Ricardo Gonzalo

Longitudinal omics data analysis of patients undergoing therapeutic plasma exchange with albumin replacement as a treatment for Alzheimer’s Disease

Ricardo Gonzalo
Plasma R&D, Scientific Innovation Office, Grifols, Barcelona, Spain

Alzheimer’s disease (AD) is a neurodegenerative process cognitive decline. Key features of AD include the accumulation of plaques of amyloid-β peptide and the presence of neurofibrillary tangles. However, evidence suggests that AD is a multifactorial pathology with oxidative stress and inflammation playing an important role in its pathogenesis and progression. The AMBAR phase 2b/3 trial treated mild-moderate AD patients (MMSE:18-26) with 18 plasma exchange with albumin replacement (PE-Alb) over 14-month to remove neurotoxic Aβ and other pathological substances from plasma.

With the objective of deepening the understanding of the multimechanistic basis of PE-Alb for AD management, levels of cytokines, proteins and lipids were measured in plasma and
cerebrospinal fluid samples from PE-Alb-treated and placebo patients, taken at different
treatment time points. Change from baseline with a mixed model for repeated measures
approach was applied.

Overall results indicate that PE-Alb procedures used in the AMBAR clinical trial induced
positive changes in the different biomarkers assessed. Relationship of some of the markers
with cognitive improvement was also demonstrated. All these findings support the
multimechanism basis of the AMBAR therapeutic approach that may contribute to slowing AD progression.