Alzheimer's Disease Clinical Trial
Official title:
Effects of Treatment With Doxycycline and Rifampicin on Biomarkers of Alzheimer's Disease in the Cerebrospinal Fluid
This study will determine if biomarkers found in the cerebrospinal fluid of people with Alzheimer's disease, are affected by treatment with two common antibiotics, doxycycline and rifampicin, suggesting a disease-modifying effect of those treatments.
Diagnostic markers in the cerebrospinal fluid (CSF) have become a rapidly growing research
field. Potential disease-modifying drugs like the antibiotics rifampicin and doxycycline,
highlight the need of improved diagnostic accuracy and offer the potential to examine how
these treatments may actually exert their clinical effects.
Cerebrospinal fluid biomarkers (the 42 amino acid form of β-amyloid (Aβ), total tau, and
phosphorylated tau) have been evaluated in scientific studies. Tau proteins are considered
"state" markers, whereas Aβ(1-42) proteins can be used as "stage" markers. These CSF markers
have high sensitivity to differentiate early AD from normal aging, depression, alcohol
dementia and Parkinson's disease. When these biomarkers are used in combination with a
medical history, clinical examination, laboratory tests and brain imaging, the diagnostic
accuracy is improved.
Matrix metalloproteinase (MMP) dysregulation is thought to contribute to a variety of
pathological conditions such as arthritis, cancer, atherosclerosis, aneurysms, nephritis,
tissue ulcers, and fibrosis. In addition, MMP involvement has been demonstrated in the
pathogenesis of a variety of CNS disorders, including bacterial and viral disorders, stroke,
multiple sclerosis, ALS, and AD.
There is an inflammatory response in AD. This includes complement activation, elevated
C-reactive protein (CRP), elevated pro-inflammatory cytokines (including IL-1-β, IL-6, TNF-α,
TGF-β, S100-β), chemokine alterations (IL-8, MIP-1-α, MIP-1-β, MCP-1), and microglial.
We are measuring the biochemical markers of Aβ(1-40) and Aβ(1-42), P-tau and T-tau, matrix
metalloproteinases (MMP-2, MMP-9), pro-inflammatory cytokines (IL-1beta, TNF-alpha), and
anti-inflammatory cytokines (IL-4 and IL-10) at the start and one year after treatment in the
multi-centered, randomized, controlled, trial of disease-modifying drugs rifampicin and/or
and doxycycline to slow the progress of Alzheimer's disease by affecting the production of
these biomarkers.
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