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24 June 2013

Advances in the Treatment of Alzheimer’s disease

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The rapid pace at which we live our lives today, focused so intensely on the present moment, means that we fail to give sufficient thought to our future and as a society fail to pause and take heed of some extremely bad developments.

Something is happening: nervous system disorders are now the fourth largest cause of death in Spain, behind diseases of the circulatory system in first place, tumors in second place and respiratory diseases in third.

According to a recent study from Neurology magazine, the number of Alzheimer‘s sufferers could triple over the next 40 years. Scary, right? This research was conducted by the Institute for Healthy Aging based in Chicago. A spike in the disease among humans is not expected to happen on its own, but is set to come as a result of an ageing population and improvements in our quality of life. The Baby Boom generation is ageing. According to the research, in Spain there are currently 400,000 people suffering from Alzheimer’s, and this number may shoot up in just a few short years due to longer life expectancy.

Alzheimer’s disease is the most frequent cause of dementia; it is a neurodegenerative disease with the main symptom of progressive memory loss. It is characterized by cognitive impairment on activities of daily life, with various psychological and behavioral disorders, as well as sleep disorder, depression, psychosis, agitation… The disease is produced by loss of neurons and synapses (connections or points of contact between the nerve cell endings), mainly in the regions of the brain related to memory.

It is an incurable disease and, at present, largely unpredictable. The most useful recent direct research into the disease has looked at the reliable use of biomarkers to identify individuals who are most likely to develop the disease. This research indicates that high levels of four specific proteins in certain individuals, combined with low levels of a further three proteins, may be our most reliable predictor of the disease at present.

These biomarkers are vitally important and have been the subject of much research. They are currently the only early warning system we have to identify the onset of the disease, allowing researchers to seek means of reversing the changes before too much brain damage occurs.

One important development is the Euroespes EB101 vaccine, from a group of Spanish scientists, led by doctor Ramón Cacabelos. In short, Alzheimer’s is a complex disease that can be affected by hundreds of genes and preexisting disorders… but the main neuropathology is an accumulation of beta amyloid peptide (a protein), which among other things can reduce total brain volume and cause specific damage to the hippocampus; neuroinflammation and gliosis (various cells, such as astrocytes, which accumulate in areas of neuronal damage).

The result is a deficit of neurotransmitters, which triggers the symptoms that we have all seen in Alzheimer’s sufferers.

While the studies are still in early stages, research using transgenic mice has sought two kinds of results: preventive and palliative. The mice were immunized with various proteinaceous compounds, with results showing a reduction in protein deposits in the hippocampus. This in itself is a real advance with a view to using the vaccine in humans.

The EB101 vaccine does not stimulate the same autoimmune response as other vaccines researched in the past. While we remain cautious for the moment, this work could be the genesis of a potential cure for the disease. Not only could it prevent the protein deposits that begin with onset of the disease, but the neurodegenerative process could even be reversed.

Which could mean real hope for Alzheimer’s sufferers, their families and perhaps many more of us.

Francisco José Cano

Risk Analyst, BBVA, Madrid (Spain)

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