Molecular dynamics of amyloid-β transport in Alzheimer's disease: Exploring therapeutic plasma exchange with albumin replacement – Current insights and future perspectives
Bibliographic record
Abstract
The complex process of amyloid-β (Aβ) transportation across the blood–brain and blood–cerebrospinal fluid barriers is crucial for preventing Aβ accumulation, which linked to dementia and neurodegeneration. This review explores therapeutic plasma exchange with albumin replacement in Alzheimer's disease, based on the dynamics of amyloid-β between the brain, plasma, and cerebrospinal fluid. A comprehensive literature review was conducted using PubMed/Medline, Cochrane Library, and open databases (bioRxiv, MedRixv, preprint.org) up to April 30, 2023. The first search utilized the following MeSH terms and keywords: ‘Plasma Exchange’, ‘Plasmapheresis’, ‘Therapeutic plasma exchange’, ‘Apheresis’, ‘Aβ’, ‘p-tau’, ‘Total-tau’, ‘Alzheimer's disease’, ‘Cognitive dysfunction’, ‘neurodegenerative diseases’, ‘centrifugation’, ‘membranous’, and ‘filtration’ in the Title/Abstract, yielding 146 results. A second search with the keywords: ‘Albumin’, ‘Aβ’, ‘BBB’, ‘Alzheimer's dementia’, and ‘Nerve degeneration’ resulted in 125 additional articles for analysis. Finally, a third search using keywords: ‘Albumin structural domains’, ‘Albumin-Aβ interactions’, ‘Albumin-endothelial interactions’, and ‘Post-Translational Modification’ produced 193 results for further review. Therapeutic plasma exchange shows potential as a disease-modifying therapy for dementia, specifically for Alzheimer's disease. Additionally, the promising role of albumin supplementation in cognitive improvement has attracted attention. However, clinical evidence supporting therapeutic plasma exchange for dementia remains limited, necessitating further research and development to mitigate potential adverse effects. A deeper understanding of the molecular dynamics of Aβ transportation and the mechanisms of therapeutic plasma exchange is essential. A critical evaluation of existing evidence highlights the importance of balancing potential benefits with associated risks, which will guide the development and application of these treatments in neurodegenerative diseases. El complejo proceso de transporte del amiloide-β (Aβ) a través de las barreras sangre-cerebro y sangre-líquido cefalorraquídeo es crucial para prevenir la acumulación de Aβ, vinculada a la demencia y la neurodegeneración. Esta revisión explora el intercambio terapéutico de plasma con reemplazo de albúmina en la enfermedad de Alzheimer, fundamentado en la dinámica del Aβ entre el cerebro, el plasma y el líquido cefalorraquídeo. Se realizó una revisión exhaustiva de la literatura utilizando PubMed/Medline, Cochrane Library y bases de datos abiertas (bioRxiv, MedRixv, preprint.org) hasta el 30 de abril de 2023. La primera búsqueda utilizó los siguientes términos MeSH y palabras clave: ‘Plasma Exchange’, ‘Plasmapheresis’, ‘Therapeutic plasma exchange’, ‘Apheresis’, ‘Aβ’, ‘p-tau’, ‘Total-tau’, ‘Alzheimer's disease’, ‘Cognitive dysfunction’, ‘neurodegenerative diseases’, ‘centrifugation’, ‘membranous’ y ‘filtration’ en el Título/Abstract, obteniendo 146 resultados. Una segunda búsqueda con las palabras clave: ‘Albumin’, ‘Aβ’, ‘BBB’, ‘Alzheimer's dementia’ y ‘Nerve degeneration’ resultó en 125 artículos adicionales para análisis. Finalmente, una tercera búsqueda utilizando las palabras clave: ‘Albumin structural domains’, ‘Albumin-Aβ interactions’, ‘Albumin-endothelial interactions’ y ‘Post-Translational Modification’ produjo 193 resultados para una revisión adicional. El intercambio terapéutico de plasma muestra potencial como una terapia modificadora de la enfermedad para la demencia, específicamente para la enfermedad de Alzheimer. Además, el papel prometedor de la suplementación con albúmina en la mejora cognitiva ha llamado la atención. Sin embargo, la evidencia clínica que respalda el intercambio terapéutico de plasma para la demencia sigue siendo limitada, lo que requiere más investigación y desarrollo para mitigar posibles efectos adversos. Es esencial una comprensión más profunda de la dinámica molecular del transporte de Aβ y los mecanismos del intercambio terapéutico de plasma. Una evaluación crítica de la evidencia existente resalta la importancia de equilibrar los beneficios potenciales con los riesgos asociados, lo cual guiará el desarrollo y la aplicación de estos tratamientos en enfermedades neurodegenerativas.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".