{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:56:48Z","timestamp":1760237808532,"version":"build-2065373602"},"reference-count":73,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T00:00:00Z","timestamp":1592524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015699","name":"Fresenius Medical Care","doi-asserted-by":"publisher","award":["201503IMAD"],"award-info":[{"award-number":["201503IMAD"]}],"id":[{"id":"10.13039\/100015699","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: agonistic autoantibodies (agAABs) against G protein-coupled receptors (GPCR) have been linked to cardiovascular disease. In dementia patients, GPCR-agAABs against the \u03b11- and \u00df2-adrenoceptors (\u03b11AR- and \u00df2AR) were found at a prevalence of 50%. Elimination of agAABs by immunoadsorption (IA) was successfully applied in cardiovascular disease. The IMAD trial (Efficacy of immunoadsorption for treatment of persons with Alzheimer dementia and agonistic autoantibodies against alpha1A-adrenoceptor) investigates whether the removal of \u03b11AR-AABs by a 5-day IA procedure has a positive effect (improvement or non-deterioration) on changes of hemodynamic, cognitive, vascular and metabolic parameters in patients with suspected Alzheimer\u2019s clinical syndrome within a one-year follow-up period. Methods: the IMAD trial is designed as an exploratory monocentric interventional trial corresponding to a proof-of-concept phase-IIa study. If cognition capacity of eligible patients scores 19\u201326 in the Mini Mental State Examination (MMSE), patients are tested for the presence of agAABs by an enzyme-linked immunosorbent assay (ELISA)-based method, followed by a bioassay-based confirmation test, further screening and treatment with IA and intravenous immunoglobulin G (IgG) replacement. We aim to include 15 patients with IA\/IgG and to complete follow-up data from at least 12 patients. The primary outcome parameter of the study is uncorrected mean cerebral perfusion measured in mL\/min\/100 gr of brain tissue determined by magnetic resonance imaging with arterial spin labeling after 12 months. Conclusion: IMAD is an important pilot study that will analyze whether the removal of \u03b11AR-agAABs by immunoadsorption in \u03b11AR-agAAB-positive patients with suspected Alzheimer\u2019s clinical syndrome may slow the progression of dementia and\/or may improve vascular functional parameters.<\/jats:p>","DOI":"10.3390\/jcm9061919","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T10:43:58Z","timestamp":1592563438000},"page":"1919","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Immunoadsorption for Treatment of Patients with Suspected Alzheimer Dementia and Agonistic Autoantibodies against Alpha1a-Adrenoceptor\u2014Rationale and Design of the IMAD Pilot Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Sylvia","family":"Stracke","sequence":"first","affiliation":[{"name":"Department for Internal Medicine A, Nephrology, University Medicine Greifswald, Ferdinand-Sauerbruch-Stra\u00dfe, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Lange","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Bornmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Kock","sequence":"additional","affiliation":[{"name":"Strategic Research Management, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Schulze","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Klinger-K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"Coordinating Centre for Clinical Trials, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antje","family":"Vogelgesang","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"von Podewils","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medicine Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"F\u00f6el","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medicine Greifswald, 17475 Greifswald, Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE), 17475 Rostock\/Greifswald, partner site Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Stra\u00dfe, 17475 Greifswald, Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Berlin Cures GmbH, 13125 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd","family":"Wallukat","sequence":"additional","affiliation":[{"name":"Berlin Cures GmbH, 13125 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harald","family":"Pr\u00fcss","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE) Berlin, 10117 Berlin, Germany"},{"name":"Department of Neurology and Experimental Neurology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9055-4327","authenticated-orcid":false,"given":"Alexander","family":"Dressel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Carl-Thiem-Klinikum, 03048 Cottbus, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudolf","family":"Kunze","sequence":"additional","affiliation":[{"name":"Science Office, Hessenhagen 2, 17268 Flieth-Stegelitz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans J.","family":"Grabe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE), 17475 Rostock\/Greifswald, partner site Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7241-1173","authenticated-orcid":false,"given":"S\u00f6nke","family":"Langner","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany"},{"name":"Institute of Diagnostic and Interventional Radiology, University Medicine Rostock, 18057 Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7471-475X","authenticated-orcid":false,"given":"Marcus","family":"D\u00f6rr","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Stra\u00dfe, 17475 Greifswald, Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,19]]},"reference":[{"key":"ref_1","unstructured":"Prince, M. 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