J Alzheimers Dis：鼻腔喷雾式胰岛素有效治疗痴呆症

v2015年1月12日 讯 /生物谷BIOON/ --近日，发表在国际杂志J Alzheimers Dis上的一篇研究报告中，来自美国威克森林浸信医学中心（Wake Forest Baptist Medical Center）的研究人员通过研究表示，一种人造胰岛素鼻腔喷雾运输装置或可有效改善成年痴呆症及轻度认知损伤个体的工作记忆以及其它的精神能力。文章中，研究者对60名诊断为遗忘型轻度认知损害（MCI）或轻度至中度阿尔兹海默氏症痴呆(AD)患者进行研究，这些患者都通过鼻腔接受40个国际单位（IU）剂量的地特胰岛素注射液，时间持续21天，结果显示，相比每日接受20IU或安慰剂治疗的个体而言，接受40IU治疗的患者大脑短期的保存及加工能力，以及语言和视觉信息得到了明显的改善。此外，携带APOE-e4基因且接受40IU剂量地特胰岛素注射液的个体的记忆能力明显增强了，APOE-e4基因可以增加个体还阿尔兹海默氏症的风险。研究者Suzanne Craft博士表示，本文研究揭示了地特胰岛素可以有效治疗轻度认知损伤及阿尔兹海默氏症相关的痴呆症个体的疾病，值得庆幸的是，我们也发现地特胰岛素也可以改善携带阿尔兹海默氏症易感基因APOE-e4的MCI成年患者的记忆力；目前我们正在进行研究来确定是否地特胰岛素的剂量会引发患者出现任何副作用，结果显示在所研究的对象中出现的副作用非常小。最后研究者说道，阿尔兹海默氏症是一种破坏性的疾病，本文研究为有效改善阿尔兹海默氏症患者的记忆力及生活质量提供了新的希望和帮助；未来我们还将通过更为深入的研究来检测本文中新型疗法的安全性和效力。（生物谷Bioon.com）

Long-Acting Intranasal Insulin Detemir Improves Cognition for Adults with Mild Cognitive Impairment or Early-Stage Alzheimer's Disease Dementia

Amy Claxton1, 2, Laura D. Baker3, Angela Hanson1, 2, Emily H. Trittschuh1, 2, Brenna Cholerton2, Amy Morgan1, 2, Maureen Callaghan1, 2, Matthew Arbuckle4, Colin Behl1, 2, Suzanne Craft3

Previous trials have shown promising effects of intranasally administered insulin for adults with Alzheimer's disease dementia (AD) or amnestic mild cognitive impairment (MCI). These trials used regular insulin, which has a shorter half-life compared to long-lasting insulin analogues such as insulin detemir. The current trial examined whether intranasal insulin detemir improves cognition or daily functioning for adults with MCI or AD. Sixty adults diagnosed with MCI or mild to moderate AD received placebo (n = 20), 20 IU of insulin detemir (n = 21), or 40 IU of insulin detemir (n = 19) for 21 days, administered with a nasal drug delivery device. Results revealed a treatment effect for the memory composite for the 40 IU group compared with placebo (p < 0.05). This effect was moderated by APOE status (p < 0.05), reflecting improvement for APOE-ε4 carriers (p < 0.02), and worsening for non-carriers (p < 0.02). Higher insulin resistance at baseline predicted greater improvement with the 40 IU dose (r = 0.54, p < 0.02). Significant treatment effects were also apparent for verbal working memory (p < 0.03) and visuospatial working memory (p < 0.04), reflecting improvement for subjects who received the high dose of intranasal insulin detemir. No significant differences were found for daily functioning or executive functioning. In conclusion, daily treatment with 40 IU insulin detemir modulated cognition for adults with AD or MCI, with APOE-related differences in treatment response for the primary memory composite. Future research is needed to examine the mechanistic basis of APOE-related treatment differences, and to further assess the efficacy and safety of insulin detemir.