Inflammatory proteins associated with Alzheimer's disease reduced by a GLP1 receptor agonist: a post hoc analysis of the EXSCEL randomized placebo controlled trial

Alzheimers Res Ther. 2024 Oct 2;16(1):212. doi: 10.1186/s13195-024-01573-x.

Abstract

Background: Glucagon-like peptide-1 receptor agonists are a viable option for the prevention of Alzheimer's disease (AD) but the mechanisms of this potential disease modifying action are unclear. We investigated the effects of once-weekly exenatide (EQW) on AD associated proteomic clusters.

Methods: The Exenatide Study of Cardiovascular Event Lowering study compared the cardiovascular effects of EQW 2 mg with placebo in 13,752 people with type 2 diabetes mellitus. 4,979 proteins were measured (Somascan V0.4) on baseline and 1-year plasma samples of 3,973 participants. C-reactive protein (CRP), ficolin-2 (FCN2), plasminogen activator inhibitor 1 (PAI-1), soluble vascular cell adhesion protein 1 (sVCAM1) and 4 protein clusters were tested in multivariable mixed models.

Results: EQW affected FCN2 (Cohen's d -0.019), PAI-1 (Cohen's d -0.033), sVCAM-1 (Cohen's d 0.035) and a cytokine-cytokine cluster (Cohen's d 0.037) significantly compared with placebo. These effects were sustained in individuals over the age of 65 but not in those under 65.

Conclusions: EQW treatment was associated with significant change in inflammatory proteins associated with AD.

Trial registration: EXSCEL is registered on ClinicalTrials.gov: NCT01144338 on 10th of June 2010.

Keywords: Alzheimer’s disease; Glucagon-like peptide-1 receptor agonists; Proteomics.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Alzheimer Disease* / blood
  • Alzheimer Disease* / drug therapy
  • C-Reactive Protein / analysis
  • C-Reactive Protein / metabolism
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / drug therapy
  • Double-Blind Method
  • Exenatide* / therapeutic use
  • Female
  • Glucagon-Like Peptide-1 Receptor* / agonists
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Inflammation / drug therapy
  • Male
  • Middle Aged
  • Plasminogen Activator Inhibitor 1 / blood

Substances

  • Glucagon-Like Peptide-1 Receptor
  • Exenatide
  • Hypoglycemic Agents
  • Plasminogen Activator Inhibitor 1
  • C-Reactive Protein

Associated data

  • ClinicalTrials.gov/NCT01144338