{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:32:13Z","timestamp":1790397133278,"version":"4.1.0"},"reference-count":72,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2023,12,6]]},"abstract":"<jats:p>Background: Alzheimer\u2019s disease (AD) is a leading killer of Americans, imparting a tremendous societal toll. Relationships between immune function and inflammation with cognition are well-established in AD, but the Th1\/Th2 ratio of immune function is unknown. Describing the Th1\/Th2 ratio and its relationship with cognition may shed light on the disease\u2019s clinical context. How the Th1\/Th2 ratio responds to dietary supplementation is another unknown question in this population. Objective: The objectives of the study were to: 1) characterize the Th1\/Th2 ratio according to IL-2\/IL-10, IFN-\u03b3\/IL-10, IL-2\/IL-4, IFN-\u03b3\/IL-4, IL-2\/TNF-\u03b1, and IFN-\u03b3\/TNF-\u03b1 in subjects with moderate-to-severe AD and in comparison to healthy adults; 2) investigate the effect of an aloe polymannose multinutrient complex (APMC) dietary supplement on the Th1\/Th2 ratios over 12 months; and 3) compare the changes in the Th1\/Th2 ratios with the changes in cognition from baseline to 12 months. Methods: Subjects consumed 2.5\u200ag of the APMC four times per day for 12 months, and they were assessed on cognition and cytokines at baseline and 12 months. Results: The Th1\/Th2 ratios in AD patients were significantly higher than the healthy controls, and five of the six ratios decreased from baseline to 12 months follow-up (other than IL-2\/TNF-\u03b1). Several significant relationships were noted between the changes in Th1\/Th2 ratios with cognitive assessments. Conclusions: Our results showed an overall rebalancing of the Th1\/Th2 ratio in response to APMC, these changes were related to improved cognition in subjects with moderate-to-severe AD, and the APMC supplement was safely tolerated.<\/jats:p>","DOI":"10.3233\/jad-230659","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T11:33:53Z","timestamp":1700566433000},"page":"1723-1737","source":"Crossref","is-referenced-by-count":9,"title":["The Characterization of the Th1\/Th2 Ratio in Moderate-Severe Alzheimer\u2019s Disease Patients and Its Response to an Aloe Polymannose-Based Dietary Supplement"],"prefix":"10.1177","volume":"96","author":[{"given":"John E.","family":"Lewis","sequence":"first","affiliation":[{"name":"Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Reginald McDaniel","sequence":"additional","affiliation":[{"name":"Wellness Quest, LLC, Grand Prairie, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judi M.","family":"Woolger","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sher Ali","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-230659_ref1","first-page":"1","article-title":"Alzheimer\u2019s disease facts and figures","volume":"19","author":"Alzheimer\u2019s Association","year":"2023","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-230659_ref2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3233\/JAD-200443","article-title":"The emerging role of nutraceuticals and phytochemicals in the prevention and treatment of Alzheimer\u2019s disease","volume":"77","author":"Calfio","year":"2020","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-230659_ref3","doi-asserted-by":"crossref","first-page":"2718","DOI":"10.1021\/acschemneuro.1c00206","article-title":"Evolving role of natural products from traditional medicinal herbs in the treatment of Alzheimer\u2019s disease","volume":"12","author":"Pandey","year":"2021","journal-title":"ACS Chem Neurosci"},{"key":"10.3233\/JAD-230659_ref4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0166-2236(97)01168-5","article-title":"Alzheimer\u2019s disease: A re-examination of the amyloid hypothesis","volume":"21","author":"Neve","year":"1998","journal-title":"Trends Neurosci"},{"key":"10.3233\/JAD-230659_ref5","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.neurobiolaging.2010.05.022","article-title":"Mechanisms of AD neurodegeneration may be independent of Abeta and its derivatives","volume":"32","author":"Robakis","year":"2011","journal-title":"Neurobiol Aging"},{"key":"10.3233\/JAD-230659_ref6","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/978-981-32-9358-8_16","article-title":"Amyloid-beta and tau at the crossroads of Alzheimer\u2019s disease","volume":"1184","author":"Gallardo","year":"2019","journal-title":"Adv Exp Med Biol"},{"key":"10.3233\/JAD-230659_ref7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s41232-022-00224-8","article-title":"Helicobacter pylori infection in the stomach induces neuroinflammation: The potential roles of bacterial outer membrane vesicles in an animal model of Alzheimer\u2019s disease","volume":"42","author":"Park","year":"2022","journal-title":"Inflamm Regen"},{"key":"10.3233\/JAD-230659_ref8","doi-asserted-by":"crossref","first-page":"e2728","DOI":"10.1002\/brb3.2728","article-title":"Is Alzheimer\u2019s disease an infectious neurological disease? 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