Can Ruti trials an unprecedented experimental technique in Europe to improve Alzheimer's symptoms

BarcelonaTo combat a disease, it is essential to understand how it works. Alzheimer's is characterized by the unusual accumulation inside and outside neurons of a peptide (a protein fragment) called beta-amyloid and of the protein known as tau. It is not known why this happens, but it is very likely what causes cells to malfunction and the brain to atrophy little by little. One of the possible treatments currently on the table is to increase the drainage of cerebrospinal fluid where these proteins are found, in order to try to reduce their accumulation in patients with the disease in its mild phase. This is a route that will be studied for the first time in Europe in a clinical trial driven by the Germans Trias i Pujol Hospital in Badalona.

The study, called ALCEA (Study of the clinical and biological effects of cervical lymphaticovenous anastomosis in Alzheimer's disease), aims to determine the safety and feasibility of this technique. The technique consists of establishing a connection between the lymphatic vessels and the veins of the neck to increase drainage, a minimally invasive microsurgery that has already been performed on two patients. The results obtained so far are very preliminary, but professionals suggest that one of the patients may have experienced a functional improvement, although the current study is designed to evaluate the safety of the intervention.

The trial will include a total of 10 patients with early-stage Alzheimer's disease, who will be followed for a minimum of one year to observe their evolution. The study is aimed at patients diagnosed with mild Alzheimer's disease who are being followed in the Neurology and Geriatrics clinics of the center and who meet the criteria for entry. The scientists' hypothesis is that the connection between the lymphatic system and the lymph nodes constitutes a direct pathway for the elimination of cerebrospinal fluid and the proteins that accumulate in the brain and cause Alzheimer's. The technique is frequently used in the treatment of lymphedema (the abnormal accumulation of lymphatic fluid in the tissues), especially in oncological surgeries or radiotherapy, with the aim of reducing fluid accumulation, improving symptoms, and preventing associated complications.

Other precedents

The first clinical studies of this technique, mainly in China, have shown promising preliminary results, with improvements in cognitive parameters and biomarkers, as well as good safety of the procedure. In a recent series of 26 patients, no complications were recorded. However, these studies have significant limitations, such as short follow-ups and a lack of randomized designs.

Currently, there are 21 clinical studies registered in China, one in Seoul, two in Singapore, and one in Taiwan, in addition to the one to be conducted in Catalonia, the first in Europe. For researchers, the results observed in the first intervened case reinforce the need to lead studies on this new therapeutic pathway.