Removal of blood amyloid-β with hemodialysis reduced brain amyloid-β, confirmed by brain imaging: a case report

Abstract

The accumulation of amyloid-β protein (Aβ) in the brain signifies a major pathological change of Alzheimer’s disease (AD). Extracorporeal blood Aβ removal system (E-BARS) has been under development as a tool for enhancing the clearance of Aβ from the brain. Previously, we revealed that dialyzers remove blood Aβs effectively, evoking substantial Aβ influx into the blood during hemodialysis sessions as one form of blood Aβ removal by E-BARS, and that postmortem brains of hemodialysis patients exhibited lower Aβ accumulation. Here, we present a case report of a 77-year-old male patient with end-stage renal failure whose Aβ accumulation in the brain declined by initiating and continuing hemodialysis for 6 months. This report suggests that blood Aβ removal by E-BARS could be an effective therapeutic method for AD.

Keywords:

• amyloid-β
• Aβ
• PiB/PET
• blood purification
• blood Aβ removal
• Alzheimer’s disease
• E-BARS
• extracorporeal blood Aβ removal system

Acknowledgments

The authors thank Dr Yoshiki Inui for discussing the ischemic status, and Clinical Psychologist Ms Tomoko Kitayama, Clinical Engineer Mr Shojiro Kitagawa, and Ms Miwa Sakata for their assistance. The authors also thank Dr Kazuyoshi Sakai and Mr Hiroshi Kawachi for discussion about ARIA and β2MG, respectively. This work was partly supported by KAKENHI (20509008, 23500531, 26282126), and the Smoking Research Foundation.

Author contributions

Nobuya Kitaguchi contributed to study design, steering the study, and measurements of blood Aβ monomers and oligomers. Takashi Kato, Kaori Iwata, and Kengo Ito contributed to performing PiB/PET, analyzing the data of PiB/PET and MRI, and single-photon emission computed tomography. Shinji Matsunaga and Hajime Takechi contributed to neurological diagnosis. Kyoko Hirano, Kiyoshi Fujita, Midori Hasegawa, and Yukio Yuzawa contributed to recruitment of the patient, diagnosis and treatment of renal failure, and initiation and maintenance of his hemodialysis. Kazunori Kawaguchi contributed to measurements of blood Aβ monomers and oligomers. All authors contributed toward data analysis, drafting and revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Dr Kitaguchi has patents issued to this work (JP5843345 and US 10,112,000). The authors report no other conflicts of interest in this work.