AMBAR Therapeutic plasma exchange
AMBAR is an innovative clinical trial aimed at slowing down the progression of Alzheimer’s disease through periodic therapeutic plasma exchange.
AMBAR targets a multimodal approach to the management of the disease based on the hypothesis that most of the amyloid-beta protein is bound to albumin and circulates in plasma. Extracting this plasma may flush amyloid-beta peptide from the brain into the plasma, thus potentially limiting the disease’s impact on the patient’s cognitive functions. Additionally, albumin has binding capacity and antioxidant properties, and both albumin and immunoglobulin display immunomodulatory and anti-inflammatory properties.
Based on this hypothesis, the build-up of beta-amyloid could be reduced before it can cause neuronal damage, thus potentially limiting the impact of Alzheimer’s disease on cognition.
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Proteins called chaperones bind to damaged or defective proteins in cells of the body. The chaperones ferry their cargo to the cells’ lysosomes, which digest and recycle waste material. To successfully get their cargo into lysosomes, however, chaperones must first “dock” the material onto a protein receptor called LAMP2A that sprouts from the membranes of lysosomes. The more LAMP2A receptors on lysosomes, the greater the level of CMA activity possible.
The team developed a novel drug that shows potential for treating Alzheimer’s. The new drug, called CA, works by increasing the number of those LAMP2A receptors. “CA (experimental drug) restores LAMP2A to youthful levels (in mice), enabling CMA to get rid of tau and other defective proteins so they can’t form those toxic protein clumps,” said Cuervo.