Extracorporeal apheresis therapy for Alzheimer disease—targeting lipids, stress, and inflammation

Stefan R. Bornstein, Karin Voit-Bak, Peter Rosenthal, Sergey Tselmin, Ulrich Julius, Ulrike Schatz, Bernhard O. Boehm, Sandrine Thuret, Gerd Kempermann, Heinz Reichmann, George P. Chrousos, Julio Licinio, Ma Li Wong, Andrew V. Schally, Richard Straube

Research output: Contribution to journalArticle

Abstract

Current therapeutic approaches to Alzheimer disease (AD) remain disappointing and, hence, there is an urgent need for effective treatments. Here, we provide a perspective review on the emerging role of “metabolic inflammation” and stress as a key factor in the pathogenesis of AD and propose a novel rationale for correction of metabolic inflammation, increase resilience and potentially slow-down or halt the progression of the neurodegenerative process. Based on recent evidence and observations of an early pilot trial, we posit a potential use of extracorporeal apheresis in the prevention and treatment of AD. Apolipoprotein E, lipoprotein(a), oxidized LDL (low density lipoprotein)'s and large LDL particles, as well as other proinflammatory lipids and stress hormones such as cortisol, have been recognized as key factors in amyloid plaque formation and aggravation of AD. Extracorporeal lipoprotein apheresis systems employ well-established, powerful methods to provide an acute, reliable 60–80% reduction in the circulating concentration of these lipid classes and reduce acute cortisol levels. Following a double-membrane extracorporeal apheresis in patients with AD, there was a significant reduction of proinflammatory lipids, circulating cytokines, immune complexes, proinflammatory metals and toxic chaperones in patients with AD. On the basis of the above, we suggest designing clinical trials to assess the promising potential of such “cerebropheresis” treatment in patients with AD and, possibly, other neurodegenerative diseases.

Original languageEnglish (US)
JournalMolecular Psychiatry
DOIs
StateAccepted/In press - Jan 1 2019

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Blood Component Removal
Alzheimer Disease
Inflammation
Lipids
Medical Chaperones
Therapeutics
Hydrocortisone
Lipoprotein(a)
Poisons
Amyloid Plaques
Apolipoproteins E
Antigen-Antibody Complex
LDL Lipoproteins
Neurodegenerative Diseases
Lipoproteins
Metals
Clinical Trials
Hormones
Cytokines
Membranes

ASJC Scopus subject areas

  • Molecular Biology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience

Cite this

Bornstein, S. R., Voit-Bak, K., Rosenthal, P., Tselmin, S., Julius, U., Schatz, U., ... Straube, R. (Accepted/In press). Extracorporeal apheresis therapy for Alzheimer disease—targeting lipids, stress, and inflammation. Molecular Psychiatry. https://doi.org/10.1038/s41380-019-0542-x

Extracorporeal apheresis therapy for Alzheimer disease—targeting lipids, stress, and inflammation. / Bornstein, Stefan R.; Voit-Bak, Karin; Rosenthal, Peter; Tselmin, Sergey; Julius, Ulrich; Schatz, Ulrike; Boehm, Bernhard O.; Thuret, Sandrine; Kempermann, Gerd; Reichmann, Heinz; Chrousos, George P.; Licinio, Julio; Wong, Ma Li; Schally, Andrew V.; Straube, Richard.

In: Molecular Psychiatry, 01.01.2019.

Research output: Contribution to journalArticle

Bornstein, SR, Voit-Bak, K, Rosenthal, P, Tselmin, S, Julius, U, Schatz, U, Boehm, BO, Thuret, S, Kempermann, G, Reichmann, H, Chrousos, GP, Licinio, J, Wong, ML, Schally, AV & Straube, R 2019, 'Extracorporeal apheresis therapy for Alzheimer disease—targeting lipids, stress, and inflammation', Molecular Psychiatry. https://doi.org/10.1038/s41380-019-0542-x
Bornstein, Stefan R. ; Voit-Bak, Karin ; Rosenthal, Peter ; Tselmin, Sergey ; Julius, Ulrich ; Schatz, Ulrike ; Boehm, Bernhard O. ; Thuret, Sandrine ; Kempermann, Gerd ; Reichmann, Heinz ; Chrousos, George P. ; Licinio, Julio ; Wong, Ma Li ; Schally, Andrew V. ; Straube, Richard. / Extracorporeal apheresis therapy for Alzheimer disease—targeting lipids, stress, and inflammation. In: Molecular Psychiatry. 2019.
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