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Open Access Highly Accessed Case report

Rapid cognitive improvement in Alzheimer's disease following perispinal etanercept administration

Edward L Tobinick12* and Hyman Gross12

Author Affiliations

1 Department of Medicine, Institute for Neurological Research, a private medical group, inc., Los Angeles, USA

2 Department of Neurology, USC School of Medicine, Los Angeles, USA

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Journal of Neuroinflammation 2008, 5:2  doi:10.1186/1742-2094-5-2

Published: 9 January 2008

Abstract

Substantial basic science and clinical evidence suggests that excess tumor necrosis factor-alpha (TNF-alpha) is centrally involved in the pathogenesis of Alzheimer's disease. In addition to its pro-inflammatory functions, TNF-alpha has recently been recognized to be a gliotransmitter that regulates synaptic function in neural networks. TNF-alpha has also recently been shown to mediate the disruption in synaptic memory mechanisms, which is caused by beta-amyloid and beta-amyloid oligomers. The efficacy of etanercept, a biologic antagonist of TNF-alpha, delivered by perispinal administration, for treatment of Alzheimer's disease over a period of six months has been previously reported in a pilot study. This report details rapid cognitive improvement, beginning within minutes, using this same anti-TNF treatment modality, in a patient with late-onset Alzheimer's disease. Rapid cognitive improvement following perispinal etanercept may be related to amelioration of the effects of excess TNF-alpha on synaptic mechanisms in Alzheimer's disease and provides a promising area for additional investigation and therapeutic intervention.