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Open AccessReview

Therapeutic Plasmapheresis with Albumin Replacement in Alzheimer’s Disease and Chronic Progressive Multiple Sclerosis: A Review

by Rut Navarro-Martínez 1,2,3 and Omar Cauli 2,3,*
1
Haematology Department, Hospital General Universitario, 46014 Valencia, Spain
2
Department of Nursing, University of Valencia, 46010 Valencia, Spain
3
Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain
*
Author to whom correspondence should be addressed.
Pharmaceuticals 2020, 13(2), 28; https://doi.org/10.3390/ph13020028
Received: 26 November 2019 / Revised: 6 February 2020 / Accepted: 7 February 2020 / Published: 12 February 2020
(This article belongs to the Special Issue Therapeutics Agents for Neural Repair)
Background: Reducing the burden of beta-amyloid accumulation and toxic autoimmunity-related proteins, one of the recognized pathophysiological markers of chronic and common neurological disorders such as Alzheimer’s disease (AD) and multiple sclerosis (MS), may be a valid alternative therapy to reduce their accumulation in the brain and thus reduce the progression of these disorders. The objective of this review was to evaluate the efficacy of plasmapheresis (PP) in AD and chronic progressive MS patients (in terms of improving clinical symptoms) and to analyze its safety and protocols. Methods: Articles related to this topic and published without time limitations in the Medline, and Cochrane databases were reviewed. Results: In AD patients, PP reduced amyloid beta (Aβ) levels in the brain, accompanied by a tendency towards cognitive stabilization, and improved language and verbal fluency. In regards to structural and functional brain changes, PP reduced brain volume and favored the stabilization, or absence, of the progression of perfusion. In chronic progressive form of MS patients, PP improved neurological deficits in 20–70% of patients with a chronic progressive form of MS, and restored interferon (IFN) responsiveness, which was not accompanied by any image change in brain plaques. Conclusions: Therapeutic plasmapheresis with albumin replacement is a promising strategy for reducing Aβ mediated toxicity and slowing the progression of the disorder. Some patients with chronic progressive forms of MS show improvement in neurological deficits. The features of AD and MS patients who benefit most from this approach need further research. View Full-Text
Keywords: plasmapheresis; albumin; auto-immunity; dementia; magnetic resonance imaging; amyloid beta plasmapheresis; albumin; auto-immunity; dementia; magnetic resonance imaging; amyloid beta
MDPI and ACS Style

Navarro-Martínez, R.; Cauli, O. Therapeutic Plasmapheresis with Albumin Replacement in Alzheimer’s Disease and Chronic Progressive Multiple Sclerosis: A Review. Pharmaceuticals 2020, 13, 28.

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