title: A prospective study on blood Aβ levels and the cognitive function of patients with hemodialysis: a potential therapeutic strategy for Alzheimer's disease.
abstract: To obtain the proof of concept of a novel therapy for Alzheimer's disease (AD), we conducted two prospective studies with hemodialysis patients who had amyloid β protein (Aβ) removed from their blood three times a week. One major pathological change in the brain associated with AD is Aβ deposition, mainly 40 amino acids Aβ1-40 and 42 amino acids Aβ1-42. Impaired Aβ clearance is proposed to be one cause of increased Aβ in the AD brain. Thus, we hypothesized that an extracorporeal removal system of Aβ from the blood may remove brain Aβ and be a useful therapeutic strategy for AD. In the first prospective study, plasma Aβ levels and the cognitive function of 30 hemodialysis patients (65-76 years old) were evaluated at baseline as well as 18 or 36 months after. Although plasma Aβ1-40 levels either decreased or remained unchanged, levels of Aβ1-42 either remained unchanged or increased at the second time point. Mini-Mental State Examination scores of most subjects increased or were maintained at the second time point. Aβ1-40 influx into the blood correlated with MMSE at the second time point. In the second prospective study, five patients (51-84 years old) with renal failure were evaluated before and after the initiation of hemodialysis. Plasma Aβ levels decreased, while cognitive function improved after initiating blood Aβ removal. Therefore, long-term hemodialysis, which effectively removes blood Aβ, might alter Aβ influx and help maintain cognitive function.
authors.affiliation: Faculty of Clinical Engineering, School of Health Sciences, Fujita Health University, 1-98 Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. nkitaguc@fujita-hu.ac.jp.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Kitaguchi
authors.affiliation: Department of Nephrology, School of Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Neurology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ito
authors.affiliation: Faculty of Clinical Engineering, School of Health Sciences, Fujita Health University, 1-98 Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kawaguchi
authors.affiliation: Faculty of Clinical Engineering, School of Health Sciences, Fujita Health University, 1-98 Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hiki
authors.affiliation: Faculty of Clinical Engineering, School of Health Sciences, Fujita Health University, 1-98 Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Sigeru
authors.initials: S
authors.lastname: Nakai
authors.affiliation: Chiryu Clinic, Chiryu, Aichi, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Gojohgawa Rehabilitation Hospital, Kiyosu, Aichi, Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Shimano
authors.affiliation: Kawana Hospital, Nagoya, Aichi, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishida
authors.affiliation: Nishichita General Hospital (formerly Chita City Hospital), Chita, Aichi, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kushimoto
authors.affiliation: Department of Nephrology, School of Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Nephrology, School of Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: Sigehisa
authors.initials: S
authors.lastname: Koide
authors.affiliation: Department of Nephrology, School of Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kanayama
authors.affiliation: National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.affiliation: National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Ito
authors.affiliation: Division of Medical Statistics, Fujita Health University, Toyoake, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Neurology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Mutoh
authors.affiliation: Kanayama Clinic, Nagoya, Aichi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sugiyama
authors.affiliation: Department of Nephrology, School of Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yuzawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood / Q000628:therapy; D016229:Amyloid beta-Peptides / Q000097:blood*; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D006435:Renal Dialysis; D012907:Smoking / Q000097:blood / Q000523:psychology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D016229:Amyloid beta-Peptides; D010446:Peptide Fragments; C078592:amyloid beta-protein (1-40); C075222:amyloid beta-protein (1-42)
keywords: Alzheimer’s disease; Amyloid-beta (Aβ); Blood purification; Cognitive function; Hemodialysis; Prospective study