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Skip to content Home / Bioimmagini / Biomarcatori retinici per la diagnosi precoce della malattia di Alzheimer Un team di ingegneri biomedici della Duke University ha ideato un nuovo dispositivo di imaging in grado di misurare sia lo spessore sia la trama dei vari strati della retina nella parte posteriore dell’occhio. La nuova tecnica potrebbe essere utilizzata per rilevare biomarcatori della malattia di Alzheimer , dando la possibilità di diagnosticare precocemente la patologia. I risultati della ricerca sono stati pubblicati sulla rivista Scientific Reports .
Come avviene la diagnosi dell’Alzheimer La diagnosi di Alzheimer attualmente viene fatta solo dopo l’insorgere dei sintomi di declino cognitivo nel paziente. Anche in uno stato della malattia più avanzato, l’unico modo per determinare definitivamente l’Alzheimer come causa di quei sintomi è sottoporre il soggetto a MRI (risonanza magnetica) e PET (tomografia ad emissione di positroni). Però, una diagnosi tempestiva permette il rallentamento del progredire della malattia attraverso la somministrazione di farmaci ed esercizio mentale, permettendo ai pazienti di avere una qualità della vita notevolmente migliore rispetto all’aspettativa con una diagnosi tardiva. Questo è il motivo per cui i ricercatori vogliono trovare biomarcatori che possano essere utilizzati come primi segnali di allarme della malattia .
“Ricerche precedenti hanno visto un assottigliamento della retina nei pazienti con Alzheimer, ma aggiungendo una tecnica di diffusione della luce alla misurazione abbiamo scoperto che anche lo strato di fibre nervose retiniche è più ruvido e più disordinato “, ha affermato Adam Wax, professore di ingegneria biomedica presso la Duke University. “La nostra speranza è che possiamo utilizzare queste informazioni per creare un dispositivo di screening semplice ed economico che non sarebbe disponibile solo nell’ufficio del medico, ma anche in luoghi come la farmacia locale.”
L’Alzheimer può causare cambiamenti nella retina Un’immagine a fluorescenza da un microscopio confocale degli strati retinici di topi selvatici e sani (a destra) e topi allevati da una selezione genetica per mostrare i sintomi della malattia di Alzheimer (a sinistra). Il verde rappresenta i depositi di amiloide che si pensa siano correlati con la malattia di Alzheimer. Credits: Scientific Reports Precedenti studi hanno dimostrato che l’Alzheimer può causare cambiamenti strutturali nella retina – che è a tutti gli effetti un’estensione del cervello – in particolare può generare un assottigliamento degli strati retinici interni.
[bquote by=”Adam Wax” other=”professore di ingegneria biomedica presso la Duke University”]La retina può fornire un facile accesso al cervello e il suo assottigliamento può essere indicativo di una diminuzione della quantità di tessuto neurale, il che può denotare la presenza dell’Alzheimer.[/bquote]
Anche altre malattie possono causare un assottigliamento della retina, come il glaucoma e il morbo di Parkinson. Risultati inconsistenti potrebbero derivare anche dalle differenze tra le macchine più utilizzate per questi tipi di misurazioni, cioè i dispositivi di tomografia a coerenza ottica (OCT), e il modo in cui i ricercatori le utilizzano.
Nell’articolo gli studiosi mostrano che lo strato più alto di neuroni nella retina di un topo con malattia di Alzheimer mostra un cambiamento nella struttura della trama . Combinata con i dati sui cambiamenti dello spesso di questo strato, la nuova misurazione potrebbe rivelarsi un buon biomarcatore dell’Alzheimer . “Il nostro nuovo approccio può misurare la rugosità o la trama dello strato di fibre nervose della retina interna”, ha detto Ge Song, studente laureato al dipartimento di ingegneria biomedica della Duke University, primo autore dell’articolo. “Può fornire un modo rapido e diretto per misurare i cambiamenti strutturali causati dall’Alzheimer, ha un grande potenziale come biomarcatore della malattia “.
Un confronto dello spessore degli strati retinici tra topi selvatici e sani (in alto) e topi allevati da una selezione genetica per mostrare i sintomi della malattia di Alzheimer (in basso). Lo strato superiore della retina dei topi con la malattia di Alzheimer è chiaramente più sottile. Credits: Scientific Reports La combinazione di due tecniche di imaging biomedico L’OCT è l’analogo ottico degli ultrasuoni. Funziona inviando onde luminose nei tessuti e misurando quanto tempo impiegano per tornare. Sebbene sia una tecnica di imaging estremamente utile, comunemente usata per fare una vasta gamma di diagnosi, ha dei limiti. Per raccogliere più dati, Wax e Song hanno aggiunto un metodo di misura chiamato interferometria a bassa coerenza risolta in angolo (a/LCI), che utilizza gli angoli della luce diffusa per raccogliere maggiori informazioni sulla struttura del tessuto. Combinando le due misurazioni, i ricercatori possono ricavare sia lo spessore sia le informazioni strutturali su ciascuno strato della retina .
“Le misurazioni con a/LCI compensano le misure dello spessore per migliorare la potenziale utilità di più biomarcatori per l’Alzheimer”, ha affermato Song. “Non è possibile ottenere informazioni sulla trama e sulla struttura della retina con la sola OCT. Sono necessarie entrambe le modalità di imaging. Questa è l’innovazione chiave “.
Schema del sistema combinato a/LCI e OCT per l’imaging della retina del topo. Le linee rosse mostrano il percorso di illuminazione a/LCI, che colpisce la retina con un raggio collimato obliquo. Le linee verdi mostrano la luce diffusa angolata dalla retina. Le linee blu mostrano il percorso del fascio OCT per l’imaging della retina. Credits: Scientific Reports Un sistema più pratico ed economico I ricercatori ora stanno lavorando per integrare questa capacità aggiuntiva in un sistema OCT a basso costo che Wax sta sviluppando attraverso una società spin-off chiamata Lumedica. Mentre le macchine OCT tradizionali pesano più di 60 pounds (circa 27 kg), occupano un’intera scrivania e costano tra $ 50.000 e $ 120.000, il design di Wax pesa 4 pounds (circa 1.8 kg), ha le dimensioni di una scatola porta-pranzo e Wax ipotizza che sarà venduto per meno di $ 15.000 .
La chiave del design ideato da Wax è una parte stampata in 3D che, sfruttando la simmetria, riesce a compensare le incoerenze meccaniche che possono sorgere nei tradizionali dispositivi OCT a causa di piccoli cambiamenti di temperatura. Inoltre, Song ha lavorato su un prisma rotazionale stampato in 3D, consentendo a/LCI di scansionare l’intera retina.
“Siamo entusiasti perché questa ricerca mostra un nuovo modo di utilizzare le tecnologie OCT a basso costo al di fuori del semplice screening per le malattie retiniche tradizionali”, ha affermato Wax. “Se possiamo usare questi dispositivi come una finestra sui primi segni di malattie neurodegenerative, forse possiamo aiutare le persone a entrare in un programma di trattamento di intervento precoce prima che sia troppo tardi .”
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