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Merck has ended a trial for the experimental Alzheimer's treatment verubecestat, a BACE1 inhibitor, after it was found to be ineffective. Biogen has increased the sample size of a trial for aducanumab, worrying some investors. The news comes after the failure of drugs such as solanezumab and intepirdine to treat Alzheimer's and dementia.
The FDA has proposed new guidelines that would make it easier to treat Alzheimer's by lowering the bar for clinical success:
In proposed new guidelines released on Thursday, the FDA appears open to trial goals that better match early patient populations, including people who have yet to display memory loss or functional impairment, such as the ability to wash or dress themselves or cook meals.
The draft guidelines suggest that improvement in biomarkers, such as amount of beta amyloid in the brain, a protein linked to the disease, may be an acceptable goal for deeming a drug successful in patients with no symptoms. FDA guidelines used in prior studies demanded that a drug demonstrate both cognitive and functional improvements.
A bipartisan group of Senators and Congressman have introduced the Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act, which would also reduce regulatory barriers faced by clinical trials. The annual cost of Alzheimer's and dementia care in the U.S. is projected to rise to $1.1 trillion by 2050.
Meanwhile, a group of researchers has found that targeting BACE1 enzymes could remove existing amyloid plaques (in mice):
Knocking back an enzyme swept mouse brains clean of protein globs that are a sign of Alzheimer's disease. Reducing the enzyme is known to keep these nerve-damaging plaques from forming. But the disappearance of existing plaques was unexpected [open, DOI: 10.1084/jem.20171831] [DX], researchers report online February 14 in the Journal of Experimental Medicine.
The brains of mice engineered to develop Alzheimer's disease were riddled with these plaques, clumps of amyloid-beta protein fragments, by the time the animals were 10 months old. But the brains of 10-month-old Alzheimer's mice that had a severely reduced amount of an enzyme called BACE1 were essentially clear of new and old plaques.
An Alzheimer's treatment, donepezil, has been used to treat alcohol-related brain damage in mice.
Finally, a study of eight patients with cerebral amyloid angiopathy (CAA), a brain bleeding condition, found that all eight had undergone brain surgery earlier in life, suggesting that insufficiently clean surgical instruments could spread amyloid proteins from one person to another and cause CAA:
None of these people have known gene variants that would raise the risk of developing CAA early. [Sebastian] Brandner's team says the most likely explanation is that amyloid proteins were seeded into their bodies during childhood brain surgery, from instruments previously used for surgeries on people with Alzheimer's disease. Creutzfeldt-Jakob Disease (CJD), a brain disease caused by prion proteins, is already known to have been spread in a similar way.
Evidence of amyloid-β cerebral amyloid angiopathy transmission through neurosurgery (open, DOI: 10.1007/s00401-018-1822-2) (DX)
(Score: 4, Interesting) by sonamchauhan on Saturday February 17 2018, @01:41AM (1 child)
No really. If it hinders disease progression, this may be a good thing. For any drug to demonstrate cognitive and functional improvements when the brain is severely damaged already is a tall order.
But I agree amyloid plaque reduction should not be the only measure. We probably need more sensitive tests that measure the earliest signs of disease progression (eg, measure the trend in gamma waves, reaction times, tough cognitive tests, etc).
And recruiting the body's own cleanup tools should be a priority. Two that I know of are below.
A. Sound, flickering light and movement, all at 40Hz, is known to generate gamma waves in the brain that cleanup amyloid plaques.
A.1. For light, see:
http://news.mit.edu/2016/visual-stimulation-treatment-alzheimer-1207 [mit.edu]
https://www.gammalighttherapy.com/ [gammalighttherapy.com]
A.2. For sound:
https://alzheimersnewstoday.com/2016/04/22/study-alzheimers-patients-finds-low-frequency-sound-stimulation-improves-cognition/ [alzheimersnewstoday.com]
http://www.iflscience.com/health-and-medicine/low-hum-therapy-seems-to-counteract-alzheimer-s-symptoms-in-mice/ [iflscience.com]
https://www.youtube.com/watch?v=wxb4-ZL7zIk [youtube.com]
https://www.youtube.com/watch?v=tUScfYhxIgk [youtube.com]
A.3. For movement: use a vibration platform.
To find what machine setting (typically 1,2,3..) corresponds to 40Hz, I did something very simple. Starting at '1', I put my finger just above the platform and counted the 'up-down-up' beats in a set interval to get the rate. Then I did the same thing with '2'. Then extrapolated. My machine setting was '13'.
B. Using ultrasound and injected microbubbles to temporarily open up the blood-brain-barrier (BBB).
In mice, their own immune system then cleared up brain plaques:
https://www.reddit.com/r/Futurology/comments/2yqtik/focused_ultrasound_unexpectedly_removes/ [reddit.com]
https://www.wsj.com/articles/ultrasound-treatment-helps-improve-memory-in-mice-1426096802 [wsj.com]
"The effect seems to be related to mild disruption of the blood brain barrier which allows the immune system to clean up the extracellular protein aggregates more effectively than otherwise possible."
A clinical trial is underway in Canada to use ultrasound to deliver anti-amyloid antibodies to the brain:
https://www.fusfoundation.org/diseases-and-conditions/neurological/alzheimers-disease [fusfoundation.org]
https://clinicaltrials.gov/ct2/show/NCT02986932 [clinicaltrials.gov]
https://www.youtube.com/watch?v=ZaeemszSJo0 [youtube.com]
Interestingly, the BBB is already compromised in many Alzhiemer's patients. Its unclear to me if this is a cause or effect or fellow-traveller of Alzhiemer's disease.
"Blood–brain barrier dysfunction as a cause and consequence of Alzheimer's disease"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790938/ [nih.gov]
At some point, I even wondered about an 'ultrasound-cleaner' device I have (the type used to clean jewellery). Could it be used with a water-filled bag to 'treat' a neighbour's dog that had dementia. Picture the dog lying on its side, with a water bag to the back of its head, and the cleaner device on the other side. I did not followed through.
C. A skin cancer drug, Bexarotene, helps certain people if prescribed off-label for Alzheimer's
http://abcnews.go.com/Health/AlzheimersCommunity/alzheimers-disease-skin-cancer-drug-sparks-hope-desperation/story?id=15573971 [go.com]
https://www.alzforum.org/news/research-news/bexarotene-first-clinical-results-highlight-contradictions [alzforum.org]
I think a full-spectrum approach is needed. All therapies should be tried - in conjunction - if likely to synergize instead of cause harm. For instance, Bexarotene decreases BBB permeability but its mechanism of action may be autophagy.
https://www.nature.com/articles/srep33176 [nature.com]
D. Excess sugar may cause Alzhiemer's
http://www.telegraph.co.uk/science/2017/02/23/alzheimers-could-caused-excess-sugar-new-study-finds-molecular/ [telegraph.co.uk]
People are now calling Alzhiemer's "diabetes of the brain":
http://www.doctoroz.com/article/alzheimers-diabetes-brain [doctoroz.com]
Practises that drain sugar from the blood could help. Like, say, the 100-pushup (or more) challenge -- where you randomly exercise at various points in your day -- say, walk into an unoccupied office meeting room, do 20 pushups, then walk out.
(Score: 1) by sonamchauhan on Saturday March 03 2018, @09:34AM
More info:
[ Mostly sourced from "What Doctors Don't Tell You" magazine Dec 2017 issue, article "Total Recall" on page 28 [wddty.com]. The part about aluminium electrodes in water heaters is from elsewhere]