Hope is on the horizon for millions of Alzheimer's disease patients as scientists develop a new target for Alzheimer's treatment: the immune system.
Alzheimer's affects roughly 5.8 million Americans, according to the Centers for Disease Control and Prevention (CDC). The progressive disease is the most common form of dementia and is associated with memory loss and cognitive decline in regions of the brain involved in thought, memory and language.
Scientists believe that Alzheimer's is caused by the abnormal buildup of proteins in and around the brain cells, but exactly what triggers this is still unclear.
Today, there is no known cure for Alzheimer's. However, new medications may offer relief to patients and slow the disease's progression. And our body's immune system can help with this.
"There are many approaches that are in various stages of development that target the immune system, which is now known to play a key role in Alzheimer's disease," Todd Golde, a professor of pharmacology, chemical biology and neurology at Emory University, told Newsweek.
One particularly exciting approach involves the use of antibodies that can target and bind to the abnormal protein clumps that form in the brain. "This results in clearance or reduction of [the protein clumps]," Golde said.
Golde and colleague Allan Levey have summarized this approach in a recently published perspective in the journal Science.
Precisely what mediates this interaction is still unknown, but Golde said that the brain's private squad of immune cells may play an important role. These cells, called microglia, are found exclusively in the brain and central nervous system and can engulf problematic proteins and infectious particles like bacteria. Therefore, researchers believe that the antibodies may act as little molecular flags to signal to the microglial cells that a mess needs cleaning up—a mess in the form of an Alzheimer 's-associated protein clump.
Based on clinical trials, these antibodies offer a very promising avenue for future treatments.
"These treatments slow decline in the very earliest symptomatic stages of Alzheimer's disease on average by about 25 to 30 percent over 18 months of treatment," Golde said. "Notably, the antibodies show quite remarkable impacts on amyloid deposits [aka the protein clumps] themselves."
Unlike previous therapies designed to ease symptoms and boost cognitive function, Golde said that these antibodies represent the first therapies capable of altering the course of the disease.
"Having a disease-modifying therapy (like this) is in some ways a game changer for Alzheimer's disease, as it says that we can alter the course of this devastating disease and slow it down," Golde said. "This is just a start, and that either improved versions of these therapies, other types of disease-modifying therapies, or combination therapies will likely in the future lead to treatments with bigger impacts, halting or preventing disease."
Two of the antibodies used in these trials have already been FDA approved; the third is expected to be approved in 2024. However, care still needs to be taken over their use.
"Because of potential for side effects, the need to treat patients early in the symptomatic phase of the disease in individuals [and] the fact that they are currently given through multiple IV infusions and require careful monitoring, there are some barriers to widespread use [of these antibodies]," Golde said. "Indeed, there is appropriate caution among most clinicians to ensure that the right patients most likely to benefit from these therapies are treated."
Golde stresses that, while these results are fascinating, we are still a long way from effectively treating Alzheimer's.
"Though this represents an initial success, huge unmet medical need remains," he said. "We need continuing investment in the public and private sectors to ensure that we can meet that need and build off this initial, but limited, success."
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Pandora Dewan is a Senior Science Reporter at Newsweek based in London, UK. Her focus is reporting on science, health ... Read more
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