Dr. McGeer is the organizer and a speaker for the AAAS symposium Defeating Alzheimer’s Disease to Avoid the Looming Worldwide Health Crisis, Monday, Feb. 20, 9:45 – 11:15 a.m.
Alzheimer’s disease is one of the most important health problems of our time. There are an estimated 35 million people worldwide suffering from this disorder, and unless solutions are found, their numbers are expected to triple by 2050. The degree of urgency is underlined by the fact that there are at least 20,000 new cases per day.
The solution lies in compensating for the two biochemical problems that characterize Alzheimer’s disease. These are aggregates of beta amyloid protein and tau. They are simple proteins, and simple molecules should be able to modify their tendency to aggregate. The challenge before us now is to identify the right agents, and bring them through trials. Once effective agents reach clinics, Alzheimer’s disease should become as rare as polio is today.
The number of those suffering will triple by 2050
Basic scientists have already identified numerous candidates, but there are hurdles for getting them into clinical practice. Granting agencies provide money to make discoveries but not the necessary money to carry them past the stringent regulations to get them into human use.
Nonetheless, there are promising agents in the wings. They include blockers of the production and aggregation of beta amyloid protein, compounds that clear it from brain, and molecules that block its inflammatory stimulation. Also included are drugs that have long been in use for other applications, and others that are components of herbal medicines. The fact that these latter agents are cheap and off patent is a strong disincentive to pharmaceutical companies who are traditionally expected to finance the clinical trials.
Promising agents are in the wings
Despite this current handicap, there is reason for long-term optimism. Early diagnosis of Alzheimer’s disease is now possible through tell-tale biomarkers. They include beta amyloid protein and phsphorylated tau in the cerebrospinal fluid and brain beta amyloid protein deposits as visualized by positron emission tomography.
Genetic analysis can identify in familial cases those who are destined to develop the disease. Stopping the disease at the earliest possible stage should be the goal of current Alzheimer’s research efforts. Skilled clinicians, with patients urgently needing help, are available on a continuing basis to test promising agents. What governments should consider in this situation is to fund a Manhattan style project of the type used to end World War II. Experts in diverse skills necessary to rush discoveries into practice need to work together in collaboration rather than competition. A series of small clinical trials with the agents now available would be a good way to start. We just need to get on with the job.
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