2023-10-23 19:05:00
Professor Jeong Won-gyu’s team at Gangdong Kyung Hee University Hospital
Meaningful outcomes, such as maintaining cognitive function
Dr. Jeong Yeon-kyung’s team at the Institute of Atomic Energy Medicine
Announcement of neuroinflammation treatment research results
Radiation, which is mainly used in cancer treatment, is emerging as a new area of treatment for degenerative brain diseases such as Alzheimer’s dementia and Parkinson’s disease. The interim results of the first clinical trial of low-dose radiation therapy for patients with early-stage Alzheimer’s disease in Korea showed significant results, such as maintaining or increasing cognitive function. In the case of Parkinson’s disease, the possibility of radiation therapy was first suggested in animal experiments conducted by domestic researchers.
According to the Central Dementia Center of the Ministry of Health and Welfare, as of last year, the estimated number of dementia patients aged 60 or older was approximately 960,000. Various treatments and treatments are being developed to overcome dementia, but it is difficult to expect high treatment effectiveness. Several new dementia drugs that have emerged recently have been proven to slow the progression of dementia by slowing down the rate of cognitive decline, but side effects such as cerebral edema and hemorrhage are cited as limitations. For this reason, some are actively researching non-invasive treatments other than drugs, and dementia treatment using low-dose radiation is one of them.
Professor Won-gyu Jeong’s team in the Department of Radiation Oncology at Kangdong Kyunghee University Hospital has been conducting a phase 2 clinical study to confirm the effectiveness and safety of low-dose radiation dementia treatment since last year along with Boramae Hospital and Chungbuk National University Hospital as a research project of Korea Hydro & Nuclear Power. It will continue until the end of next year for 60 patients aged 60 to 85 who have been diagnosed with mild Alzheimer’s dementia. This is a method that examines changes in cognitive function through various tests at 6 months and 1 year following irradiating a total of 6 times for a total of 3 weeks, twice a week. The radiation dose is controlled to less than 0.8 to 5% of the amount used to treat brain metastatic cancer patients, and is one-tenth of the general cancer treatment dose.
The research team attracted attention by presenting interim research results at the Korean Neurodegenerative Disease Society conference last month. The research team analyzed changes in the condition of 15 of the 31 early-stage Alzheimer’s disease dementia patients recruited so far at 6 months following low-dose radiation treatment. The patients were divided into 3 groups of 5 each. The control group was to take only existing treatment drugs without radiation treatment, and the ultra-low-dose radiation therapy group (irradiation of 24 cGy, 4 cGy per time, 6 times total), and the low-dose radiation therapy group (irradiation of 300 cGy, 50 cGy, 6 times, total). distinguished. cGy is ‘centi gray’, a unit of therapeutic radiation dose.
As a result of the analysis, following 6 months, the Alzheimer’s disease assessment scale ‘ADAS-K’ in the extremely low dose group and the low dose group decreased by an average of 0.2 points and 0.4 points, respectively, showing a much slower rate of cognitive decline than the control group (3.8 point decrease). In addition, in the case of ‘K-MMSE’, a simple cognitive status test, the average of the extremely low dose group and the low dose group increased by 0.8 points and 1.2 points, respectively, showing an increase in cognitive function compared to the control group (decreased by 1.8 points). In addition, a significant increase or maintenance of cognitive function was confirmed following radiation treatment in various cognitive function diagnostic tools (CDR, CGA-NPI, K-iADL). Professor Jeong said on the 23rd, “We compared the cerebral volume before and following treatment using MRI for 6 patients. In the experimental group (4 patients), there was almost no change in the volume of the hippocampus or cerebral ventricle, while in the control group (2 patients), there was atrophy of the hippocampus and It was also confirmed that the cerebral ventricular volume increased. “He was able to observe changes in typical Alzheimer’s dementia treatment,” he explained. No side effects related to radiation therapy were found in any experimental group.
Low-dose radiation therapy uses the ‘radiation hormesis effect.’ Large amounts of radiation cause damage to living organisms, but small amounts of radiation actually stimulate self-protection and homeostasis maintenance activities. Several studies have confirmed that even in patients with Alzheimer’s disease, low-dose radiation treatment increases neuroprotection and restores the function of microglial cells (which act as cleaners in the brain, including removing beta-amyloid, a toxic substance). Professor Jeong pointed out, “However, the follow-up period is still short at 6 months, and the number of patients analyzed is small, so more research is needed in the future.” Professor Jeong is also developing radiation equipment optimized for treating dementia patients, not cancer.
Dr. Yeon-Kyung Jeong’s team at the Korea Institute of Atomic Energy and Medical Sciences published the results of a study that was the first in Korea to identify the efficacy of low- and medium-dose radiation in treating Parkinson’s disease neuroinflammation in the latest issue of the international journal Neurobiology of Aging. Parkinson’s disease occurs when dopamine-secreting cells are damaged due to neuroinflammation in the substantia nigra of the midbrain. It causes body tremors and abnormal movement disorders, and there is currently no fundamental treatment to stop its progression.
The research team confirmed that brain neuroinflammation-related protein (GFAP) decreased by regarding 20% on the 7th day following irradiating the brains of Parkinson’s disease-inducing experimental mice to the brains of mice with low to medium doses (0.6Gy 5 times each), compared to mice that did not receive radiation. Another inflammatory protein (ICAM-1) was found to be reduced by regarding 75% compared to mice that did not receive radiation.
Dr. Jeong said, “This is the world’s first study to show the possibility of radiation treatment for Parkinson’s disease.” He added, “Existing Parkinson’s disease treatment drugs have a mechanism to increase the missing dopamine, but radiation therapy is more effective in resolving neuroinflammation, which is the cause of dopamine deficiency. “It can be said that we have come closer to a more fundamental treatment,” he said. The research team is planning additional research, including clinical trials, in the future.
Taewon Min, medical reporter twmin@kmib.co.kr
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