Risultati per: Nuovi possibili trattamenti per il morbo di Alzheimer

New England Journal of Medicine, Volume 389, Issue 21, November 2023.

Studio del San Martino, insieme al digiuno affamano le cellule del cancro

New England Journal of Medicine, Volume 389, Issue 20, Page 1862-1876, November 2023.

New England Journal of Medicine, Volume 389, Issue 20, Page 1918-1920, November 2023.

L’accudimento di un bambino, anche attraverso la simulazione, fa bene ai malati di Alzheimer. È quanto emerge dalla sperimentazione “Hero”, realizzata da un gruppo di ricerca dell’Università di Napoli Federico…

Vendruscolo alla Sissa: “Siamo ad uno stadio iniziale”

Il biofisico:’ma siamo a stadio iniziale, occorre stare attenti’

New England Journal of Medicine, Volume 389, Issue 19, November 2023.

Circulation, Volume 148, Issue Suppl_1, Page A13370-A13370, November 6, 2023. Introduction:Alzheimer’s Disease (AD) causes neuroinflammation characterized by degradation of neurological functions resulting in memory loss and confusion. Activated Protein C (APC), a plasma zymogen, has shown promising cytoprotection, anti-inflammation, and anti-apoptotic properties. ScRNA-seq allows for examining the underlying mechanisms by which APC therapy on AD at the cellular level.Hypothesis:APC treatment can ameliorate AD symptoms of 5xFAD transgenic mice. The scRNA Seq analysis could provide detailed responses of various cell populations to Alzheimer’s disease pathogenesis and molecular aspects of APC therapy.Methods:Whole brain tissue were collected at 7 months, APC-treated 5xFAD mice received daily recombinant APC or saline injections. The 10x Genomics Next Gem kit was used to dissociate the tissue for sequencing. Bioinformatic analysis was performed using Seurat in R and an integrated dataset was used to compare multiple single-cell samples.Results:Bioinformatic analysis of 5xFAD versus wild type (WT) C57BL/6J mouse brain revealed much of the sample consists of microglial cells. Interestingly, 5xFAD versus WT brains have notable decreases in astrocyte and neuron populations. Administration of recombinant APC rebounds these populations to comparable levels as WT while dramatically reduces the microglial population in 5xFAD versus WT brain. The largest proportion of oligodendrocytes are also recorded after APC treatment. Differential expression testing conveys transcriptomic regulation of known AD critical genes such asApoe,Ctsb,Trem2, andTyrobpby APC. Consequently, GO term enrichment uncovers inflammatory biological processes such as microglial activation to be downregulated by APC-treated 5xFAD. Additionally, recuperation of nervous system developmental processes was found in APC-treated 5xFAD mice.Conclusions:APC treatment drastically impacts the cellular pathophysiology of AD. Differential expression testing of APC treated 5xFAD versus WT mice revealed transcriptomic downregulation of AD implicated genes throughout multiple cell-types. Administration of APC significantly impacts AD implicated genes associated with AD pathogenesis through enrichment analysis.

Circulation, Volume 148, Issue Suppl_1, Page A14800-A14800, November 6, 2023. Background:Alzheimer’s disease and related dementias (ADRD) are highly prevalent among adults with heart failure (HF). HF is associated with disability among older adults, especially those with ADRD. This may impact aging in place after HF hospitalizations, which is concerning given this is an important outcome for patients recovering from serious illnesses. We aimed to examine the association between ADRD and aging in place among Medicare beneficiaries hospitalized for HF.Methods:We identified 80,694 fee-for-service beneficiaries hospitalized for HF between 2017 and 2019 in a 20% random sample of Medicare claims. HF hospitalization and ADRD were identified using ICD codes. The primary outcome was restricted home time, a patient-centered claims-based measure of successful aging in place defined as spending ≥ 10 days not at home (e.g., hospitalized, nursing home, inpatient facility) over 6 months post-discharge. Multivariable logistic regression was used to examine the association between ADRD and restricted home time adjusting for demographic and clinical characteristics; secondary analyses evaluated the likelihood of returning to pre-hospitalization days at home 6 months post-discharge.Results:Eighteen percent (n= 14,503/80,694) of adults hospitalized for HF had concurrent ADRD. HF patients with ADRD were older (83 vs 77 years), more likely to be female (56% vs 48%), and have dual Medicaid/Medicare eligibility (27% vs 21%), but had similar hospital length of stays and days at home preceding HF hospitalization compared to those without ADRD. Of HF patients with ADRD, 63% had restricted home time (vs. 51% without ADRD) and 52% failed to return to baseline days at home (vs. 42% without ADRD). In adjusted models, older adults with ADRD had 34% greater odds of experiencing restricted home time (OR=1.34, 1.30-1.40), and 20% lower odds of returning to baseline days at home (OR=0.80, 0.77-0.83) 6 months post- discharge than those without ADRD.Conclusions:HF hospitalizations impact the ability of older adults to successfully age in place, especially among those with ADRD. Tailored post-discharge care solutions are urgently needed to address the challenges faced by HF patients with ADRD.

Does AD change the gut microbiome, or does the gut microbiome influence risk for developing AD?

Objective
Estimate the prevalence of diagnosed Alzheimer’s disease (AD) and early Alzheimer’s disease (eAD) overall and stratified by age, sex and deprivation and combinations thereof in England on 1 January 2020.

Design
Cross-sectional.

Setting
Primary care electronic health record data, the Clinical Practice Research database linked with secondary care data, Hospital Episode Statistics (HES) and patient-level deprivation data, Index of Multiple Deprivation (IMD).

Outcome measures
The prevalence per 100 000 of the population and corresponding 95% CIs for both diagnosed AD and eAD overall and stratified by covariates. Sensitivity analyses were conducted to assess the sensitivity of the population definition and look-back period.

Results
There were 448 797 patients identified in the Clinical Practice Research Datalink that satisfied the study inclusion criteria and were eligible for HES and IMD linkage. For the main analysis of AD and eAD, 379 763 patients are eligible for inclusion in the denominator. This resulted in an estimated prevalence of diagnosed AD of 378.39 (95% CI, 359.36 to 398.44) per 100 000 and eAD of 292.81 (95% CI, 276.12 to 310.52) per 100 000. Prevalence estimates across main and sensitivity analyses for the entire AD study population were found to vary widely with estimates ranging from 137.48 (95% CI, 127.05 to 148.76) to 796.55 (95% CI, 768.77 to 825.33). There was significant variation in prevalence of diagnosed eAD when assessing the sensitivity with the look-back periods, as low as 120.54 (95% CI, 110.80 to 131.14) per 100 000, and as high as 519.01 (95% CI, 496.64 to 542.37) per 100 000.

Conclusions
The study found relatively consistent patterns of prevalence across both AD and eAD populations. Generally, the prevalence of diagnosed AD increased with age and increased with deprivation for each age category. Women had a higher prevalence than men. More granular levels of stratification reduced patient numbers and increased the uncertainty of point prevalence estimates. Despite this, the study found a relationship between deprivation and prevalence of AD.

This Medical News story examines the complexity of determining who to treat with lecanemab, the new Alzheimer disease drug.

This Viewpoint discusses how the design of the Centers for Medicare & Medicaid Services (CMS) registry could impact Medicare’s ability to evaluate whether monoclonal antibodies are reasonable and necessary for patients with Alzheimer disease and help physicians understand when the drug is most beneficial.

This Medical News feature discusses a Quest Diagnostics blood biomarkers test that is supposed to help consumers assess their Alzheimer disease risk.

Lodi, numeri di casi altissimi e in crescente aumento.