Summary: A novel blood test for Alzheimer’s disease has 90 percent accuracy, even if a person is at the earliest stages of Alzheimer’s disease, say a team of researchers from Australia and Japan, who add the blood test can detect early stages of dementia, three decades before the onset of symptoms. [This article first appeared on LongevityFacts. Author: Brady Hartman. ]
A novel non-invasive blood test could speed up and reduce the costs of developing new Alzheimer’s treatments. Moreover, this blood test has the potential to detect dementia decades in advance, prompting early intervention to head-off the disease before it takes hold.
The novel blood test measures a specific peptide to detect, with 90 percent accuracy, if a person is at the earliest stages of Alzheimer’s disease. To assess the accuracy of the approach, researchers analyzed blood to identify the relevant peptides taking samples from patients in an extensive study conducted by the Japanese National Center for Geriatrics and Gerontology (NCGG). Those samples indicating brain amyloid-beta burden were then tested against patient samples from the Australian Imaging, Biomarker and Lifestyle Study of Aging to validate the results. An international team of researchers participated in the study, including Katsuhiko Yanagisawa, Koichi Tanaka, and Colin Masters, who co-authored the study published in the journal Nature.
Professor Katsuhiko Yanagisawa, Director-general of the NCGG ‘s Research Institute says:
“Our study demonstrates the high accuracy, reliability and reproducibility of this blood test, as it was successfully validated in two independent large datasets from Japan and Australia.”
Dr. Koichi Tanaka of the Shimadzu Corporation was instrumental in developing the initial blood test. Tanaka won the 2002 Nobel prize in Chemistry for the technique. Dr. Tanaka says
“From a tiny blood sample, our method can measure several amyloid-related proteins, even though their concentration is extremely low. We found that the ratio of these proteins was an accurate surrogate for brain amyloid burden.”
Hallmarks Of Alzheimer’s Disease
The buildup of amyloid beta in the brain is one of the hallmarks of Alzheimer’s disease. The process starts silently about three decades before outward signs of dementia have begun, such as cognitive decline or memory loss. However, researchers have not reached a consensus on whether amyloid beta plaques are the cause of Alzheimer’s or a merely a symptom of the underlying condition. The amyloid plaques are possibly benign because similar deposits are found in older adults without symptoms of Alzheimer’s disease. Rather than targeting amyloid deposits, some researchers have shifted focus to other avenues of attack, such as tau tangles and brain inflammation.
Analysts estimate that 20 to 40 percent of people over 70 years old have amyloid beta build-up in their brain and are considered to be at risk of developing Alzheimer’s in the future. The total worldwide costs of dementia were estimated at $818 billion in 2015
Current tests for amyloid beta include brain scans with costly radioactive tracers, or analyzing spinal fluid taken via a lumbar puncture. These tests are invasive and expensive and usually only available in a research setting. Instead of using these tools, doctors typically make a diagnosis by assessing a patient’s symptoms. Unfortunately, the diagnosis is usually given after the disease is well on its way.
Since the 1980s, Laureate Professor Colin Masters has been at the forefront of Alzheimer’s research. Professor Masters works at the Florey Institute of Neuroscience and Mental Health, and the University of Melbourne. Professor Masters who co-led the study says,
“This new test has the potential to eventually disrupt the expensive and invasive scanning and spinal fluid technologies. In the first instance, however, it will be an invaluable tool in increasing the speed of screening potential patients for new drug trials.”
As medical advances enable us to live longer, the rates of dementia will continue to climb. The World Health Organization (WHO) estimates that 47 million people on the planet are currently living with dementia and projects that number to increase to 75 million by 2030. Moreover, the WHO projects that the number of dementia cases will nearly triple by 2050.
Progress in developing new treatments for Alzheimer’s disease has been disappointingly slow. None of the new drugs currently on the market treat the underlying disease. New medications are urgently required, and the only way to do that is to speed up the drug development process. An inexpensive blood test would be a boon to clinical trials for Alzheimer’s treatments.
Early Detection and Treatment of Alzheimer’s
The failures with Alzheimer’s treatments are leading researchers to the realization that an effective treatment may have to begin long before symptoms appear. Often, the earlier a condition is diagnosed, the more likely it is that it can be successfully managed or even cured. When doctors treat a disease early, they are usually able to prevent or delay problems from the condition. For example, type 2 diabetics can avoid the bulk of the deadly effects of the disease by properly managing their condition. Similar examples of the benefits of nipping a disease in the bud exist for cancer and heart conditions.
Perhaps early detection and treatment will be the ultimate solution to the Alzheimer’s problem. Such treatments could prevent the build-up of amyloid plaques and neurofibrillary tangles before the disease takes hold.
Some Alzheimer’s treatment developers are betting on early detection and treatment. In March of 2017, Bloomberg magazine interviewed Phyllis Ferrell, a who heads up Eli Lilly’s Alzheimer’s program. Ms. Ferrell explained the reasoning behind the shift in focus to early detection of the disease, saying
“It’s like cancer,” … “You want to catch it at stage one, not at stage four.”
In the early detection strategy, brain researchers employ imaging technology to detect Alzheimer’s disease before it has a chance to do damage. Researchers use this technique to identify early physical symptoms, like plaque buildup, that may differentiate healthy aging from early-onset Alzheimer’s. Scientists monitor beta-amyloid deposits in the brain via an imaging technique called amyloid positron emission tomography (amyloid PET), also known as ‘amyloid imaging.’
Researchers reported several drugs that prevent Alzheimer’s in mice, including rapamycin, metformin, resveratrol and NAD boosters. What works well in mice, often doesn’t work well in humans. Big Pharma won’t touch these potential treatments because they are off patent. Instead, the pharmaceutical is testing new molecules that treat or prevent Alzheimer’s disease. New medicines are patentable and profitable, especially the medications a patient has to take for the rest of his life.
To that end, pharmaceutical companies have developed many new compounds and are testing them on patients in the early stages of Alzheimer’s, sometimes including people who merely have brain scans showing beta-amyloid plaques and aren’t showing signs of forgetfulness at all.
For example, the current prevention trial called “Anti-Amyloid Treatment of Asymptomatic Alzheimer’s” (A4) is testing a series of compounds that reduce the accumulation of beta-amyloid.
Gilmore O’Neil, an executive in clinical development at Biogen, also supports the early detection hypothesis. Bloomberg also interviewed Mr. O’Neil, who said:
“many industry studies so far have looked at patients who were already so sick that they’d probably be beyond saving.”
The idea of preventative treatment is nothing new. For example, patients with diabetes or high blood pressure are often treated with a combination of two or three drugs to head off complications down the road. The authors of the Mount Sinai New York opinion piece say that one day, doctors will keep Alzheimer’s disease at bay in the same way they ward off heart disease – with a cocktail of drugs.
Preventing Alzheimer’s at its earliest stages looks to be a better approach than curing the disease after is well on its way. Combining early detection with early intervention is a well-worn strategy used in managing other conditions.
In the case of Alzheimer’s disease, using amyloid positron emission tomography to screen every middle-aged adult is expensive and impractical. The low-cost blood test being developed by doctors Yanagisawa, Tanaka, and Masters could enable wholesale screening and early detection of Alzheimer’s.
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Cover photo credit: Getty Images.
Akinori Nakamura et al. “High performance plasma amyloid-β biomarkers for Alzheimer’s disease.” Nature (2018). DOI: 10.1038/nature25456
“Can These Novel Treatments Cure Alzheimer’s Disease?” Web. 02 Feb. 2018.
“Researchers Report These Drugs Could Prevent Alzheimer’s Disease.” Web. 02 Feb. 2018
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