Therapeutic effects of anti-amyloid ß antibody after intravenous injection and efficient nose-to-brain delivery in Alzheimer's disease mouse model.

Antibody drugs that target amyloid ß (Aß) are considered possible treatments for Alzheimer's disease; however, most have been dropped from clinical trials. We hypothesized that administration route for antiAß antibody (AntiAß) might affect its therapeutic potential and thus compared delivery of antibodies to the brain and their effect on cognitive dysfunction and amyloid disposition via intravenous (i.v.) and intranasal routes with and without the cell-penetrating peptide, L-penetratin. We demonstrated that intranasal administration with L-penetratin more efficiently delivered human immunoglobulin G (IgG), a model molecule for AntiAß, to the brain compared with i.v. injection. We found that multiple intranasal treatments with Alexa 594-labeled AntiAß (A594-AntiAß) with L-penetratin significantly improved learning by mice with aged amyloid precursor protein (APP) knock-in (App KI mice). Further, intranasal administration of A594-AntiAß increased the amount of soluble Aß (1-42) in the brain, suggesting suppression of Aß aggregation in insoluble form and involvement of activated microglia in Aß clearance. Thus, administration route may be critical for efficient delivery of AntiAß to the brain, and the nose-to-brain delivery with L-penetratin can maximize its therapeutic efficacy.

Investigation of the Transport Pathways Associated with Enhanced Brain Delivery of Peptide Drugs by Intranasal Coadministration with Penetratin.

We previously found that coadministering peptides and proteins with the cell-penetrating peptide L-penetratin intranasally significantly increased transport to the brain and enhanced pharmacological effects. The present study aimed to clarify the mechanisms of nose-to-brain drug delivery enhancement by L-penetratin coadministration. First, we compared the concentrations of Exendin-4 in plasma and brain after intranasal and subcutaneous administration and suggested that coadministration with L-penetratin facilitated the direct nose-to-brain transport of Exendin-4. Second, we demonstrated that L-penetratin did not stimulate the transport of Cy7-labeled Exendin-4 and insulin through the trigeminal nerves but shifted their distribution to the olfactory mucosal pathway. Third, we investigated the distribution of insulin into the deeper regions of the brain after delivery via the olfactory pathway and suggested that insulin had entered the olfactory bulb, bottom part of the brain, and perivascular space through the cerebrospinal fluid and had diffused throughout the brain. We further demonstrated that intranasally delivered insulin with L-penetratin specifically accumulated on the hippocampus neuronal cells. Thus, this study suggested that administrating peptide drugs intranasally with L-penetratin allows direct transport to the olfactory bulb, bottom part of the brain, and perivascular space of the cerebral artery. This technique also potentially allows targeting of specific brain areas.

Reliability and validity of the Mongolian version of the Zarit Caregiver Burden Interview.

[Purpose] Our study aimed to verify the reliability and validity of the translated Mongolian version of the Zarit Caregiver Burden Interview (ZBI). [Participants and Methods] We obtained the basic information of patients and their caregivers when they were hospitalized (Study 1). Subsequently, after the hospital discharged the patients, the caregivers answered the ZBI by telephone during the 4th and 5th weeks (Studies 2 and 3, respectively). To evaluate reliability, we calculated the correlation coefficient, compared the total scores of the ZBI obtained in Studies 2 and 3, and calculated Cronbach's alpha coefficient. To evaluate validity, we calculated the correlation coefficient of the score of item 22 and the sum of the scores of items 1-21. [Results] The correlation coefficient for reliability was high, and the difference between the two studies was insignificant. Cronbach's alpha coefficient was 0.92. The correlation coefficient was high for validity as well. [Conclusion] The Mongolian version of the ZBI has high reliability and validity.