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Read more: Alzheimer?s Advance: Gene Could Help to Clear Brain Plaques Responsible for the Disease | TIME.comMapping out how an Alzheimers gene works could lead to new treatments.
So far, nearly two dozen genes scattered across four chromosomes have been linked to an increased risk of Alzheimers disease. But identifying such genetic risk factors doesnt mean that researchers fully understand how they contribute to the cognitive decline and dementia symptoms related to the condition. And that understanding is often crucial to turning genetic information into effective treatments.
The company says that people who received 18 months of infusions with its drug, Gammagard, fared no better than others given infusions of a dummy solution. Gammagard is immune globulin, natural antibodies culled from donated blood. Researchers thought these antibodies might help remove amyloid, the sticky plaque that clogs patients' brains, sapping memory and ability to think.
Patients with moderate disease and those with a gene that raises risk of Alzheimer's who were taking the higher of two doses in the study seemed to benefit, although the study was not big enough to say for sure. "The study missed its primary endpoints, however we remain interested by the prespecified sub-group analyses" in groups that seemed to benefit, Ludwig Hantson, president of Baxter's BioScience business, said in a statement. Gammagard is already sold to treat some blood disorders, and the results of the Alzheimer's study do not affect those uses. About 35 million people worldwide have dementia, and Alzheimer's is the most common type. In the U.S., about 5 million have Alzheimer's. Current medicines such as Aricept and Namenda just temporarily ease symptoms. There is no known cure.
Excitement about Gammagard grew last summer, when researchers reported at a medical conference that the drug had stabilized Alzheimer's disease for as much as three years in four patients who had been receiving the highest dose of it for three years in the study. People typically go from diagnosis to death in about eight years, so to be stable for so long was considered remarkable. The new results on the full group of study participants are disappointing, said the study's leader, Dr. Norman Relkin, head of a memory disorders program at New York-Presbyterian Hospital/Weill Cornell Medical Center. "The bar was set very high" for the drug to show improvement, and "there does appear to be a signal" that it helped the two-thirds of patients in the study who had the apoE4 gene that raises the risk of developing Alzheimer's, as well as those with moderate versus mild disease, Relkin said.
No new side effects were seen in the study. About 5 percent of patients on the drug had a rash and decreases in hemoglobin, which carries oxygen in the blood. There were 17 serious reactions, 12 in the drug group and five in the placebo group. Full results will be presented in July at an Alzheimer's conference in Boston. Meanwhile, other studies are under way to test drugs earlier in the course of the disease. An experimental drug, Eli Lilly & Co.'s solanezumab, showed some promise in that setting in an earlier study. Shares of Baxter fell $2.53, or 3.6 percent, to $67.78 in morning trading.
Baxter drug fails to slow Alzheimer's in big study
Alzheimers disease is a leading cause of dementia worldwide in people ages 65 and older. According to the organization Alzheimer's Disease International, almost 36 million people were living with dementia globally in 2010, and the number is projected to rise to 115 million by 2050. Alzheimers is caused by the toxic accumulation of a protein called amyloid beta. Amyloid beta forms plaques in the brain that are the hallmark of the disease. But the mechanism underlying the collection of the protein is unknown.
Now, researchers have concluded that one of the main environmental triggers of Alzheimers disease appears to be copper, an important metal that is in meat, fruits and vegetables as well as drinking water. Copper plays an important role in nerve conduction, bone growth and hormone secretion. Rashid Deane is a professor of neurosurgery at the University of Rochester Medical Center in New York. According to Deane, copper accumulates in the brains of those with Alzheimers, contributing to the collection of beta amyloid, normally swept away in healthy individuals by a protein called LRP1, which Deane likens to a garbage truck. It looks like in the copper-dosed animals that are aging, the capacity to remove the toxin amyloid from the brain is reduced in these animals because there isnt so many garbage trucks to take it away," said Deane.
Researchers led by Deane fed copper-laced drinking water to mice for three months. Investigators found the copper in the blood stream made its way to the walls of capillaries that protect the brain from toxins, including copper. Over time, Deane says, the copper broke down the so-called blood-brain barrier that prevents harmful substances, such as copper, from entering and harming the brain. Researchers noted the same effect in human brain cells. The mystery is why copper collects in the brains of some individuals, potentially causing Alzheimers disease, and not in others.
Deane says those who develop Alzheimers are at risk because of genetics as well as their body's ability to prevent damage to cells. And then theres the impact of modern life. Humans live in different places sometimes over their lives, they eat things, they try different foods. And some people are very conscious in what they are eating now because they are wise about the composition of the food and they know the nutritional value of the food they are eating. So, that may be one variable component which may tend to explain why it develops," said Deane. Because copper is in everything, other researchers say trace amounts are unlikely to account for the epidemic of Alzheimer's disease. An article on copper's potential role in Alzheimer's disease is published in the journal Proceedings of the National Academy of Sciences.
Copper Implicated as a Possible Cause of Alzheimer?s Disease
When conflicts and natural disasters trigger mental health problems, psychological help is needed, but usually is not available. Humanitarian agencies work hard to help people recover. But WHO found much of the support offered tends to be of short duration. Mark Van Ommeren of WHO's Department of Mental Health and Substance Abuse noted that many people affected by catastrophic events have long-term problems and are in need of long-term help.
He said emergencies present an enormous opportunity to build back better health systems, especially mental health systems, which, according to WHO, are virtually nonexistant in low-and-middle income countries. Those systems would be for all people in need - people with new mental health problems and people with pre-existing mental health problems," Van Ommeren explained. "That is important because in many areas of the world, as you know, there are no mental health services. So, this is an opening. This is also very important because societies that go through major emergencies need to recover and mental health is essential for recovery of these events for the functioning of society, for the resilience of society.
Resident of Half Way Home, a government-run home for the mentally ill located inside a mental health hospital premise, sits on her bed in Mulleriyawa, on the outskirts of Colombo, Sri Lanka
WHO's 110-page report provides guidance for strengthening mental health systems after emergencies. It focuses on 10 cases, where countries have taken advantage of this opportunity. One nation the report cites is Sri Lanka. In the aftermath of the catastrophic 2004 Tsunami, it said the government created a new national mental health policy, which extends to most parts of the country.
Another example is that of Iraq. Dr. Van Ommeren said it is particularly appropriate to focus on Iraq since the WHO report is being issued on World Humanitarian Day, marking the 10th anniversary of the bombing of United Nations headquarters in Baghdad, which killed at least 22 people including UN Special Representative in Iraq, Sergio Vieira de Mello. Iraq since 2004, has made substantial progress towards the creation of a mental health system-meaning that, making sure that people have access to mental health care," he said. "So, now over all these years about half of all the general practitioners--you can imagine it is a big country, there are a lot of general practitioners--about half of them have been trained in mental health. That brings mental health care closer to the people. Before that, most mental health care was only available in big cities, in asylums. The situation was much more negative. Now, it is more positive.
More New WHO Report Focuses on Mental Health
Scientists at Rowan University in the eastern state of New Jersey say their blood test can detect mild cognitive impairment, which is generally seen in patients 10 or more years before they develop severe symptoms of Alzheimer's Disease, an affliction that is almost always fatal.
Not everyone with mild cognitive impairment develops Alzheimer's, and the condition known as MCI can be caused by a wide variety of causes, including multiple sclerosis, Parkinson's Disease, vascular problems, depression and traumatic brain injury. The Rowan researchers, writing in a journal of the Alzheimer's Association, say their blood test can distinguish between the various forms of cognitive impairment and identify with nearly 100 percent accuracy those that will most likely progress to advanced Alzheimer'.
One hemisphere of a healthy brain (L) is pictured next to one hemisphere of a brain of a person suffering from Alzheimer disease.
The small-scale study conducted at Rowan, in Glassboro, New Jersey, tested the blood of 236 subjects, 50 of whom had MCI. “Our results show that it is possible to use a small number of blood-borne autoantibodies to accurately diagnose early-stage Alzheimer’s,” said Cassandra DeMarshall, the study's lead author and a doctoral candidate at the public university. “These findings could eventually lead to the development of a simple, inexpensive and relatively noninvasive way to diagnose this devastating disease in its earliest stages.”
The original proof-of-concept study would need to be repeated on a larger scale, experts said, but if the original findings are confirmed, patients suffering from mild cognitive impairment could seek appropriate early treatment, including lifestyle changes. This could also ease the significant financial and psychological cost for family members responsible for caring for elderly Alzheimer's patients. DeMarshall said about 60 percent of the patients her team studied had MCI caused by an early stage of Alzheimer's Disease, so "to provide proper care, physicians need to know which cases of MCI are due to early Alzheimer’s and which are not.”
Dr. Robert Nagele, the research team leader, said the results now being reported were particularly important because pre-Alzheimer's changes in the brain begin "at least a decade before the emergence of telltale symptoms.” “To the best of our knowledge," Naegele said, "this is the first blood test using autoantibody biomarkers that can accurately detect Alzheimer’s at an early point in the course of the disease when treatments are more likely to be beneficial – that is, before too much brain devastation has occurred” Nagele is director of the Biomarker Discovery Center at Rowan’s New Jersey Institute for Successful Aging, and the co-founder and chief scientific officer of Durin Technologies Inc. His team's research is to be published in a forthcoming issue of Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring.
New Blood Test Could Detect Early Stages of Alzheimer?s
The more fit a person is in middle age, the less likely he or she will have a crippling stroke after age 65. That is the result of a new study by the University of Texas Southwestern Medical Center.
A stroke patient undergoes an electrocardiogram while recovering at Juntendo University Hospital in Tokyo.
Doctors studied 20,000 men and women between the ages of 45 and 50, and concluded that those who were most fit from moderate to vigorous exercise had a 37 percent lower risk of a stroke than those who were the least fit.
They say the reduced risk of a future stroke was present even when the subjects had other risk factors, including high blood pressure and type-2 diabetes. The study urges doctors not to ignore low levels of exercise and fitness as risk factors for a stroke. The study was published in the latest issue of the medical journal called Stroke.
Study: Fitness in Middle Age Cuts Risk of Stroke After 65
