First-in-human study of blood amyloid β removal from early Alzheimer's disease patients with normal kidney function

Introduction: Amyloid β (Aβ) is a brain protein that causes Alzheimer's disease (AD). This study aimed to verify whether hemadsorption using a hexadecyl-alkylated cellulose bead (HexDC) column removes blood Aβ and brain Aβ accumulation in mild cognitive impairment/mild AD cases with normal kidney function. Methods: Two patients with positive Aβ on brain imaging underwent HexDC hemadsorption weekly for 6 months. Results: The Aβ removal efficiency of HexDC was 87–99%. Aβ₁₋₄₀/Aβ₁₋₄₂ influx into the blood in one session was 596/56 and 489/48 ng for Case A and Case B, respectively. Although brain Aβ accumulation did not clearly change after 6 months of hemadsorption, cognitive functions measured by the two tests were maintained or slightly improved. Conclusion: Blood Aβ removal was performed in two early AD patients with normal kidney function without adverse events, and it slightly improved or maintained cognitive function.