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Small clinical trial tests blood plasma as Alzheimer’s treatment

A preliminary and small clinical trial in California suggests that infusions of blood plasma from young people may improve the cognition of patients with Alzheimer’s disease, but doctors caution that more research is required.

The investigation, to be presented Saturday at the Clinical Trials on Alzheimer’s Disease conference in Boston, bolsters a similar effort undertaken by a Lenox Hill/Northwell Health doctor several years ago. That attempt, which involved only some of the components of blood plasma, was abandoned because appreciable improvement was not seen in most of the treated patients.

But the new effort by doctors from Stanford University hints at cognitive improvements for patients via infusions of the largest constituent in human blood — the plasma. The substance is made up of proteins, enzymes, antibodies, salts, water and the infinitesimal hormone-like components known as cytokines.

Explained another way: When red and white blood cells are removed from blood, what remains is the plasma, the tan-colored liquid, cell-free portion of blood.

Stanford University doctors used plasma from donors between the ages of 18 and 30 for infusions into a group of nine older people with mild to moderate Alzheimer’s disease.

“There have been several studies in the past looking at immunoglobulins, which are components of plasma, in the treatment of patients with dementia,” said Dr. Gayatri Devi, a neurologist and specialist in memory disorders at Lenox Hill Hospital, a division of Northwell Health.

Immunoglobulins are the proteins present in the blood and are associated with the immune system.

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Devi said that she treated patients “off-label” with immunoglobulins and saw some slight cognitive improvements in a few, but that most had no response to the therapy. The term “off-label,” widely used in medicine, means providing patients with a treatment that does not pose harm, but is not approved for that purpose by the U.S. Food and Drug Administration.

In the recent clinical trial, Dr. Sharon Sha, a Stanford University physician, used whole plasma instead. All nine patients were infused with plasma or a harmless placebo. The clinical research is based on a hypothesis by Dr. Tony Wyss-Coray, a Stanford professor of neurology and neurological sciences.

“Our enthusiasm concerning these findings needs to be tempered by the fact that this was a small trial,” Sha said in a statement. “But these results certainly warrant further study.”

Sha is to report at the Boston meeting that the trial was conducted in two stages, with participants divided into two groups. One group was given plasma in four weekly infusions; the other received four placebo infusions. A saline solution was used as the placebo.

Neither the participants nor those administering the infusions knew which of the two infusions a participant received. In the trial’s second stage, the regimen was reversed. Participants who received plasma the first time got the placebo during the second round, and vice versa.

Stanford doctors would only say that their conclusion was that the therapy is safe. They intend to expand the research to a larger group.

Devi, the author of a book about dementia titled “The Spectrum of Hope: An Optimistic and New Approach to Alzheimer’s Disease,” said there is a difference between the Stanford study and her clinical therapy.

Whole plasma has anti-inflammatory components in it, she said, and that may help explain the cognitive improvements reported by the Stanford team. Devi said more work on a larger number of patients is required before plasma therapy can be widely prescribed.

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