Removal of blood amyloid-β as an effective and safe therapeutic strategy for Alzheimer's disease

Abstract Clearance of amyloid-β (Aβ) from the brain is impaired in patients with Alzheimer's disease (AD). Increasing Aβ clearance in the brains of patients with AD represents a potentially promising treatment option. We hypothesized that extracorporeal blood Aβ removal systems (E-BARS) that rapidly remove Aβ from the blood may accelerate Aβ clearance from the brain. The following supportive observations are discussed: (1) several medical materials, including hexadecyl-alkylated cellulose particles and hemodialyzers with appropriate membrane materials, can effectively remove blood Aβ; (2) the concentrations of blood Aβ decreases during hemodialysis; (3) removal of blood Aβ evokes a large influx of Aβ into the blood, most likely from the brain, in human and rat studies; (4) Aβ deposition in the brain of hemodialysis patients is significantly lower than in controls; and (5) patients who undergo hemodialysis maintain or show improved cognitive functions, and longer periods of hemodialysis are correlated with reduced dementia risk. Thus, blood Aβ removal, via E-BARS, may reduce brain Aβ concentrations and serve as a therapeutic option and/or preventive method for AD.