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Of all our organs, our brains and our hearts attract the most attention. But the liver held the first place, dominating the heart and mind as the seat of emotion and even of the soul. As its name implies, we need our liver to live, not only because it works hard as a detox unit, but also because it quietly treats components that our brains need to prosper.
The research community on Alzheimer's disease at this liver-brain connection. This new interest is reflected in a quartet of new studies presented on July 24 at the International Conference of the Alzheimer's Association 2018. The findings can help provide clues to both the fundamental biology of AD. and on the relationship between diet and brain health. More specifically, he can give an overview of why clinical trials on fish oil have not helped protect against AD and other forms of dementia.
In all four studies, blood levels of liver and lipid-badociated molecules were badociated with AD risk – a first step toward further examination of the liver-brain link. "There appears to be positive results that correlate lipid levels with cognition and cognitive progression," says Paul Schulz, director of the Dementia and Memory Clinic at the University of Texas McGovern Medical School, who did not participate in the studies. "The challenge will be to establish the cause and the effect."
The brain is mainly composed of fats, which contribute to both its shape and function. These lipids facilitate the communication of the neuron to the neuron and constitute a large part of the isolation that surrounds these cells. It's the liver that makes the fats that the brain needs – and many genes related to Alzheimer's disease are related to the production or transport of fats, including a version of one's own. gene badociated with high risk of Aujeszky's disease. The brain needs omega-3 fatty acids, which we get from our diets. But the omega-3 sources we consume can not be delivered as such to the brain. Microbes in our gut, known as the microbiome, contribute to the treatment of lipids. In the final stages, the liver creates specific fats from the brain inside the cell structures called peroxisomes. Once these fats are synthesized, the blood transports them to the brain, where they form cellular structures and help the neurons to communicate.
Recognizing the central role of the liver in brain health, the four research groups measure the blood levels of these neurons. critical lipids and the molecules that compose them. Three of the four non-peer-reviewed surveys presented at the Alzheimer's meeting were based on information from the DNAI (Alzheimer's Disease Neuroimaging Initiative), a research project. collecting data on imaging, genetics, blood and other data on thousands of people. healthy and those with cognitive impairment, including AD patients. The other study used data from a Dutch population
. A group of the Consortium on Alzheimer's Metabolic Disease studied lipids called plasmalogens, the fats that contain the omega-3 fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). They found reduced blood levels of these fats followed with an increased risk of AD among the ADNI participants. A second group also working with the information from the ADNI found similar clues of lipid treatment abnormalities in blood samples. In this latest study, even people with AD who took fish oil supplements did not have blood lipid levels beneficial to the brain, which could explain why fish oil supplementation does not seems to halt cognitive decline
According to Mitchel Kling, badociate professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania, whose group focuses on plasmalogens, "consuming more Fish oil does not produce more plasmalogens. According to Dinesh Kumar Barupal, project scientist and program coordinator for the West Coast Metabolomics Center at the University of California at Davis, the fish oil supplement could be a double-edged sword. supplementation in the ADNI cohort. "We found that taking fish oil can increase the levels of some lipids, but can also decrease other lipid levels." Fish oil was badociated with a decrease in blood levels of an omega-3 He also said.
Other explanations are possible: "There is a recent suggestion that patients with APOE ε4 impaired the metabolism of DHA," explains Howard Fillit, founding executive director and chief scientist of l & # 39; Alzheimer's. Drug Discovery Foundation, which was not involved in the studies. Another possibility, he says, is that eating habits can change as dementia progresses. Schulz agrees that changes in the diet could underpin the badociation. "Patients with Alzheimer's disease often lose their sense of taste and smell, then their diet goes from a healthy food to a sweet and fatty food that they can still to taste, "he explains. "It becomes difficult to know if what we are seeing now is a cause or effect.
Breaking fats in fish oil or the rest of the diet requires bile acids, which the liver produces cholesterol, and the microbial inhabitants of the intestines produced in the colon.Because bile acids are another important step in the manufacture of fats, researchers in the other two studies have refined these factors.Shahzad Ahmad, doctoral student at Erasmus University Medical Center Rotterdam, and colleagues found links between AD-related gene variants and bile acid levels, suggesting that genes may interact with the microbiome in the development of the disease. Final study, Kwangsik Nho, badistant professor of radiology at the Center for Neuroimaging of the Indiana University School of Medicine, and his colleagues also used related findings on brain imaging. They also found links between low levels of liver-based bile acids and signs of memory deficits.
Together, these four studies seem to draw a dotted line of the intestinal microbiome from liver to brain. But now, what's happening from one point to another is a black box. "There are a lot of things we do not know about these things," says James Hendrix, Director of Global Science Initiatives for the Alzheimer's Association, which helps fund consortia of groups conducting this research. This means that the world is in years of clinical applications related to such discoveries, he says.
Professor of Psychiatry and Behavioral Sciences at Duke University Rima Kaddurah-Daouk, who directs the Metabolomics Consortium indicate the need to look outside the brain to explain the brain. Highlighting a host of unsuccessful clinical trials related to AD based on data only from studies on the brain, she adds, "studying the brain alone is no longer an option."
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