Scientists on the verge of developing a cure for Alzheimer’s disease

Scientists say that this is only the beginning: the moment will come when there will be drugs that cure Alzheimer’s completely. The only sad thing is that the prospects for these innovations to come to Russia are very vague.

Alzheimer’s disease is a progressive brain disorder characterized by declines in memory, language skills, and cognitive function, as well as changes in mood and behavior. It affects almost every family in the world, this most common form of dementia (60-80% of cases) affects more than 55 million people, and by 2030 their number is projected to reach 78 million. Approximately 10 million people are diagnosed with asthma each year.

It is known that biological changes in the brain begin decades before the first symptoms of the disease appear. One of the most common theories of the occurrence of AD is amyloid. For the first time, deposits of beta-amyloid protein (amyloid plaques) in the brain of patients with dementia were described by the doctor of the Imperial Medical and Surgical Academy S.A. Belyakov back in 1887; subsequently, scientists have repeatedly confirmed the relationship between the accumulation of amyloid plaques in the brain and a decrease in cognitive functions.

For many years, studies have been conducted on drugs that could suppress the production of this protein, but there has been little success, and therefore the theory has been questioned more than once. However, the results of many years of research have finally been crowned with success – now monoclonal antibodies, which have already proven themselves in the treatment of oncological and rheumatic diseases, have come into the focus of attention of scientists.

Several anti-amyloid-beta antibodies are in Phase III clinical trials in the US and Switzerland, and one, which will be completed later this year, has already received Breakthrough Therapy designation from the US Food and Drug Administration ( FDA). Breakthrough therapy designation is given to medicines for the treatment of serious or life-threatening diseases that, according to preliminary scientific evidence, can significantly improve the condition of patients compared to drugs that previously received full FDA approval.

The MK reviewer took part in the International Online Conference “Rethinking Alzheimer’s Disease: Exploring the Complexities of Clinical Research”, where leading scientists in the field of Alzheimer’s disease spoke about the latest advances in the diagnosis and treatment of the disease. Professor Bruno Welles of the University Hospital of Toulouse, head of the Clinical Center for Alzheimer’s Research, has devoted 35 years to this topic.

“In the past, we had only symptomatic therapy, which did not affect the course of the disease. But the main goal was to find drugs that affect the biology of disease progression. First, we studied patients in severe stages of AD, with multiple lesions in the brain. And in the 2010s, they started looking for biomarkers for early diagnosis and found that many patients in the early stages have an amyloid signature. Then the search for targeted therapies that could prevent the progression of the disease began, and today a class of anti-amyloid drugs has appeared, ”says Bruno Welles.

As the head of neurological research at the biotechnology corporation, Dr. Rachel Doudy, author of more than 200 works on AD therapy, notes, scientists tried to influence other biomarkers of the disease besides amyloids: fibrins, plaques, amyloid precursors, reactive processes in the brain – as targets for targeted drugs . So far, only anti-amyloid agents have shown effectiveness, but today the field of research has generally shifted towards the early stage of the disease and even its prevention.

“Of course, we will see patients with severe stages for some time. However, soon the disease will begin to be treated in the early stages, and in this situation it is important to ensure that therapy is available to everyone. In addition, it is necessary to ensure the availability of early diagnosis of asthma, ”says Rachel Doody.

“We are seeing an incredible revolution in science. We are trying to develop tests using routine blood tests to detect early signs of illness in asymptomatic patients. So far, evolution has not reached such a level, but we have set a goal. For example, today we define an increased risk of heart attacks by cholesterol levels and the presence of plaques, the same will be with Alzheimer’s disease, ”says Professor Welles.

Tests for blood biomarkers to detect amyloid pathology have already appeared in the world. According to their results, the disease is confirmed using positron emission tomography or by examining the cerebrospinal fluid. “Now we know the right patient pool, the right biomarkers, but we need to continue to look for targets that will help assess the progression of the disease,” says Professor Welles. The challenges for the future are to detect the disease in asymptomatic patients. According to scientists, the average age of onset of mild cognitive impairment is 55 years. And today more and more patients have this risk.

According to a specialist in the field of diagnostics, Dr. Bruce Georgean, today more than 75,000 diagnostic tools are used in the world to detect amyloid pathologies, but such diagnostics are inaccessible even in Europe, testing needs to be expanded. For example, there are blood tests that detect the presence of amyloid, which poses a risk: confirmation of amyloid pathology is clinically important for a diagnosis of Alzheimer’s disease. There are markers of fibrin neuroinflammation that indicate its progression in the brain. And scientists are working to create new tests that will allow personalized treatment.

According to the head of the Department of Early Research Development in Neurology and Rare Diseases of the American biotech company, Dr. Jeffrey Ketcher, there is an active search for antibodies that affect amyloids: “Years pass from the moment amyloid begins to form multidimensional plaques and inflammation. Therapy that targets amyloid reduces the progression of the disease. Beta-amyloid exists in different forms in the brain, and each molecule against them is unique. The task of scientists today is to identify patients with a certain type of amyloid pathology in the brain, who will receive the maximum therapy.”

Experts emphasize that new drugs significantly reduce the level of amyloid in the brain in patients in the early stages of the disease, but only over time it will be possible to assess whether this will completely get rid of symptoms and achieve victory over the disease.

“Purifying the brain of amyloid is one story, but whether we get a regression of the disease is another question,” the scientists say. “The clinical outcome of patients is the most important issue. The patient does not really understand what amyloid beta is, but he wants to improve the condition and cure the symptoms. A new group of drugs is only the first step. This is not yet a cure for Alzheimer’s, it’s just that the patient is given the opportunity to preserve cognitive functions, preserve memory, and take care of himself. There is still a long way to go before a complete cure, but we are on the right track,” says Bruno Welles. “We are getting closer to the era of therapy that changes the course of the disease,” says Bruce Georgian.

Scientists are confident that the future belongs to complex therapy, which will combine different methods of treatment that affect different targets. That is, doctors will individually combine different types of therapy in order to attack the disease from all sides.

The prospects for access of breakthrough drugs to Russia are still very illusory. Scientists note that they dream of the day when they will be available to all those in need, but they could not comment on the possibilities of our country’s access to revolutionary therapy. Recall that many pharmaceutical companies have already refused to register their new developments in Russia.