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A “Leaky” Blood-Brain Barrier and Alzheimer痵

Alzheimer’s disease (AD) affects 4.5 million Americans according to the National Institutes of Aging; the direct and indirect costs of the disease// exceed $100 billion each year. As the wave of baby boomers continues to age it is apparent that the number of people with AD will increase, along with the costs for care. While no one knows the precise underlying cause leading to the characteristic pathology of the disease, a new study finds that a “leaky” blood-brain barrier (BBB) — and levels of water-soluble antioxidants — may offer clues to unlocking this haunting disease.

Methodology Thirty-six participants (mean age 70 + 7 years) diagnosed with mild to moderate Alzheimer’s disease (Mini-Mental Status Exam 19+5) participated in a prospective biomarker study. The evaluation of the participants included clinical assessments, brain imaging, and cerebral spinal fluid (CSF) along with plasma collection for a period of one year. The participants were evaluated at baseline, three months and 12 months. The researchers employed the CSF-albumin index to determine blood-brain barrier integrity. CSF and plasma levels of ascorbic acid (AA) and uric acid (UA) were also measured.

Results The researchers observed the following: § As expected, the concentration of AA was higher in the CSF compared to the plasma reflected by a CSF-to-plasma ratio of AA greater than 1.0 in all cases, with an average of 4.0. In contrast, the concentration of UA in the CSF was lower than plasma reflected by a CSF-to-plasma ratio of UA was less than 0.25 in all subjects.

§ The mean CSF-albumin index was 7.2. However, in 22% of the study participants, the CSF-albumin index was greater than 9.0, indicating blood-brain barrier disruption.

§ There were no correlations appreciated between plasma AA and age, gender, APOE status, MMSE at baseline or rates of clinical decline at 12 months. However, a positive correlation did exist between plasma AA and hippoca
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