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Alzheimer Patients Treated With an AchE Inhibitor Show Higher IL-4 and Lower IL-1β Levels and Expression in Peripheral Blood Mononuclear Cells

Gambi, Francesco MD*; Reale, Marcella PhD; Iarlori, Carla MD; Salone, Anatolia MD*; Toma, Lucia MD; Paladini, Carlo MD*; De Luca, Giovanna MD; Feliciani, Claudio MD§; Salvatore, Mirella PhD; Salerno, Rosa M. MD*; Theoharides, Theoharis C. MD, PhD; Conti, Pio PhD; Exton, Michael PhD#; Gambi, Domenico MD

Journal of Clinical Psychopharmacology: June 2004 - Volume 24 - Issue 3 - p 314-321
doi: 10.1097/01.jcp.0000125683.74595.2f
Original Contributions
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The study evaluates the expression and production of cytokines in peripheral blood mononuclear cells of patients with Alzheimer disease treated or not treated with acetylcholinesterase inhibitor, which enhances neuronal transmission. Cytokines associated with brain inflammation such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α have been implicated in the regulation of amyloid peptide protein synthesis. The anti-inflammatory cytokine, IL-4, may suppress the activity of IL-1β.

Patients were assessed for clinical and immunologic features at baseline and after 1 month of treatment with Donepezil, an acetylcholinesterase inhibitor. Peripheral blood mononuclear cells were cultured with and without phytohemagglutinin stimulation. IL-1β and IL-4 levels were measured by enzyme-linked immunosorbent assay. Reverse transcriptase-polymerase chain reaction was used to determine the expression of cytokines in peripheral mononuclear cells. Compared with untreated patients and healthy control subjects, IL-1β levels and expression decreased in Alzheimer disease patients treated with Donepezil (P < 0.001). In contrast, IL-4 levels and expression were significantly higher in Alzheimer patients treated with the acetylcholinesterase inhibitor. This increment was observed in both unstimulated and phytohemagglutinin-stimulated peripheral blood mononuclear cells.

*Psychiatry Unit, Department of Oncology and Neuroscience, University G. d'Annunzio, Chieti, Italy; †Immunology Unit, Department of Oncology and Neuroscience, University G. d'Annunzio, Chieti, Italy; ‡Neurology Unit, Department of Oncology and Neuroscience, University G. d'Annunzio, Chieti, Italy; §Dermatology Unit, Department of Oncology and Neuroscience, University G. d'Annunzio, Chieti, Italy; ∥Department of MQIE, Faculty of Economics, Tufts University, Boston, MA; ¶Department of Pharmacology and Experimental Therapeutics, Tufts University, Boston, MA; #Eli Lilly, West Ryde, NSW, Australia.

Received February 11, 2003; accepted after revision November 5, 2003.

Address correspondence and reprint requests to Domenico Gambi, MD, Neurology Unit, Department of Oncology and Neuroscience, University G. d'Annunzio, Via dei Vestini, 66013 Chieti, Italy. E-mail: Gambi@unich.it.

© 2004 Lippincott Williams & Wilkins, Inc.