Alzheimer Disease Clinical Trial
Official title:
Research of Olfactory Neuroepithelial Tissue as a Potential Biomarker of Alzheimer Disease
The purpose of this study is to evaluate the olfactory neuroepithelium as a biomarker of Alzheimer disease. The early diagnosis of Alzheimer disease is of importance for obtaining better response to treatment, but recently reported biomarkers have some limitations. Olfactory neuroepithelium tissue which is accessible through office-based biopsy without difficulty is known to reflect brain pathology that confirms the diagnosis of Alzheimer disease. This study will help in the early detection and treatment of Alzheimer disease.
Alzheimer disease is the most common form of dementia characterized by insidious onset and
slow progression. Pathological changes in the brain of Alzheimer disease (AD) precede
clinical symptoms many years, and early treatment provide better outcome. Consequently,
detection of AD in early stages is needed. Biologic markers including beta-amyloid and tau
protein have been studied for early diagnosis of AD. Recently remarkable biomarkers have
drawn attention including CSF proteins and PIB (Amyloid-binding carbon 11-labeled Pittsburgh
compound B) PET findings, but they pertain to supportive markers since they reflect brain
pathology indirectly.
Postmortem studies of AD patients revealed that beta-amyloid and tau proteins are found in
olfactory neuroepithelium and correlate with brain pathological changes. Olfactory
neuroepithelium tissue can be obtained through office-based biopsy safely and easily by
nasal endoscopy. Especially, early pathological changes of AD can be found in entorhinal
cortex and piriform cortex adjacent to olfactory neuroepithelium, this study would be
valuable for early detection of AD.
MicroRNAs are small, single-stranded RNA comprising about 20 nucleotides and involved in
cell differentiation, growth and death. Recently the investigators reported that microRNA
206 have important role in pathomechanism of AD, thus can be new biomarker and
disease-modifying therapeutic target of AD.
Study participants are enrolled from primary care clinic at department of Neurology, Seoul
National University Hospital. Patients' clinical presentation, MMSE (Mini mental status
exam), CDR (Clinical Dementia Rating) and ADAS-COG-K (Alzheimer Disease Assessment Scale
Cognitive Subscale) are collected from routinely executed exams in the clinic. Participants
are categorized into four groups according to CDR, and each group enrolls 10 patients
respectively. The number of 10 patients per each group was calculated based on previous
studies, costs, time and ethical perspectives.
Method for olfactory neuroepithelium biopsy was adopted from Lovell et al. (Arch
Otolaryngol. 1982). Concentrations of beta-amyloid and tau proteins are analyzed from ELISA,
and microRNA 206 from RT-PCR, northern blot and microarray. These data will be evaluated
with clinical features and exam results of participants using general statistical methods.
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Observational Model: Case Control, Time Perspective: Cross-Sectional
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