Thursday 7 July 2022 02:21 PM Will we ever cure cruel Alzheimer's? trends now

Thursday 7 July 2022 02:21 PM Will we ever cure cruel Alzheimer's? trends now
Thursday 7 July 2022 02:21 PM Will we ever cure cruel Alzheimer's? trends now

Thursday 7 July 2022 02:21 PM Will we ever cure cruel Alzheimer's? trends now

It was officially described 115 years ago. But billions of pounds and hundreds of failed trials later, scientists still haven't been able to crack one of the world's most devastating diseases — Alzheimer's.

Curing the cruel memory-robbing disorder is considered one of the Holy Grails of medicine but it has alluded scientists for decades. Currently, the only approved drugs for Alzheimer's merely dampen some of the symptoms — and only temporarily — but do not stop the disease from progressing.  

But there is some tentative optimism among experts who feel they are finally edging closer. Dr Mark Dallas, a neuroscientist from the University of Reading, told MailOnline he hopes a big breakthrough could come within the next decade.

On Tuesday, scientists found giving dementia patients ADHD drugs like Ritalin, normally prescribed to hyperactive children, can improve memory and learning, and reduce apathy — one of the sad symptoms of Alzheimer's that often sees patients cut themselves off emotionally from loved ones.

The British researchers who found the link after reviewing existing research believe the drugs help kickstart the brain region responsible for cognition — and they are calling for new clinical trials. 

Elsewhere, new therapies are being trialled that involve injecting people with stem cells that can mimic brain tissue to regrow parts of the organ damaged by the disease. 

There is also optimism about antibody jabs that train the body to recognise the early signs of Alzheimer's. They are already being trialled in humans and several antibody cocktails were rapidly developed and approved for Covid during the pandemic.  

Other teams are studying zapping the brain with light or using oxygen therapy in an attempt to reverse the damage caused by the disease. 

These potential treatments are still years away from being rolled out on a mass scale, even if they are found to work. But in the meantime, scientists are looking at whether any existing medications can be repurposed to fight the memory robbing disorder.  

MailOnline looks at some of the potential breakthroughs that could one day lead to curing or reversing of Alzheimer's:

Vaccines and antibodies, brain zapping helmets, oxygen therapy and stem cells are just some of the areas experts are exploring in the hunt for a cure for Alzheimer's

Vaccines and antibodies, brain zapping helmets, oxygen therapy and stem cells are just some of the areas experts are exploring in the hunt for a cure for Alzheimer's

A study by researchers at the University of Washington School of Medicine revealed that global dementia cases are set to nearly triple by 2050, from 57.4million to 152.8. But the rate of illness is expected to increase varies between different parts of the world. In Western Europe, cases are expected to rise by just 75 per cent, mainly due to an ageing population, while they are expected to double in North America. But the biggest increase is expected to be seen in North Africa and the Middle East, where cases are projected to rise by 375 per cent

A study by researchers at the University of Washington School of Medicine revealed that global dementia cases are set to nearly triple by 2050, from 57.4million to 152.8. But the rate of illness is expected to increase varies between different parts of the world. In Western Europe, cases are expected to rise by just 75 per cent, mainly due to an ageing population, while they are expected to double in North America. But the biggest increase is expected to be seen in North Africa and the Middle East, where cases are projected to rise by 375 per cent

'Vaccines' 

In November, scientists at Brigham and Women's Hospital in Boston in the US started a phase one trial of nasal spray that is hoped could be a viable vaccine for Alzheimer's.

The spray uses the chemical Protollin to stimulate a person's immune system. 

It's thought to activate white blood cells that can clear plaques of amyloid beta protein that build up around brain cells and cause them die in Alzheimer's patients.  

The vaccine is given as a two-dose regimen, administered one week apart. The early trial involves 16 participants between the ages of 60 and 85.

What is Alzheimer's and how is it treated? 

Alzheimer's disease is a progressive, degenerative disease of the brain, in which build-up of abnormal proteins causes nerve cells to die.

This disrupts the transmitters that carry messages, and causes the brain to shrink. 

More than 5 million people suffer from the disease in the US, where it is the 6th leading cause of death, and more than 1 million Britons have it.

WHAT HAPPENS?

As brain cells die, the functions they provide are lost. 

That includes memory, orientation and the ability to think and reason. 

The progress of the disease is slow and gradual. 

On average, patients live five to seven years after diagnosis, but some may live for ten to 15 years.

EARLY SYMPTOMS:

Loss of short-term memory Disorientation Behavioral changes Mood swings Difficulties dealing with money or making a phone call 

LATER SYMPTOMS:

Severe memory loss, forgetting close family members, familiar objects or places Becoming anxious and frustrated over inability to make sense of the world, leading to aggressive behavior  Eventually lose ability to walk May have problems eating  The majority will eventually need 24-hour care   

HOW IT IS TREATED?

There is no known cure for Alzheimer's disease.

However, some treatments are available that help alleviate some of the symptoms.

One of these is Acetylcholinesterase inhibitors which helps brain cells communicate to one another. 

Another is menantine which works by blocking a chemical called glutamate that can build-up in the brains of people with Alzheimer's disease inhibiting mental function. 

As the disease progresses Alzheimer's patients can start displaying aggressive behaviour and/or may suffer from depression. Drugs can be provided to help mitigate these symptoms.   

Other non-pharmaceutical treatments like mental training to improve memory helping combat the one aspect of Alzheimer's disease is also recommended. 

 Source: Alzheimer's Association and the NHS

 

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All participants displayed early symptoms of Alzheimer's disease, like mild cognitive impairment and early signs of plaque build-up in the brain, but have not been diagnosed with Alzheimer's yet. 

The trial will hope to find whether or not the vaccine is safe, and what dosage doctors should use for it.

The treatment will need to go through two more rounds of trials to see if it actually works, which is generally where most medicines fail in the development cycle.  

This means it could be years away from being rolled out as a general treatment. 

The potential vaccine is the result of 20 years of research from Dr Howard Weiner, the co-director of the Ann Romney Center for Neurologic Diseases at the US hospital.

'The launch of the first human trial of a nasal vaccine for Alzheimer's is a remarkable milestone,' he said at the time.

'If clinical trials in humans show that the vaccine is safe and effective, this could represent a nontoxic treatment for people with Alzheimer's, and it could also be given early to help prevent Alzheimer's in people at risk.' 

Antibody therapies

A number of potential Alzheimer's drugs have aimed to use specially developed antibodies, part of the body's immune system, to help clear plaque from the brain. 

Most of these have failed when trialled on humans but that hasn't stopped scientists from developing new ones in an attempt halt or even reverse the spread of the disease. 

One of the most promising is TAP01, which was developed by a team of researchers from the University of Leicester, the University Medical Center Göttingen in Germany and British medical research charity LifeArc. 

TAP01 works by targeting the amyloid beta protein, while it is in a soluble form rather than other Alzheimer's antibody candidates which attempt to target the protein after it becomes the plaque in the brain.

Professor Thomas Bayer, from Göttingen, said: 'We identified an antibody in mice that would neutralise the truncated forms of soluble amyloid beta, but would not bind either to normal forms of the protein or to the plaques.'

The researchers want to artificially create versions of this antibody and 'humanise' it — so the immune system wouldn't reject it.  

Further tests on rodents with Alzheimer’s using these antibodies produced promising results.

Rodents showed improvements to brain activity and memory, as well as reduced levels of the protein in the brain.

The authors of the study hope TAP01 could act as either therapeutic treatment for Alzheimer’s patients or as a kind of 'vaccine' preventing the disease from developing in the first place. 

Leicester's Professor Mark Carr, an expert in chemical biology, added: 'While the science is currently still at an early stage, if these results were to be replicated in human clinical trials, then it could be transformative.'

'It opens up the possibility to not only treat Alzheimer’s once symptoms are detected, but also to potentially vaccinate against the disease before symptoms appear.'

The researchers are now looking to find a commercial partner to take TAP01 through clinical trials in humans.

Another Alzheimer’s antibody treatment currently being trialled in the US is gantenerumab. 

It is supposed to work in the more conventional way, by clearing amyloid plaque once it has already built-up in the brain. 

Antibody treatments which have been used for years in things like cancer treatment or organ transplants, sprung to wider attention as a potential Covid treatment during the pandemic. One such product from AstraZeneca, called Evusheld, or Covid antibody therapy AZD7442 could allow people who can't be protected by vaccines a chance to return to normal life

Antibody treatments which have been used for years in things like cancer treatment or organ transplants, sprung to wider attention as a potential Covid treatment during the pandemic. One such product from AstraZeneca, called Evusheld, or Covid antibody therapy AZD7442 could allow people who can't be protected by vaccines a chance to return to normal life

In the latest trial, completed in June last year, 144 people with a genetic risk of Alzheimer's were either given gantenerumab or a placebo for up to seven years. But neither drug prevented or slowed cognitive decline in the participants.

The drug reduced plaque in their brains but participants were not found to be any less forgetful, and there was no statistical improvement to their cognition. 

Experts are now setting out to test if the drug works in patients at even earlier stages of the disease, with its developers still holding out hope.

Will we ever cure Alzheimer's?

MailOnline asked British Alzheimer's experts on if science might find a cure for the disease, and which might be the most likely to work.

Dr Mark Dallas, expert in cellular neuroscience, University of Reading:

Dr Dallas said while all the potential breakthroughs highlighted by this website had merit, drugs and new medication remained the most fruitful rea of research. 

'All these approaches have their relative merits, but we are further down the line with antibodies and vaccines to understand how these can disrupt the disease,' he said.

'As the science develops and we accumulate more evidence the other approaches may be used as part of a combination of interventions to stall the disease from progressing.'

He added that he expects new Alzheimer’s medicines will become available in the next five to 10 years which will provide great benefit to patients, but these would not be a cure.

Whatever breakthrough comes, Dr Dallas said it would be thanks to all those with disease that have offered to take part in clinical trials. 

Dr Susan Kohlhaas, Alzheimer’s Research UK director of research:  

'Finding a life-changing treatment for Alzheimer’s disease that can stop or prevent it altogether is within our reach, but the process of identifying drug targets in the laboratory through to people getting the treatments takes many years,' she said.

'The research effort to find new treatments is huge, and often success stories come from repurposing existing drugs for other diseases, or from taking a new approach to an already successful treatment.'

Dr Kohlhaas said she believed a cure for Alzheimer’s was achievable but that many barriers stand in the way. 

'We must improve the way a diagnosis is made so that people with dementia are identified when their symptoms first appear, where treatments may be more effective,' she said.

'This will also help give people the option of taking part in research that informs the search for future innovative treatments.'

While we wait for a cure, Dr Kohlhaas urged people to do what they could to minimise their dementia risk by exercising more and learning new skills and hobbies to keep their mind sharp.  

Professor David Smith, expert in pharmacology, University of Oxford:

Professor Smith argued we'll never 'cure' Alzheimer’s, only prevent or slow it. 

'Even if the tissue could be replaced the memories that have been lost could never be replaced,' he said. 

'The best we can do is to try to prevent the disease developing and to slow down its progression once it starts.'

He said while more research was needed several risk factors had been identified, some of which we had control over. 

'Modifiable risk factors include smoking, high blood pressure, high blood glucose, low omega-3 fatty acid status (limited fish intake), low physical activity, low mental activity, depression, high blood homocysteine (caused by low B vitamin intake, especially B12,' he said.

'Attention to these risk factors may slow development of Alzheimer’s and may also slow its progression once it starts, although more research is needed.'

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'The drug's ability to shift multiple Alzheimer's biomarkers toward normal indicates that it is positively affecting the disease process,' the researchers said. 

In March this year, a new gantenerumab trial, called SKYLINE was launched and will run for four years. 

It will recruit 1,200 participants between the ages of 60 and 80 who show signs of protein plaque building up in their brains but are yet to suffer any cognitive decline. 

Participants will receive a weekly, or biweekly dose of gantenerumab and their outcome will be compared to a placebo group.

Dr Dallas, from the University of Reading, told MailOnline this was still the best area for potential new ways to combat the disease.

'We are further down the line with antibodies and vaccines to understand how these can disrupt the disease,' he said. 

‘The Alzheimer’s drug pipeline is filled with over 30 vaccines and antibodies that are currently being tested as active agents against

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