Cantero-Fortiz Yahveth, Boada Mercè
Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain.
Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
Front Neurol. 2024 Sep 30;15:1443132. doi: 10.3389/fneur.2024.1443132. eCollection 2024.
AD is a progressive neurodegenerative disorder causing significant cognitive decline and impaired daily functioning. Current treatments offer only modest relief, and many amyloid-targeting therapies have failed, prompting exploration of alternative approaches such as PE with albumin replacement.
This scoping review systematically maps the literature on PE with albumin replacement in AD management, focusing on outcomes, methodologies, and reported benefits and risks.
A comprehensive search in PubMed, supplemented by reference scanning and hand-searching, identified studies involving PE with albumin replacement in AD patients. Data charting and critical appraisal were conducted using standardized tools.
Seven primary studies from the AMBAR (Alzheimer Management by Albumin Replacement) trial met the inclusion criteria, consistently reporting improvements in cognitive function, positive neuroimaging results, and favorable neuropsychiatric outcomes. For instance, one study found a significant slowing of cognitive decline ( < 0.05) among patients receiving PE with albumin replacement. Another study showed better preservation of hippocampal volume and improved brain perfusion metrics in the treatment group ( < 0.05). The intervention was generally well-tolerated with manageable side effects.
PE with albumin replacement is a promising therapeutic approach for AD, warranting further investigation to confirm its efficacy and safety across broader settings.
https://osf.io/v6dez/?view_only=1cd9637e7e0347d39713bf19aac0dfe8.
阿尔茨海默病（AD）是一种进行性神经退行性疾病，会导致显著的认知衰退和日常功能受损。目前的治疗方法只能提供有限的缓解，许多针对淀粉样蛋白的疗法都已失败，这促使人们探索诸如白蛋白置换血浆置换（PE）等替代方法。
本范围综述系统地梳理了关于白蛋白置换血浆置换在AD治疗中的文献，重点关注治疗结果、方法以及所报道的益处和风险。
在PubMed上进行全面检索，并辅以参考文献扫描和手工检索，以确定涉及AD患者白蛋白置换血浆置换的研究。使用标准化工具进行数据图表绘制和批判性评价。
来自AMBAR（白蛋白置换治疗阿尔茨海默病）试验的七项主要研究符合纳入标准，一致报告了认知功能的改善、积极的神经影像学结果以及良好的神经精神学结果。例如，一项研究发现接受白蛋白置换血浆置换的患者认知衰退显著减缓（<0.05）。另一项研究显示治疗组海马体积的保留情况更好，脑灌注指标有所改善（<0.05）。该干预措施总体耐受性良好，副作用可控。
白蛋白置换血浆置换是一种有前景的AD治疗方法，需要进一步研究以确认其在更广泛情况下的疗效和安全性。
https://osf.io/v6dez/?view_only=1cd9637e7e0347d39713bf19aac0dfe8 。
