Treatment for Alzheimer’s

AMBAR stands for Alzheimer Management by Albumin Replacement and refers to a procedure called therapeutic plasma exchange (TPE). This means that a patient’s blood is filtered through a device called an apheresis machine that extracts plasma and replaces it with an infusion of the patient’s red blood cells and a saline mixture containing human serum albumin. That is reintroduced into the patient’s bloodstream. In AMBAR, the procedure was done weekly for eight weeks, then monthly for four months.

Human serum albumin is produced in the liver and has many functions. It also seems to have a role in clearing toxins from the body and that, plus removal of misfolded proteins and molecules that signal other cells to age, may be how TPE helps control Alzheimer’s. The brain changes associated with Alzheimer’s, including accumulation of tau protein and amyloid tangles, may result from toxic substances that accumulate for unknown reasons.

How does it work? In this study, when albumin was reintroduced into the patient’s bloodstream, the researchers saw that it binds to amyloid-beta protein — one of the proteins that accumulate in the brains of Alzheimer’s patients. By periodically extracting plasma using TPE and replacing it with “fresh” albumin, it is possible to continually clear out excess amyloid-beta, reducing its negative effect on cognitive functions. Additionally, it maintains albumin’s immunomodulatory and anti-inflammatory properties. The repeated infusions seem to recondition the body so it doesn’t continue to be badly damaged by brain-muddling proteins and chemicals.

The results? Overall, patients with mild AD saw a 61% reduction in the progression of cognition problems if they received the TPE infusion, compared to folks who received a sham treatment. In addition, some patients with mild Alzheimer’s actually experienced the reversal of some of their cognitive dysfunction — and the improvement lasted over the 15 months the patients were tested. That’s an important sign of its effectiveness.