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Alzheimer’s Q&A: What are some mysteries of Alzheimer’s disease that puzzle researchers?

The Acadiana Advocate

10-01-19

Despite intensive, worldwide research efforts for more than three decades to better understand Alzheimer’s disease, there are still numerous mysteries surrounding the condition.
Dr. John Morris, a professor of neurology and director of the Knight Alzheimer’s Disease Research Center at Washington University School of Medicine in St. Louis, and Dr. Dennis Selkoe, co-director of the Ann Romney Center for Neurological Disease at Brigham and Women’s Hospital in Boston, agree on some mysteries of Alzheimer’s disease that confound researchers:
What will be a safe and effective treatment for Alzheimer’s disease? Though there are FDA-approved medications that help for a time with memory symptoms and cognitive changes, there is no safe and effective treatment to slow down Alzheimer’s disease or prevent it from developing. Selkoe’s research centers around the idea that there is an imbalance between the production and removal of the amyloid beta protein (triggering Alzheimer’s) in the brain.
Why have clinical trials of some highly promising drugs failed to show positive results? Over the last 15 years, as reported in Live Science, high-profile clinical trials have included people who may have not had Alzheimer’s disease but had symptoms, only to find that they had another form of dementia. Currently, people in experimental drug trials must test positive for biomarkers of Alzheimer’s disease before participating in the research. Additionally, some people entered trials and the drugs did not appear to work because the people’ disease was too advanced; the brain had already been too damaged by the plaques and tangles with a great loss of brain cells. Now that biomarkers can better identify which older adults should be in drug trials, researchers are introducing experimental medications at earlier stages of the disease – years or decades before symptoms appear – to see if the medicines might slow down or halt the disease process in the brain. Also, typically it takes the Federal Drug Administration a minimum of 10 years to approve any medication, so it is a long process from clinical trials to FDA approval.
Has the relationship between the plaques and tangles found in the brain been resolved? Part of the answer has been unraveled as researchers have discovered the plaques develop in the brain first, before the tangles. The buildup of the amyloid protein damages and kills the nerve cells, and the strands of tau protein twist and form tangles inside the nerve cells. Though all of this is well known, researchers are still perplexed how these plaque and tangles affect brain function that eventually leads to memory and behavior changes and other symptoms of Alzheimer’s disease. Additionally, researchers do not know if the amyloid in the plaques and tau protein work separately or together in damaging these nerve cells.
Other mysteries include: How do brain cells die once the amyloid plaque gets deposited? Is inflammation related to Alzheimer’s? How is the disease first manifested in a person? The mysteries of the disease continue as researchers tirelessly work to find a cause, prevention and cure. But for Selkoe, the most important mystery to solve is “finding a safe and effective treatment for this neurological disorder.”
Questions about Alzheimer’s disease or related disorders can be sent to Dana Territo, the Memory Whisperer, owner of Dana Territo Consulting, LLC, at thememorywhisperer@gmail.com.
via Life Extension Daily News