New approach to treating Alzheimer's blood

New therapeutic approach: Spetz Blutwäsche could improve future Alzheimer's and dementia sequelae.

08/04/2012

Scientists at the University Hospital Charité in Berlin have apparently succeeded in developing a new treatment approach in Alzheimer's therapy. With the help of a blood wash the consequences of the incurable illness could be substantially reduced. In the course of a study, initial successes have already been achieved. However, the research approach is still in its infancy and further large-scale studies are necessary to clinically secure existing results.

Blood washing could improve memory performance
At the beginning of the research work, the scientists wondered if some forms of Alzheimer's disease were caused by autoimmune diseases. It could possibly be that the human organism is mistakenly directed against its own immune system. Based on these questions, Berlin physicians and researchers from the University of Charité and the Max Delbrück Center for Molecular Medicine (MDC) in Berlin-Buch searched for new therapeutic approaches to treat Alzheimer's and dementia. Both research institutions found in blood serum of Alzheimer's patients different antibodies from an erroneously misdirected immune response of the body. In two experiments, the researchers were able to use a special blood wash in the subjects to achieve that the antibodies could be removed from the bloodstream. Subsequent evaluations showed a significant improvement in the health status of the patients. Among other things, the memory achievements could be significantly improved. So far, however, only a few people have been treated with this method.

Still too few case numbers to secure insights
In the opinion of Richard Dobel of the German society for neurology the results are "very exciting and also a new beginning". Based on the current data, it is still too early to stir up hopes of patients on an immediately available therapy. According to the expert, further studies have to follow to substantiate the results.
The research team also admits that the "case numbers are still very low," as Marion Bimmler of the MDC explained. So far, only a small number of patients have been treated and observed between six months and one year. According to the expert, but the first results are promising.

Immune system antibodies damage blood vessels in the brain
In a second experimental setup, the scientists achieved another breakthrough in cooperation with the Max Delbrück Center. In an animal experiment it could be determined that certain defense substances of the immune system damage blood vessels in the brain.

For the first time it could be proven that certain "misregulated immune system antibodies definitely damage the blood vessels in the brain", as the team reports in the journal "PloS ONE". The substances of the immune system would be misleading antibodies that fight the own organism (1-AR-antibodies). The researchers were able to demonstrate at laboratory rates using magnetic resonance imaging that these autoantibodies bind to certain surface proteins of blood vessel cells. This process, in turn, damages the brain. It causes a permanent stimulation of the receptors and thus a thickening of the vessel walls. Because the vessels are poorly supplied with blood, "no pollutants such as plaques can be removed," said study director Bimmler. For this reason, the scientific team, in cooperation with the Geriatric Department at the Charité Hospital, attempted to subject patients with Alzheimer's and vascular dementia to a special blood wash. With the result: "In the six to twelve months since treatment, the memory and everyday skills of the treated patients improved significantly. The condition of others who stopped treatment, however, deteriorated dramatically, "says the researcher.

Blood washing could help many Alzheimer's patients
If the new approach were to be developed into a standard therapy, many patients with Alzheimer's and dementia could benefit from it. According to the researcher, "around half of Alzheimer's or dementia patients carry such antibodies" in themselves. Until then, further clinical evidence and numbers from large-scale studies would have to follow to secure previous findings. "Taken together, we have demonstrated in the present study that the specific antibodies cause damage to the cerebral vessels in a rat model. Our data suggest that the antibodies are also responsible for diseases of the central nervous system, such as stroke and dementia, "as the study authors write in the journal summarizing.

Similar research approach with the same result
The team around the neurologist Harald Prüß from the Charité Berlin is pursuing a similar and yet somewhat different research approach. Although they also assume that symptoms of dementia are caused by a misdirected immune system and are therefore treatable as a sequelae of autoimmune disease, but they are looking for other antibodies. Their suggestion is that the specific antibodies against a specific ion channel in the brain (NMDA) are produced and subsequently damage the functions of the nerves.

Regardless, here too, the blood washing had an equally promising therapeutic effect. Similar to the "Bimmler study", the number of test persons was low in the "Prüß study" in order to provide clear evidence. Therefore, the scientists want to undertake a large-scale study in a few months to show how high the proportion of antibody carriers in Alzheimer's patients. In addition, patients with Creutzfeldt-Jakob Disease and Parkinson's Disease are also expected to participate. Although Prüß can not reveal anything specific, but her "share is relevant," said Prüß. (Sb)

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Picture: Gerd Altmann