AAICAD 2010：アルツハイマー病・ＭＣＩ 経鼻インスリン投与効果

アルツハイマー病・ＭＣＩに対する経鼻インスリン臨床トライアルで効果

アルツハイマーと糖尿病/インスリン抵抗性に密接な関連がある。アルツハイマーは脳のインスリンシグナル化減少そして、脳脊髄液インスリン値の低下と関連する。このインスリン関連の欠乏が、脳内インスリンの旗ｋらき低下に関与しているのではないか？
Suzanne Craft, PhD　（VA Puget Sound Health Care System/University of Washington in Seattle）は、脳の正常インスリン機能回復によるアルツハイマー病成人に治療的効果の可能性を示唆
Craft らが以前、経鼻インスリン21日間の投与による、ＭＣＩ、アルツハイマー病初期の認知機能促進、日常生活機能改善を示した。109名のＭＣＩ、アルツハイマー型認知症に対して、プラセボ、経鼻インスリン 20 or 40 IU連日投与
２０ IU投与群（1日2回10ＩＵずつ）で、有意にプラセボ比較でdelayed story recall の改善を認めた。また、Dementia Severity Rating Scale測定機能状態の改善も認めた
delayed memory recall改善は、インスリン治療終了後も2ヶ月経過後も継続
しかし、ＡＤＡＳ－Ｃｏｇによる記憶、学習スコア、ＡＤＣＳ－ＡＤＬスコアによるＡＤＬ能力スコアは不変
記憶、機能状態改善のあった、インスリン治療15名で、脊髄液採取同意を得て、biomarker profile検査し、CSF tau/Aβ42の低下が観察された。

Suzanne Craft：Insulin Resistance and　Alzheimer Alzheimer’s Disease: A Novel Therapeutic Target
http://www.alz.washington.edu/NONMEMBER/SPR06/craft.pdf

ホノルルで開かれている、Alzheimer's Association International Conference on Alzheimer's Disease 2010 (AAICAD 2010)からのpress release
上記報告を含め３つ

(1) a newly-discovered risk gene for Alzheimer's may have early impact on memory skills and brain volume

Two studies reported at AAICAD 2010 give us more information about the TOMM40 gene – a newly identified risk gene for Alzheimer's. They found that healthy, middle aged people who have the high risk version of TOMM40 (a) did worse on memory tests and (b) had reduced brain volume in two regions affected early in Alzheimer's.

(2) intranasal insulin may be beneficial in Alzheimer's

A short-term trial of intranasal insulin in Alzheimer's and MCI showed statistically significant benefits on certain tests of memory and functioning, but no changes on some others. In those who showed benefits on memory tests, there were also positive changes in Alzheimer's biomarkers in spinal fluid.

(3) beta amyloid deposits in the brains of people with Alzheimer's disease may take different shapes based on a known Alzheimer's risk gene.

Researchers using a new imaging tool suggest that there are different shapes of beta amyloid deposits in the Alzheimer brain based on which version a person has of a well-established Alzheimer's risk gene, known as APOE. This may be especially important because in some recent drug trials the therapy provided benefits in people who had certain types of APOE but were less effective or not effective in others.