Newswise, September 14, 2015— The largest nationwide
clinical trial to study high-dose resveratrol long-term in people with mild to
moderate Alzheimer’s disease found that a biomarker that declines when the
disease progresses was stabilized in people who took the purified form of
resveratrol.
Resveratrol
is a naturally occurring compound found in foods such as red grapes,
raspberries, dark chocolate and some red wines.
The
results, published online today in Neurology, “are very
interesting,” says the study’s principal investigator, R. Scott Turner, MD,
PhD, director of the Memory Disorders Program at Georgetown University Medical
Center. Turner, who treats patients at MedStar Georgetown University Hospital,
cautions that the findings cannot be used to recommend resveratrol.
“This
is a single, small study with findings that call for further research to
interpret properly.”
The
resveratrol clinical trial was a randomized, phase II, placebo-controlled,
double blind study in patients with mild to moderate dementia due to Alzheimer’s
disease.
An
“investigational new drug” application was required by the U.S. Food and Drug
Administration to test the pure synthetic (pharmaceutical-grade) resveratrol in
the study.
It
is not available commercially in this form.
The
investigators enrolled 119 participants for the one-year study. The highest
dose of resveratrol tested was one gram by mouth twice daily — equivalent to
the amount found in about 1,000 bottles of red wine.
Patients
who were treated with increasing doses of resveratrol over 12 months showed
little or no change in amyloid-beta40 (Abeta40) levels in blood and
cerebrospinal fluid.
In
contrast, those taking a placebo had a decrease in the levels of Abeta40
compared with their levels at the beginning of the study.
“A
decrease in Abeta40 is seen as dementia worsens and Alzheimer’s disease
progresses; still, we can’t conclude from this study that the effects of
resveratrol treatment are beneficial,” Turner explains.
“It
does appear that resveratrol was able to penetrate the blood brain barrier,
which is an important observation. Resveratrol was measured in both blood and
cerebrospinal fluid.”
John
Bozza, 80, participated in the study. Five years ago, his wife, Diana, began
noticing “something wasn’t quite right.” He was diagnosed with mild cognitive
impairment, but only a year later, his condition progressed to mild
Alzheimer’s.
Diana, whose twin sister died from the same disease, says there are multiple reasons she and John decided to participate in the resveratrol study, and they now know he was assigned to take the active drug.
“I
definitely want the medical community to find a cure,” she says. “And of course
I thought there’s always a chance that John could have been helped, and who
knows, maybe he was.”
The
researchers studied resveratrol because it activates proteins called sirtuins,
the same proteins activated by caloric restriction.
The
biggest risk factor for developing Alzheimer’s is aging, and studies with
animals found that most age-related diseases—including Alzheimer’s—can be
prevented or delayed by long-term caloric restriction (consuming two-thirds the
normal caloric intake).
Turner
says the study also found that resveratrol was safe and well tolerated. The
most common side effects experienced by participants were gastrointestinal-related,
including nausea and diarrhea. Also, patients taking resveratrol experienced
weight loss while those on placebo gained weight.
One
outcome in particular was confounding, Turner notes. The researchers obtained
brain MRI scans on participants before and after the study, and found that
resveratrol-treated patients lost more brain volume than the placebo-treated
group.
“We’re not sure how to interpret this finding. A similar decrease in brain volume was found with some anti-amyloid immunotherapy trials,” Turner adds. A working hypothesis is that the treatments may reduce inflammation (or brain swelling) found with Alzheimer’s.
“We’re not sure how to interpret this finding. A similar decrease in brain volume was found with some anti-amyloid immunotherapy trials,” Turner adds. A working hypothesis is that the treatments may reduce inflammation (or brain swelling) found with Alzheimer’s.
The
study, funded by the National Institute on Aging and conducted with the
Alzheimer’s Disease Cooperative Study, began in 2012 and ended in 2014. GUMC
was one of 21 participating medical centers across the U.S.
Further
studies, including analysis of frozen blood and cerebrospinal fluid taken from
patients, are underway to test possible drug mechanisms.
“Given
safety and positive trends toward effectiveness in this phase 2 study, a larger
phase 3 study is warranted to test whether resveratrol is effective for
individuals with Alzheimer’s — or at risk for Alzheimer’s,” Turner says.
Resveratrol
and similar compounds are being tested in many age-related disorders including
cancer, diabetes and neurodegenerative disorders. The study Turner led,
however, is the largest, longest and highest dose trial of resveratrol in
humans to date.
The
research was supported by a grant from the National Institute on Aging (U01
AG010483). Turner reports no personal financial interests related to the study.
About
Georgetown University Medical Center
Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health).
Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health).
GUMC’s
mission is carried out with a strong emphasis on public service and a
dedication to the Catholic, Jesuit principle of cura personalis -- or
"care of the whole person."
The
Medical Center includes the School of Medicine and the School of Nursing &
Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive
Cancer Center, designated as a comprehensive cancer center by the National
Cancer Institute; and the Biomedical Graduate Research Organization, which
accounts for the majority of externally funded research at GUMC including a
Clinical and Translational Science Award from the National Institutes of
Health.
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