Long-acting exenatide does not prevent cognitive decline in mild cognitive impairment: a proof-of-concept clinical trial.

PURPOSE: According to preclinical evidence, GLP-1 receptor may be an actionable target in neurodegenerative disorders, including Alzheimer's disease (AD). Previous clinical trials of GLP-1 receptor agonists were conducted in patients with early AD, yielding mixed results. The aim was to assess in a proof-of-concept study whether slow-release exenatide, a long-acting GLP-1 agonist, can benefit the cognitive performance of people with mild cognitive impairment (MCI). METHODS: Thirty-two (16 females) patients were randomized to either slow-release exenatide (n = 17; 2 mg s.c. once a week) or no treatment (n = 15) for 32 weeks. The primary endpoint was the change in ADAS-Cog11 cognitive test score at 32 weeks vs baseline. Secondary endpoints herein reported included additional cognitive tests and plasma readouts of GLP-1 receptor engagement. Statistical analysis was conducted by intention to treat. RESULTS: No significant between-group effects of exenatide on ADAS-Cog11 score (p = 0.17) were detected. A gender interaction with treatment was observed (p = 0.04), due to worsening of the ADAS-Cog11 score in women randomized to exenatide (p = 0.018), after correction for age, scholar level, dysglycemia, and ADAS-Cog score baseline value. Fasting plasma glucose (p = 0.02) and body weight (p = 0.03) decreased in patients randomized to exenatide. CONCLUSION: In patients with MCI, a 32-week trial with slow-release exenatide had no beneficial effect on cognitive performance. TRIAL REGISTRATION NUMBER: NCT03881371, registered on 21 July, 2016.

[Serological survey for virus and Mycoplasma infections (author's transl)]. / Comportamento delle reazioni sierologiche e liquorali per infezioni virali e da Micoplasmi nel corso di un biennio.

The Authors describe the two years follow up of complement fixing antibodies vs 4 viral antigens (Herpes simplex, Herpes zoster, Cytomegalovirus, respiratory syncytial virus, Mycoplasma pneumoniae). They evaluate the seasonal trend and the eventual clinical correlations on 3267 sera and 254 spinal fluids from hospitalized patients.

[The post-transfusional toxoplasmosis (author's transl)]. / Note sulla toxoplasmosi post-trasfusionale.

The sera of 85 patients suffering from Cooley anemia, 100 normal children of the same group of age, and 550 blood donors have been tested for the presence of anti-toxoplasma antibodies by indirect immunofluorescence test. The sera of 10 thalassemic patients gave positive reactions at a dilution reaging from 1/64 to 1/2048; in 2 sera a positive reaction was obtained with specific anti-IgM antibodies, indicating an active infection. In the control group, only 2 positive sera have been found. In donors group, instead, 5 sera were positive, and in 2 cases IgM antibodies were detectable. The analysis of data confirms, although indirectly, that heavily transfused patients are at a particular risk to acquire the infection from Toxoplasma Gondii.

[Research on the eventual cross-reactivity of anti-Wr(a) with various viral, bacterial and mycotic antigenes (author's transl)]. / Ricerca sulla eventuale cross-reattività dell'anti-Wr(a) con alcuni antigeni virali, batterici e micotici.

Among the sera of 1011 blood donors, they have been collected 34 anti-Wr(a) antibodies. By IgG antiglobulin test, the titer was 1/8 or more in 21 sera. After absorption on viral, bacterial and mycotic antigens, the sera were still reactive with Wr(a) + red blood cells. These results show that no tested antigen is cross-reactive with Wr(a) antigen. However, the AA. suggest that the research of a widley diffused antigen, cross-reactive with Wr(a) + red blood cells, is a valuable approach to the problem of IgG anti-Wr(a) antibodies in normal, never transfused blood donors.