measures of Physical Behavior for Alzheimer's Disease Drug Development. J Alzheimers Dis 2023; 95:379-389. [PMID: 37545234 PMCID: PMC10578291 DOI: 10.3233/jad-230152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 08/08/2023]
Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disease and the primary cause of dementia worldwide. Despite the magnitude of AD's impact on patients, caregivers, and society, nearly all AD clinical trials fail. A potential contributor to this high rate of failure is that established clinical outcome assessments fail to capture subtle clinical changes, entail high burden for patients and their caregivers, and ineffectively address the aspects of health deemed important by patients and their caregivers. AD progression is associated with widespread changes in physical behavior that have impacts on the ability to function independently, which is a meaningful aspect of health for patients with AD and important for diagnosis. However, established assessments of functional independence remain underutilized in AD clinical trials and are limited by subjective biases and ceiling effects. Digital measures of real-world physical behavior assessed passively, continuously, and remotely using digital health technologies have the potential to address some of these limitations and to capture aspects of functional independence in patients with AD. In particular, measures of real-world gait, physical activity, and life-space mobility captured with wearable sensors may offer value. Additional research is needed to understand the validity, feasibility, and acceptability of these measures in AD clinical research.
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Affiliation(s)
| | | | - Michael Busa
- Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Corinna Serviente
- Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Moebius HJ, Church KJ. The Case for a Novel Therapeutic Approach to Dementia: Small Molecule Hepatocyte Growth Factor (HGF/MET) Positive Modulators. J Alzheimers Dis 2023; 92:1-12. [PMID: 36683507 PMCID: PMC10041442 DOI: 10.3233/jad-220871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
An estimated 6.5 million Americans aged 65 years or older have Alzheimer's disease (AD), which will grow to 13.8 million Americans by 2060. Despite the growing burden of dementia, no fundamental change in drug development for AD has been seen in > 20 years. Currently approved drugs for AD produce only modest symptomatic improvements in cognition with small effect sizes. A growing mismatch exists between the urgent need to develop effective drugs for symptomatic AD and the largely failed search for disease modification. The failure rate of clinical trials in AD is high overall, and in particular for disease-modifying therapies. Research efforts in AD have focused predominantly on amyloid-β and tau pathologies, but limiting clinical research to these "classical hallmarks" of the disease does not address the most urgent patient, caregiver, or societal needs. Rather, clinical research should consider the complex pathophysiology of AD. Innovative approaches are needed that provide outside-the-box thinking, and re-imagine trial design, interventions, and outcomes as well as progress in proteomics and fluid biomarker analytics for both diagnostics and disease monitoring. A new approach offering a highly specific, yet multi-pronged intervention that exerts positive modulation on the HGF/MET neurotrophic system is currently being tested in mid-to-late-stage clinical trials in mild to moderate AD. Findings from such trials may provide data to support novel approaches for development of innovative drugs for treating AD at various disease stages, including among patients already symptomatic, and may offer benefits for other neurodegenerative diseases.
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Wu T, Lin D, Cheng Y, Jiang S, Riaz MW, Fu N, Mou C, Ye M, Zheng Y. Amyloid Cascade Hypothesis for the Treatment of Alzheimer's Disease: Progress and Challenges. Aging Dis 2022; 13:1745-1758. [PMID: 36465173 PMCID: PMC9662281 DOI: 10.14336/ad.2022.0412] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/12/2022] [Indexed: 07/29/2023] Open
Abstract
The amyloid cascade hypothesis has always been a research focus in the therapeutic field of Alzheimer's disease (AD) since it was put forward. Numerous researchers attempted to find drugs for AD treatment based on this hypothesis. To promote the research of anti-AD drugs development, the current hypothesis and pathogenesis were reviewed with expounding of β-amyloid generation from its precursor protein and related transformations. Meanwhile, the present drug development strategies aimed at each stage in this hypothesis were also summarized. Several strategies especially immunotherapy showed the optimistic results in clinical trials, but only a small percentage of them eventually succeeded. In this review, we also tried to point out some common problems of drug development in preclinical and clinical studies which might be settled through multidisciplinary cooperation as well as the understanding that reinforces the amyloid cascade hypothesis.
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Affiliation(s)
- Tong Wu
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Hangzhou 311300, China
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Ding Lin
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Hangzhou 311300, China
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Yaqian Cheng
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Hangzhou 311300, China
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Senze Jiang
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Muhammad Waheed Riaz
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Hangzhou 311300, China
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Nina Fu
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Chenhao Mou
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Menglu Ye
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
| | - Ying Zheng
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Hangzhou 311300, China
- Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine, Zhejiang A&F University, Hangzhou 311300, China
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Wang QY, Chen HP, Wu KY, Li X, Liu JK. Antibacterial and β-amyloid precursor protein-cleaving enzyme 1 inhibitory polyketides from the fungus Aspergillus chevalieri. Front Microbiol 2022; 13:1051281. [PMID: 36483193 PMCID: PMC9722750 DOI: 10.3389/fmicb.2022.1051281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/07/2022] [Indexed: 11/04/2023] Open
Abstract
One new prenylated benzenoid, (±)-chevalieric acid (1), and four new anthraquinone derivatives, (10S,12S)-, (10S,12R)-, (10R,12S)-, and (10R,12R)-chevalierone (2-5), together with ten previously described compounds (6-15), were isolated from the fungus Aspergillus chevalieri (L. Mangin) Thom and Church. The structures of new compounds were elucidated by extensive 1D and 2D nuclear magnetic resonance (NMR), and HRESIMS spectroscopic analysis. The absolute configurations of 2-5 were determined by experimental and calculated electronic circular dichroism (ECD) and DP4+ analysis. Compound 10 showed weak cytotoxicity against human lung cancer cell line A549 with IC50 39.68 μM. Compounds 2-5 exhibited antibacterial activities against the methicillin-resistant Staphylococcus aureus (MRSA) and opportunistic pathogenic bacterium Pseudomonas aeruginosa. The MIC value for compound 6 against MRSA is 44.02 μM. Additionally, Compounds 8, 10, 11 showed weak to moderate inhibitory activities against the β-secretase (BACE1), with IC50 values of 36.1, 40.9, 34.9 μM, respectively.
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Affiliation(s)
- Qing-Yuan Wang
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan, China
| | - He-Ping Chen
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan, China
| | - Kai-Yue Wu
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan, China
| | - Xinyang Li
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Japan
| | - Ji-Kai Liu
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan, China
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Abstract
Although the cause(s) of Alzheimer's disease in the majority of cases remains elusive, it has long been associated with hypertension. In animal models of the disease, hypertension has been shown to exacerbate Alzheimer-like pathology and behavior, while in humans, hypertension during mid-life increases the risk of developing the disease later in life. Unfortunately, once individuals are diagnosed with the disease, there are few therapeutic options available. There is neither an effective symptomatic treatment, one that treats the debilitating cognitive and memory deficits, nor, more importantly, a neuroprotective treatment, one that stops the relentless progression of the pathology. Further, there is no specific preventative treatment that offsets the onset of the disease. A key factor or clue in this quest for an effective preventative and therapeutic treatment may lie in the contribution of hypertension to the disease. In this review, we explore the idea that photobiomodulation, the application of specific wavelengths of light onto body tissues, can reduce the neuropathology and behavioral deficits in Alzheimer's disease by controlling hypertension. We suggest that treatment with photobiomodulation can be an effective preventative and therapeutic option for this neurodegenerative disease.
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Affiliation(s)
- Audrey Valverde
- Université Grenoble Alpes, Fonds de dotation Clinatec, Grenoble, France
| | - John Mitrofanis
- Université Grenoble Alpes, Fonds de dotation Clinatec, Grenoble, France,
Institute of Ophthalmology, University College London, London, United Kingdom,Correspondence to: John Mitrofanis, E-mail:
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Lecca D, Jung YJ, Scerba MT, Hwang I, Kim YK, Kim S, Modrow S, Tweedie D, Hsueh S, Liu D, Luo W, Glotfelty E, Li Y, Wang J, Luo Y, Hoffer BJ, Kim DS, McDevitt RA, Greig NH. Role of chronic neuroinflammation in neuroplasticity and cognitive function: A hypothesis. Alzheimers Dement 2022; 18:2327-2340. [PMID: 35234334 PMCID: PMC9437140 DOI: 10.1002/alz.12610] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Evaluating the efficacy of 3,6'-dithioPomalidomide in 5xFAD Alzheimer's disease (AD) mice to test the hypothesis that neuroinflammation is directly involved in the development of synaptic/neuronal loss and cognitive decline. BACKGROUND Amyloid-β (Aβ) or tau-focused clinical trials have proved unsuccessful in mitigating AD-associated cognitive impairment. Identification of new drug targets is needed. Neuroinflammation is a therapeutic target in neurodegenerative disorders, and TNF-α a pivotal neuroinflammatory driver. NEW HYPOTHESIS AD-associated chronic neuroinflammation directly drives progressive synaptic/neuronal loss and cognitive decline. Pharmacologically mitigating microglial/astrocyte activation without altering Aβ generation will define the role of neuroinflammation in AD progression. MAJOR CHALLENGES Difficulty of TNF-α-lowering compounds reaching brain, and identification of a therapeutic-time window to preserve the beneficial role of neuroinflammatory processes. LINKAGE TO OTHER MAJOR THEORIES Microglia/astroglia are heavily implicated in maintenance of synaptic plasticity/function in healthy brain and are disrupted by Aβ. Mitigation of chronic gliosis can restore synaptic homeostasis/cognitive function.
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Affiliation(s)
- Daniela Lecca
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
| | - Yoo Jin Jung
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA,Stanford Neurosciences Interdepartmental ProgramStanford University School of MedicineStanfordCaliforniaUSA
| | - Michael T. Scerba
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
| | | | | | - Sun Kim
- Aevis Bio, Inc.DaejeonRepublic of Korea
| | - Sydney Modrow
- Comparative Medicine SectionNational Institute on AgingBaltimoreMarylandUSA
| | - David Tweedie
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
| | - Shih‐Chang Hsueh
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
| | - Dong Liu
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
| | - Weiming Luo
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
| | - Elliot Glotfelty
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA,Department of NeuroscienceKarolinska InstitutetStockholmSweden
| | - Yazhou Li
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
| | - Jia‐Yi Wang
- Graduate Institute of Medical SciencesTaipei Medical UniversityTaipeiTaiwan,Department of NeurosurgeryTaipei Medical University HospitalTaipei Medical UniversityTaipeiTaiwan,Neuroscience Research CenterTaipei Medical UniversityTaipeiTaiwan
| | - Yu Luo
- Department of Molecular Genetics and BiochemistryCollege of MedicineUniversity of CincinnatiCincinnatiOhioUSA
| | - Barry J. Hoffer
- Department of Neurological SurgeryCase Western Reserve University HospitalClevelandOhioUSA
| | - Dong Seok Kim
- Aevis Bio, Inc.DaejeonRepublic of Korea,AevisBio, Inc.GaithersburgMarylandUSA
| | - Ross A. McDevitt
- Comparative Medicine SectionNational Institute on AgingBaltimoreMarylandUSA
| | - Nigel H. Greig
- Drug Design & Development SectionTranslational Gerontology BranchIntramural Research Program National Institute on AgingNIHBaltimoreMarylandUSA
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Ultrasensitive probeless capacitive biosensor for amyloid beta (Aβ1-42) detection in human plasma using interdigitated electrodes. Biosens Bioelectron 2022; 212:114365. [DOI: 10.1016/j.bios.2022.114365] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/09/2022] [Indexed: 11/19/2022]
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Khoury R, Gallop A, Roberts K, Grysman N, Lu J, Grossberg GT. Pharmacotherapy for Alzheimer’s disease: what’s new on the horizon? Expert Opin Pharmacother 2022; 23:1305-1323. [DOI: 10.1080/14656566.2022.2097868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Rita Khoury
- Department of Psychiatry and Clinical Psychology, St. Georges Hospital University Medical Center, Beirut, Lebanon
- University of Balamand, Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine, St. Louis, Missouri, United States
| | - Amy Gallop
- Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine, St. Louis, Missouri, United States
| | - Kelsey Roberts
- Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine, St. Louis, Missouri, United States
| | - Noam Grysman
- Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine, St. Louis, Missouri, United States
| | - Jiaxi Lu
- Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine, St. Louis, Missouri, United States
| | - George T. Grossberg
- Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine, St. Louis, Missouri, United States
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Park SA, Jang YJ, Kim MK, Lee SM, Moon SY. Promising Blood Biomarkers for Clinical Use in Alzheimer's Disease: A Focused Update. J Clin Neurol 2022; 18:401-409. [PMID: 35796265 PMCID: PMC9262460 DOI: 10.3988/jcn.2022.18.4.401] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 12/11/2022] Open
Abstract
Alzheimer’s disease (AD) is the most-common cause of neurodegenerative dementia, and it is characterized by abnormal amyloid and tau accumulation, which indicates neurodegeneration. AD has mostly been diagnosed clinically. However, ligand-specific positron emission tomography (PET) imaging, such as amyloid PET, and cerebrospinal fluid (CSF) biomarkers are needed to accurately diagnose AD, since they supplement the shortcomings of clinical diagnoses. Using biomarkers that represent the pathology of AD is essential (particularly when disease-modifying treatment is available) to identify the corresponding pathology of targeted therapy and for monitoring the treatment response. Although imaging and CSF biomarkers are useful, their widespread use is restricted by their high cost and the discomfort during the lumbar puncture, respectively. Recent advances in AD blood biomarkers shed light on their future use for clinical purposes. The amyloid β (Aβ)42/Aβ40 ratio and the concentrations of phosphorylated tau at threonine 181 and at threonine 217, and of neurofilament light in the blood were found to represent the pathology of Aβ, tau, and neurodegeneration in the brain when using automatic electrochemiluminescence technologies, single-molecule arrays, immunoprecipitation coupled with mass spectrometry, etc. These blood biomarkers are imminently expected to be incorporated into clinical practice to predict, diagnose, and determine the stage of AD. In this review we focus on advancements in the measurement technologies for blood biomarkers and the promising biomarkers that are approaching clinical application. We also discuss the current limitations, the needed further investigations, and the perspectives on their use.
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Affiliation(s)
- Sun Ah Park
- Lab for Neurodegenerative Dementia, Department of Anatomy, Ajou University School of Medicine, Suwon, Korea.,Department of Neurology, Ajou University School of Medicine, Suwon, Korea.,Neuroscience Graduate Program, Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Korea.
| | - Yu Jung Jang
- Lab for Neurodegenerative Dementia, Department of Anatomy, Ajou University School of Medicine, Suwon, Korea.,Neuroscience Graduate Program, Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Korea
| | - Min Kyoung Kim
- Lab for Neurodegenerative Dementia, Department of Anatomy, Ajou University School of Medicine, Suwon, Korea.,Neuroscience Graduate Program, Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Korea
| | - Sun Min Lee
- Department of Neurology, Ajou University School of Medicine, Suwon, Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Korea
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Jicha GA, Abner EL, Arnold SE, Carrillo MC, Dodge HH, Edland SD, Fargo KN, Feldman HH, Goldstein LB, Hendrix J, Peters R, Robillard JM, Schneider LS, Titiner JR, Weber CJ. Committee on High-quality Alzheimer's Disease Studies (CHADS) consensus report. Alzheimers Dement 2022; 18:1109-1118. [PMID: 34590417 PMCID: PMC8960469 DOI: 10.1002/alz.12461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/14/2021] [Accepted: 07/30/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Consensus guidance for the development and identification of high-quality Alzheimer's disease clinical trials is needed for protocol development and conduct of clinical trials. METHODS An ad hoc consensus committee was convened in conjunction with the Alzheimer's Association to develop consensus recommendations. RESULTS Consensus was readily reached for the need to provide scientific justification, registration of trials, institutional review board oversight, conflict of interest disclosure, funding source disclosure, defined trial population, recruitment resources, definition of the intervention, specification of trial duration, appropriate payment for participant engagement, risk-benefit disclosure as part of the consent process, and the requirement to disseminate and/or publish trial results even if the study is negative. CONCLUSIONS This consensus guidance should prove useful for the protocol development and conduct of clinical trials, and may further provide a platform for the development of education materials that may help guide appropriate clinical trial participation decisions for potential trial participants and the general public.
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Affiliation(s)
- Greg A. Jicha
- Department of Neurology & the Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
| | - Erin L. Abner
- Department of Epidemiology & the Sanders‐Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
| | - Steven E. Arnold
- Department of NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | | | - Hiroko H. Dodge
- Department of Neurology & Layton Aging and Alzheimer's Disease CenterOregon Health & Science UniversityPortlandOregonUSA
| | - Steven D. Edland
- Division of BiostatisticsSchool of Public Health and Human Longevity ScienceUniversity of California, San DiegoSan DiegoCaliforniaUSA
| | - Keith N. Fargo
- Alzheimer's Association, Chicago, Illinois, USA (affiliation at time of publication is CMT Research Foundation, Atlanta, Georgia, USA)
| | - Howard H. Feldman
- Department of NeuroscienceUniversity of CaliforniaSan DiegoCaliforniaUSA
| | | | - James Hendrix
- Alzheimer's Association, Chicago, Illinois, USA (affiliation at time of publication is LuMind IDSC Foundation, Burlington, Massachusetts, USA)
| | - Ruth Peters
- Department of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia,Neuroscience Research AustraliaSydneyNew South WalesAustralia,School of Public HealthImperial CollegeLondonUK
| | - Julie M. Robillard
- Division of Neurology, Department of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Lon S. Schneider
- Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
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Abstract
The blood-brain barrier (BBB) is an interface between cerebral blood and the brain parenchyma. As a gate keeper, BBB regulates passage of nutrients and exogeneous compounds. Owing to this highly selective barrier, many drugs targeting brain diseases are not likely to pass through the BBB. Thus, a large amount of time and cost have been paid for the development of BBB targeted therapeutics. However, many drugs validated in in vitro models and animal models have failed in clinical trials primarily due to the lack of an appropriate BBB model. Human BBB has a unique cellular architecture. Different physiologies between human and animal BBB hinder the prediction of drug responses. Therefore, a more physiologically relevant alternative BBB model needs to be developed. In this review, we summarize major features of human BBB and current BBB models and describe organ-on-chip models for BBB modeling and their applications in neurological complications.
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Affiliation(s)
- Baofang Cui
- Department of Biotechnology, Yonsei University, Seoul 03722, Korea
| | - Seung-Woo Cho
- Department of Biotechnology, Yonsei University, Seoul 03722, Korea
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Li TR, Yao YX, Jiang XY, Dong QY, Yu XF, Wang T, Cai YN, Han Y. β-Amyloid in blood neuronal-derived extracellular vesicles is elevated in cognitively normal adults at risk of Alzheimer's disease and predicts cerebral amyloidosis. Alzheimers Res Ther 2022; 14:66. [PMID: 35550625 PMCID: PMC9097146 DOI: 10.1186/s13195-022-01010-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/27/2022] [Indexed: 02/08/2023]
Abstract
Background Blood biomarkers that can be used for preclinical Alzheimer’s disease (AD) diagnosis would enable trial enrollment at a time when the disease is potentially reversible. Here, we investigated plasma neuronal-derived extracellular vesicle (nEV) cargo in patients along the Alzheimer’s continuum, focusing on cognitively normal controls (NCs) with high brain β-amyloid (Aβ) loads (Aβ+). Methods The study was based on the Sino Longitudinal Study on Cognitive Decline project. We enrolled 246 participants, including 156 NCs, 45 amnestic mild cognitive impairment (aMCI) patients, and 45 AD dementia (ADD) patients. Brain Aβ loads were determined using positron emission tomography. NCs were classified into 84 Aβ− NCs and 72 Aβ+ NCs. Baseline plasma nEVs were isolated by immunoprecipitation with an anti-CD171 antibody. After verification, their cargos, including Aβ, tau phosphorylated at threonine 181, and neurofilament light, were quantified using a single-molecule array. Concentrations of these cargos were compared among the groups, and their receiver operating characteristic (ROC) curves were constructed. A subset of participants underwent follow-up cognitive assessment and magnetic resonance imaging. The relationships of nEV cargo levels with amyloid deposition, longitudinal changes in cognition, and brain regional volume were explored using correlation analysis. Additionally, 458 subjects in the project had previously undergone plasma Aβ quantification. Results Only nEV Aβ was included in the subsequent analysis. We focused on Aβ42 in the current study. After normalization of nEVs, the levels of Aβ42 were found to increase gradually across the cognitive continuum, with the lowest in the Aβ− NC group, an increase in the Aβ+ NC group, a further increase in the aMCI group, and the highest in the ADD group, contributing to their diagnoses (Aβ− NCs vs. Aβ+ NCs, area under the ROC curve values of 0.663; vs. aMCI, 0.857; vs. ADD, 0.957). Furthermore, nEV Aβ42 was significantly correlated with amyloid deposition, as well as longitudinal changes in cognition and entorhinal volume. There were no differences in plasma Aβ levels among NCs, aMCI, and ADD individuals. Conclusions Our findings suggest the potential use of plasma nEV Aβ42 levels in diagnosing AD-induced cognitive impairment and Aβ+ NCs. This biomarker reflects cortical amyloid deposition and predicts cognitive decline and entorhinal atrophy. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01010-x.
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Affiliation(s)
- Tao-Ran Li
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Yun-Xia Yao
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Xue-Yan Jiang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.,School of Biomedical Engineering, Hainan University, Haikou, 570228, China
| | - Qiu-Yue Dong
- Key Laboratory of Specialty Fiber Optics and Optical Access Networks, Joint International Research Laboratory of Specialty Fiber Optics and Advanced Communication, School of Information and Communication Engineering, Shanghai University, Shanghai, 200444, China
| | - Xian-Feng Yu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Ting Wang
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Yan-Ning Cai
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China. .,School of Biomedical Engineering, Hainan University, Haikou, 570228, China. .,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, 100053, China. .,National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
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