The accumulation of β-amyloid (Aβ) in the extracellular spaces of the brain is one of the most significant characteristics of Alzheimer’s disease (AD) and represents one of the most important targets for the development of new therapies. Javier Olazarán, MD, PhD, Gregorio Marañón Hospital, Madrid, Spain, explains the rationale for using plasma exchange plus albumin replacement for the treatment of AD. This strategy is being investigated on the basis that Aβ in the cerebrospinal fluid (CSF) is in dynamic equilibrium with plasma Aβ through the blood-brain barrier. Furthermore, it has been shown that albumin is one of the most important binding proteins and inhibitors of Aβ aggregation. However, plasma albumin from AD patients has a reduced ability to inhibit Aβ aggregation. Therefore, replacing AD patients’ albumin with healthy donors’ albumin may increase sequestration of plasma Aβ, altering the balance and reducing Aβ levels in the brain. This interview took place during the European Academy of Neurology 2021 congress.
