Regenold William T, Blumenthal Jacob B, Loreck David J, Mordecai Kristen L, Scarinzi Gina, Doddi Seshagiri R, Adler Lawrence
1 Department of Psychiatry (Geriatric), University of Maryland School of Medicine, Baltimore, MD, USA.
2 GRECC, Baltimore VA Medical Center, Baltimore, MD, USA.
Am J Alzheimers Dis Other Demen. 2017 Sep;32(6):347-352. doi: 10.1177/1533317517707288. Epub 2017 Apr 27.
BACKGROUND/RATIONALE: Accumulating evidence suggests that the use of angiotensin-converting enzyme inhibitor (ACE-I) medication protects against cognitive decline in the elderly patients. We investigated whether ACE-I use was associated with higher plasma levels of amyloid-β (Aβ), possibly indicating improved Aβ clearance from brain to blood.
We measured and compared plasma concentrations of Aβ42, Aβ40, and creatinine in cognitively impaired individuals with amnestic mild cognitive impairment, probable Alzheimer's disease (AD) dementia, and mixed probable AD/vascular dementia.
Plasma Aβ42 levels and Aβ42/Aβ40 ratios of participants taking ACE-Is (n = 11) significantly exceeded ( t = 3.1, df = 19, P = .006; U = 24, P = .029, respectively) those not taking ACE-Is (n = 10).
This study is the first to show an association between ACE-I use and increased plasma Aβ42 level and Aβ42/Aβ40 ratio in cognitively impaired individuals. Future investigations should assess whether a possible ACE-I-induced increase in plasma Aβ42 indicates improved Aβ42 clearance from brain that contributes to protection from cognitive decline.
背景/原理：越来越多的证据表明，使用血管紧张素转换酶抑制剂（ACE-I）药物可预防老年患者的认知衰退。我们研究了使用ACE-I是否与较高的血浆β淀粉样蛋白（Aβ）水平相关，这可能表明从脑到血的Aβ清除有所改善。
我们测量并比较了患有遗忘型轻度认知障碍、可能的阿尔茨海默病（AD）痴呆症以及混合型可能的AD/血管性痴呆症的认知障碍个体的血浆Aβ42、Aβ40和肌酐浓度。
服用ACE-I的参与者（n = 11）的血浆Aβ42水平和Aβ42/Aβ40比值显著高于（分别为t = 3.1，自由度 = 19，P = 0.006；U = 24，P = 0.029）未服用ACE-I的参与者（n = 10）。
本研究首次表明，在认知障碍个体中，使用ACE-I与血浆Aβ42水平升高及Aβ42/Aβ40比值增加之间存在关联。未来的研究应评估ACE-I可能导致的血浆Aβ42升高是否表明Aβ42从脑的清除改善，这有助于预防认知衰退。
