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Peripheral inflammation was related to increased risk of Alzheimer's disease as a whole and earlier onset of disease in apolipoprotein E4 ( APOE4 ), reported by researchers.
Defined as a C-reactive protein (CRP) of 8, 9 or 10 mg / L, this low-grade inflammation was badociated with an increased risk of Alzheimer's disease only in those carrying APOE4 especially in the absence of cardiovascular disease (HR 6.63, 95% CI 1.80-24.50, P = 0.005), according to Wendy Qiu, MD, PhD of the School of Boston University Medicine and colleagues.
In addition, of APOE4 . with chronic inflammation had an increased risk of early onset of the disease that carriers of APOE4 who did not have inflammation (HR 3.52, 95% CI 1.27-9.75 , P = 0.009), they reported Open Network JAMA .
"Investigating Mediating Factors for APOE4 Increasing the risk of contracting Alzheimer's disease is important for the development of an intervention and the prevention of the disease," Qiu said in a statement . "Since many seniors suffer from low-grade chronic inflammation after suffering from common diseases such as cardiovascular disease, diabetes, pneumonia, and urinary tract infection, or after surgery, the rigorous treatment of high blood pressure can not be avoided. chronic systemic inflammation in APOE4 carriers could be effective for the prevention of Alzheimer's dementia. "
The results are consistent with those of animal models with Alzheimer's disease and recent human research, noted Keenan Walker, PhD, of Johns Hopkins Medical School in Baltimore, who did not participate in the study. [19659002] "It is becoming increasingly apparent that inflammation is an important component of the pathophysiology of Alzheimer's disease," said Walker MedPage Today . "This study provides additional evidence that low-grade systemic inflammation may be a potent risk factor for the development of Alzheimer's disease."
In the study, the Qiu group evaluated data from 2,656 members of the Framingham Offspring Study (Generation 2). , a cohort of children from the Framingham Heart Study. They defined the chronic inflammation status as having at least two longitudinal serum CRP measurements above the pre-specified levels.
Patients had an average of about 61 years at their last CRP measurement. During 17 years of follow-up, 194 people developed dementia, of which 152 had Alzheimer's disease.
This phenomenon of increased Alzheimer's disease and earlier onset of the disease in APOE4 was not observed in . APOE3 and APOE2 carriers of low grade chronic inflammation. Even though carriers APOE2 had higher CRP levels with age than APOE3 and APOE4 high levels of CRP did not occur. were not related to the risk of Alzheimer's in this area. group.
In a subgroup of study participants who underwent magnetic resonance imaging of the brain (n = 1,761), APOE4 and low grade chronic inflammation was badociated with atrophy of the brain. brain in the temporal lobe (beta = -0.88, SE 0.22, P <0.001) and the hippocampus (beta = -0.04, SE 0.01, P = 0.005).
"Our results suggest that low-grade chronic inflammatory interactions are basic with APOE4 to accelerate the onset of Alzheimer's disease according to a CRP-dependent pattern," Qiu observed. and his collaborators.
"As it is well established that infection and inflammation are common in the elderly, preclinical studies have reported that inflammation induces pathologically-specific Alzheimer's disease in carrier mice only APOE4 our findings may explain why APOE4 increased the risk of Alzheimer's disease at an advanced age and suggests that the treatment of chronic inflammation of low grade can delaying onset concluded.
The limitations of the study are the lack of more frequent badessments of CRP, the reduced sample size for sub-badyzes and its inability to perform observational research to prove Framingham cohort lacks ethnic diversity and results may not be applicable to non-white populations
Funding for this study was provided by the National Heart, Lung, and Blood Institute and by grants from the National Institute of Neurological Disorders and Stroke and the National Institute. on aging. The researchers have not reported any conflicts of interest.
1969-12-31T19: 00: 00-0500
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