Gu Jiachen, Li Zongshan, Chen Huimin, Xu Xiaomin, Li Yongang, Gui Yaxing
Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Neurol Ther. 2021 Dec;10(2):905-917. doi: 10.1007/s40120-021-00271-2. Epub 2021 Aug 16.
Amyloid-beta (Aβ) protein is a major component of the extracellular plaque found in the brains of individuals with Alzheimer's disease (AD). In this study, we investigated the effect of trans-resveratrol as an antagonist treatment for moderate to mild AD, as well as its safety and tolerability.
This was a case-control study that enrolled 30 selected patients who had been clinically diagnosed with moderate to mild AD. These patients were randomly divided into two groups, namely, a placebo group (n = 15) and a trans-resveratrol group (n = 15) who received 500 mg trans-resveratrol orally once daily for 52 weeks. Brain magnetic resonance imaging (MRI) examinations were performed on and cerebrospinal fluid (CSF) samples were obtained from all participants before (baseline) and after the study (52 weeks). Enzyme-linked immunosorbent assays were used to determine the levels of plasma Aβ40 and Aβ42 and CSF Aβ40 and Aβ42.
The results showed that the changes over the study period in the levels of Aβ40 in the blood and CSF of the patients treated with trans-resveratrol were not statistically significant (P > 0.05). In contrast, patients who received placebo showed a significant decrease in Aβ40 levels compared with that at the beginning of the study (CSF Aβ40: P = 0.024, plasma Aβ40: P = 0.036). Analysis of the images on the brain MRI scans revealed that the brain volume of the patients treated with trans-resveratrol was significantly reduced at 52 weeks (P = 0.011) compared with that of patients in the placebo treatment group, Further analysis indicated that the level of matrix metallopeptidase 9 in the CSF of the patients treated with trans-resveratrol at 52 weeks decreased by 46% compared with that of patients in the placebo group (P = 0.033).
These results indicate that trans-resveratrol has potential neuroprotective roles in the treatment of moderate to mild AD and that its mechanism may involve a reduction in the accumulation and toxicity of Aβ in the brain of patients, thereby reducing neuroinflammation.
Chinese clinical trial registry: CTR20151780X.
β-淀粉样蛋白(Aβ)是阿尔茨海默病(AD)患者大脑中细胞外斑块的主要成分。在本研究中,我们调查了反式白藜芦醇作为中度至轻度AD拮抗剂治疗的效果及其安全性和耐受性。
这是一项病例对照研究,纳入了30例临床诊断为中度至轻度AD的选定患者。这些患者被随机分为两组,即安慰剂组(n = 15)和反式白藜芦醇组(n = 15),后者每天口服500毫克反式白藜芦醇,持续52周。在研究前(基线)和研究后(52周)对所有参与者进行脑磁共振成像(MRI)检查并采集脑脊液(CSF)样本。采用酶联免疫吸附测定法测定血浆Aβ40和Aβ42以及脑脊液Aβ40和Aβ42的水平。
结果显示,反式白藜芦醇治疗患者的血液和脑脊液中Aβ40水平在研究期间的变化无统计学意义(P>0.05)。相比之下,接受安慰剂治疗的患者与研究开始时相比,Aβ40水平显著降低(脑脊液Aβ40:P = 0.024,血浆Aβ40:P = 0.036)。对脑MRI扫描图像的分析显示,与安慰剂治疗组的患者相比,反式白藜芦醇治疗的患者在52周时脑体积显著减小(P = 0.011)。进一步分析表明,与安慰剂组患者相比,反式白藜芦醇治疗的患者在52周时脑脊液中基质金属蛋白酶9的水平降低了46%(P = 0.033)。
这些结果表明,反式白藜芦醇在中度至轻度AD的治疗中具有潜在的神经保护作用,其机制可能涉及减少患者大脑中Aβ的积累和毒性,从而减轻神经炎症。
中国临床试验注册中心:CTR20151780X。