Studies of the Efficacy of Cereton in Mild Cognitive Impairment of the Amnestic Type Based on Testing Lipid Markers

Objectives. To determine the efficacy and safety of treatment with Cereton (alfoscerate) in patients with mild cognitive impairment syndrome (MCI) and its effects during and after treatment on phosphatidyl-choline, sphingomyelin, and ceramide (a sphingolipids metabolite) contents and the activity of genes controlling the synthesis of enzymes (sphingomyelinase and ceramidase) involved in the sphingomyelin and ceramide metabolism. Materials and methods. A total of 20 patients (14 women, six men) aged 51–82 (mean 70.3 ± 9.1) years were studied. Patients’ status corresponded to the criteria for diagnosis of MCI syndrome of the anamnestic type. Plasma phosphatidylcholine, sphingomyelin, and ceramide were estimated by thin layer chromatography, while expression of the sphingomyelinase and ceramidase genes was determined using the reverse transcriptase polymerase chain reaction. Results and conclusions. Sharp increases in the contents of phosphatidylcholine and ceramide – hydrolysis products of sphingomyelin – were seen. Expression of the genes (acid sphingomyelinase and ceramidase) controlling ceramide metabolism decreased in most patients during Cereton treatment. Increases in the levels of phosphatidylcholine and decreases in the expression of ceramide metabolism genes during treatment with Cereton and other agents affecting phosphatidylcholine and sphingomyelin metabolism can be used as markers for treatment efficacy.