Cholinesterase inhibitors exert a protective effect on endothelial damage in Alzheimer disease patients

It has been recently suggested that in Alzheimer disease (AD), the current available therapy with cholinesterase inhibitors (ChEls) influences platelets amyloid orecursor protein (APP) metabolism towards the nonamyloidogenic pathway. In order to investigate whether ChEls may exert a protective role on vascular damage due to abeta deposition, several parameters of coagulation and fibrinolysis were assessed. Twenty patients with mild AD and 30 age-matched controls entered the study. All subjects performed a multidimensional neuropsychological assessment and a laboratory protocol. Individuals with vascular risk factors and systemic diseases were excluded. In mild AD patients, increased levels of markers of endothelial dysfunction, such as thrombomodulin (TM) and sE-selectin (sE-sel), were seen. After I-month ChEls treatment, a significant reduction of TM (p < 0.05) and sE-sel (p < 0.05) values towards the normal range was observed. These findings suggest that endothelial-related ChEls action might contribute to the clinical efficacy in AD, slowing down pathology progression. (c) 2004 Elsevier B.V. All rights reserved.