About this trial
Metabolic and hormonal deregulations are both a risk factor and a hallmark of Alzheimer's disease (AD) and frontotemporal dementia (FTD), occurring early in the course of the disease. In FTD in particular, hyperorality and dietary changes are associated with metabolic and hormonal changes such as altered levels of the anorexigenic hormone leptin.
The hypothalamus is a brain region that controls metabolism and hormonal systems. Hypothalamic function depends on its ability to sense peripheral signals. The hypothalamus sits on a circumventricular organ called the median eminence (ME) that puts it in contact with systemic blood circulation. In the ME, fenestrated capillaries allow the diffusion of bloodborne factors. However, despite the lack of blood-brain barrier at brain microvessels, diffusion is controlled by specialized ependymoglial cells, the tanycytes, which exert a barrier function between the ME and the third ventricle and controls the access of blood-borne molecules into the hypothalamus. Previous work from our laboratory and the ERC consortium has highlighted the role of tanycytes not only in the regulation of the release of neurohormones from neuroendocrine nerve terminals into the pituitary portal blood circulation, but also in the transport of circulating leptin into the hypothalamus. Hence hypothalamic dysfunction in AD and FTD can result either from dysregulation of neuroendocrine secretions, direct neuronal loss or from defective transport (and hence resistance) to hormones like leptin.
This study is to demonstrate that leptin transport though tanycytes is early altered in FTD and AD and correlates
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Subjects able to undergo a lumbar puncture
Subjects registered with the French Social Security, in agreement with the French law on biomedical experimentation
absence of cognitive complaint (completion of the memory complaint questionnaire)
absence of significant cognitive impairment: normal MMSE according to age and education levels
Disqualifiers
Subjects with dementia caused by a non-neurodegenerative disease, including patients with severe cerebrovascular risk factor load
Subjects who have contraindications to perform a lumbar puncture
Subjects who have contraindications to perform a MRI scan
Weighted less than 45 kg
Trial population
Subjects intended to participate will be recruited in Lille in the memory clinic and in the memory clinic network Meotis (North of France above Paris)
Trial design
Case-control
Prospective
Treatments tested in this trial
Lumbar puncture
Biological/Vaccine5 mL of CSF
blood sample
Biological/Vaccine6x5 mL of blood sample collected :1 dry tube, 2 EDTA tubes, 1 fluoride tube, and 2 polypropylene tubes
Treatment groups
Trial outcomes
Primary outcomes
Mean CSF-to-blood ratio (CBR) of leptin concentration.
Leptin concentration in blood and CSF (in the pg/mL range) will be measured by enzyme-linked immunosorbent assay (ELISA).
Secondary outcomes
Mean of the CSF-to-blood ratio (CBR) of hypothalamus-related hormones
CSF-to-blood ratio (CBR) of hypothalamus-related hormones
Blood metabolomics
Blood and CSF metabolites will be measured by LC MS/MS.Will be used a mix of targeted and untargeted approach for metabolomics using the Thermo Q-Exactive Orbitrap.
CSF metabolomics
Blood and CSF metabolites will be measured by LC MS/MS.Will be used a mix of targeted and untargeted approach for metabolomics using the Thermo Q-Exactive Orbitrap.
Correlation coefficient between leptin CBR and general cognitive functioning assessed by the Mattis Dementia Rating Scale (MDRS)6
Correlation coefficient between leptin CBR and general cognitive functioning
Sponsors and contacts
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University Hospital, Lille
Lead sponsor
European Research Council
Collaborator
CH Calais
Collaborator
Centre Hospitalier VALENCIENNES
Collaborator
Région Nord-Pas de Calais, France
Collaborator
Centre Hospitalier de Bethune
Collaborator