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Tuesday, 15 May 2012

Prevention treatments for a genetically predestined disease: Alzheimer’s

Prevention is Better than Cure

Prevention well before a disease becomes evident is obviously the most prefered approach especially in health matters because "Health is Prosperity". Now researchers, institutions and industries are making exactly one such attempt. The trial will be financed with $16 million from the National Institutes of Health, $15 million from private donors through the Banner Institute and about $65 million from Genentech, the drug’s American manufacturer.

These studies are conducted on people who are genetically guaranteed to develop the disease — but who do not yet have any symptoms.

Experts say the study will be one of the few ever conducted to test prevention treatments on people who are cognitively normal but at very high risk for Alzheimer’s disease,” said Dr. Francis S. Collins, director of the National Institutes of Health.

Many Alzheimer’s researchers believe amyloid is an underlying cause of Alzheimer’s. For very long time researchers believed that Alzheimer's is the result of over production of amyloid plaques in the the brain. Recently reseachers have demonstrated that Alzheimer's is certainly because of accumulation of amylod plaques and moreover such an accumulation is due to imperfect assimilation of the plaques but not because of the over production of it.

Alzheimer’s has repeatedly resisted attempts to treat it. Current drugs, for people who are already impaired, show little benefit. Now scientists want to attack earlier. New findings show “the brain is badly damaged by the time they have dementia,” said Dr. John C. Morris, an Alzheimer’s researcher at Washington University in St. Louis. “Perhaps the reason our therapies have been ineffective or mostly ineffective is that we’re administering them too late.”       

Understably, preventive research is difficult. Participants should be people guaranteed, or highly likely, to develop the disease and identifying such people is challenging because the disease’s cause is unknown. Also, because people would not be sick when treated, potential negative side effects of drugs are especially worrisome. The researchers believe that Colombia appears to be the best option because they are young, without many old-age ailments, with the extended family’s single location, large size and similar lifestyles provide enough comparable participants for solid scientific data. “We’re going to be treating people who are completely healthy,” Dr. Kosik said. “The nightmare scenario is obviously that there’s a serious side effect.”       

The drug, Crenezumab, that is used in the current study attacks amyloid plaques in the brain. If it can forestall memory or cognitive problems, scientists will know that prevention or delay is possible and appears to lie in targeting amyloid years before dementia develops.

Crenezumab is currently being given in two clinical trials to people with mild to moderate symptoms of dementia in the United States, Canada and Western Europe to see if it can help reduce cognitive decline or amyloid accumulation, according to Genentech.

In the current study three hundred family members from Colombia will participate in the initial trial. Those with the mutation will be years away from symptoms, some as young as 30. This study is expected to start early next year and 100 family members with the mutation will receive the drug every two weeks in an injection at a hospital. Another 100 carriers will receive a placebo. And because many people do not want to know if they have the mutation, researchers will include 100 noncarriers in the study and they will receive a placebo.

The cardinal features of the disease are “irritability, sadness, crying, anxiety, impulsivity and emotions. Dr. Tariot said researchers would assess these changes. The scientists will take physiological measurements and if any improvement with this drug, Dr. Reiman said, scientists may then be able to treat one of these early physiological changes, just as high blood pressure and cholesterol are treated to prevent heart disease.      

One of the members, Gladys Betancur, - whose mother died of Alzheimer’s, three of her siblings already have symptoms, and she had a hysterectomy because of her fears that she has the mutation and would pass it on to her children, - beautifully said “Because of this study, we do not feel as alone,” and “sometimes we think that life is ending, but now we feel that people are trying to help us.
The $100 million study will last five years, but sophisticated tests may indicate in two years whether the drug helps delay memory decline or brain changes, said Dr. Eric M. Reiman, executive director of the Banner Alzheimer’s Institute in Phoenix and a study leader.

 Lets hope that the current study prevents memory loss or brain atrophy and help the needy to lead a normal life.


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