2023-09-13 16:13:00
“Breakthrough in Alzheimer’s Research: Antibodies Show Promising Effects, but Challenges Remain”
Alzheimer’s disease, the most common form of dementia worldwide, affects around a million people in Germany alone. With an aging population, the number of people suffering from Alzheimer’s is steadily increasing, highlighting the urgent need for effective therapy options. In 2019, hopes were shattered when two studies on an Alzheimer’s drug were halted due to a lack of success. The setback was regarded as a “disaster” and a “huge disappointment” for the field of neuroscience.
However, there is renewed optimism four years later. The antibody aducanumab, which had previously shown little prospect of success, was approved for Alzheimer’s therapy in the USA in 2021, sparking controversy. Another antibody, Lecanemab, entered the US market in early 2023, and its approval in the EU is currently under examination. Furthermore, a recently published study in the journal “JAMA” presented promising results for a third antibody called donanemab, which is pending approval in the USA. These antibodies aim to break down specific deposits in the brain associated with Alzheimer’s disease.
While the media has hailed these developments as a “breakthrough” and a “milestone,” experts remain cautious. Richard Dodel, an Alzheimer’s expert at the German Society for Neurology, acknowledges that the benefits of these antibodies are currently limited. Özgür Onur, a neurologist at the University Hospital of Cologne, states that they are not miracle cures. However, he adds that for the first time, studies are showing some effects. Johannes Levin from the German Center for Neurodegenerative Diseases and the Munich Ludwig Maximilians University suggests that researchers now have a better understanding of where it might be worthwhile to start therapeutically.
Alzheimer’s disease poses a significant challenge for researchers due to its undetectable progression in the brain for many years before a diagnosis is made. By the time dementia is diagnosed, it is already well advanced, and individuals, on average, live for only another ten years. The brains of Alzheimer’s patients exhibit deposits of two proteins, amyloid beta (Abeta) and tau, which play a significant role in the disease process. Previous research focused on either Abeta or tau as the primary cause of symptoms, but recent evidence suggests that both are involved in the disease mechanism.
The antibody studies mainly target the clearance of Abeta plaques between nerve cells, which they do effectively. However, the impact on the disease itself remains modest, with the progression of dementia slowed by up to 35% compared to placebo therapy. Side effects and the considerable effort required for treatment pose additional challenges. Regular monitoring is necessary due to potentially dangerous side effects, such as brain swelling and edema.
According to Levin, the limited efficacy of the therapy in slowing disease progression may be due to the tau protein, which accumulates in nerve cells and is believed to be the actual cause of cell death. The abnormal processes leading to Alzheimer’s disease begin roughly 20 years before symptoms appear, starting with the formation of Abeta plaques and subsequent tau fibrils. In order to stop the progression of the disease, both these deposits would need to be addressed. However, removing tau fibrils is more challenging since they are located within the nerve cells.
While Alzheimer’s disease cannot be reversed due to permanent cell damage, researchers aim to eventually halt its progression. Experts suggest that a combination therapy targeting the clearance of both Abeta and tau deposits, as well as addressing inflammation and vascular changes in the brain, would be the most effective approach. Early intervention would be crucial, requiring the ability to identify the onset of dementia before symptoms manifest. Reliable blood tests are being developed to aid in early diagnosis and identify individuals who could benefit from preventive treatments. Although several tests are currently being studied, a reliable blood biomarker for diagnosing Alzheimer’s is still lacking.
While the recent developments in Alzheimer’s research offer hope, challenges and uncertainties remain. Further research, clinical trials, and advancements in diagnostics are necessary to fully understand and effectively treat this devastating disease.]
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