Höglund Kina, Wiklund Olov, Vanderstichele Hugo, Eikenberg Oliver, Vanmechelen Eugeen, Blennow Kaj
Institute of Clinical Neuroscience, The Sahlgrenska Academy at Göteborg, Sweden.
Arch Neurol. 2004 Mar;61(3):333-7. doi: 10.1001/archneur.61.3.333.
Epidemiological studies suggest that statins reduce the risk of developing Alzheimer disease. Cell and animal experiments have revealed a connection between cholesterol metabolism and the processing of amyloid precursor protein. To our knowledge, the mechanism for statins in risk reduction of Alzheimer disease is unknown.
To test the effect of statin treatment on beta-amyloid (A beta) metabolism in humans.
A prospective, randomized, dose-finding 36-week treatment trial with statins. Plasma samples were taken at baseline (week 0) and at weeks 6, 12, and 36.
Outpatient clinical study at a university hospital.
Thirty-nine patients who met the criteria for hypercholesterolemia.
Patients were randomized to oral treatment with either simvastatin or atorvastatin calcium according to the following regimen: simvastatin, 40 mg/d, or atorvastatin, 20 mg/d, for 6 weeks; followed by simvastatin, 80 mg/d, or atorvastatin, 40 mg/d, for 6 weeks; and finally, simvastatin, 80 mg/d, or atorvastatin, 80 mg/d, for 24 weeks.
Plasma levels of A beta(1-40) and A beta(1-42) were measured using 2 enzyme-linked immunosorbent assays, and total A beta was quantified by Western blotting.
Treatment with both statins reduced total plasma cholesterol levels by 56% (P =.00). The plasma levels of A beta(1-40), A beta(1-42), and total A beta were stable in individual patients during the treatment period. No significant change in the level of A beta(1-40), A beta(1-42), or total A beta was found.
This study questions the effect of statins on the processing of amyloid precursor protein in humans.
流行病学研究表明,他汀类药物可降低患阿尔茨海默病的风险。细胞和动物实验揭示了胆固醇代谢与淀粉样前体蛋白加工之间的联系。据我们所知,他汀类药物降低阿尔茨海默病风险的机制尚不清楚。
测试他汀类药物治疗对人体β淀粉样蛋白(Aβ)代谢的影响。
一项使用他汀类药物的前瞻性、随机、剂量探索性36周治疗试验。在基线(第0周)以及第6、12和36周采集血浆样本。
大学医院的门诊临床研究。
39名符合高胆固醇血症标准的患者。
根据以下方案将患者随机分为口服辛伐他汀或阿托伐他汀钙治疗组:辛伐他汀40mg/d或阿托伐他汀20mg/d,持续6周;然后辛伐他汀80mg/d或阿托伐他汀40mg/d,持续6周;最后,辛伐他汀80mg/d或阿托伐他汀80mg/d,持续24周。
使用2种酶联免疫吸附测定法测量血浆Aβ(1-40)和Aβ(1-42)水平,并通过蛋白质印迹法定量总Aβ。
两种他汀类药物治疗均使总血浆胆固醇水平降低了56%(P = 0.00)。在治疗期间,个体患者血浆中Aβ(1-40)、Aβ(1-42)和总Aβ水平保持稳定。未发现Aβ(1-40)、Aβ(1-42)或总Aβ水平有显著变化。
本研究对他汀类药物对人体淀粉样前体蛋白加工的影响提出了质疑。