[Homestead] Alzheimers, the horror-story that is everybody's worst enemy

Tvoivozhd tvoivozd at infionline.net
Tue Sep 21 11:52:58 EDT 2004


/ource/:
	
University Of Bonn <http://www.uni-bonn.de/>
/Date/:
	
2004-09-20

	
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    Therapy For Alzheimer's In Sight?

Immunoglobulins which are already being used to treat multiple sclerosis 
may also be able to help patients with Alzheimer's. This, at least, is 
the finding of a pilot study on five patients at the University of Bonn. 
The results are set out in the forthcoming edition of the Journal of 
Neurology, Neurosurgery and Psychiatry (vol. 75, pp. 1472-1474), which 
also devotes its editorial to this discovery.

	


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Immunoglobulins contain, among other things, anti-bodies against a 
protein which is the 'main suspect' thought to trigger off Alzheimer's. 
After six months of immuno-globulin doses the concentration of this 
protein in the patients' cerebrospinal fluid was reduced by one third. 
The patients' cognitive abilities improved slightly.

However, the medical team involved emphasise that their findings are 
still very tentative. They are now planning a large-scale double-blind 
clinical trial with about sixty patients so as to further confirm the 
positive effect of the immunoglobulins.

The cerebral cortex of Alzheimer's patients regularly contains large 
protein aggregates, what are known as Alzheimer's glands. They 
predominantly consist of beta-amyloid peptide, a small protein. This 
peptide collects in the brain of Alzheimer's patients and forms protein 
deposits which can damage and even destroy the sensitive nerve cells.

A promising approach in combating the disease seems to be the treatment 
with anti-bodies which are specifically effective against beta-amyloid. 
Thus, in animal experiments the injection of beta-amyloid anti-bodies 
led to a reduction in the protein deposits and an improvement in the 
behavioural deficits in these animals. Another study recently showed 
that immunising was not only able to reduce amyloid plaques, it also 
prevented the formation of the abnormal tau protein.

Recently the team led by the Bonn lecturer Dr. Richard Dodel was able to 
show that every person's blood contains anti-bodies against 
beta-amyloid, but that the concentra-tion in Alzheimer's patients is 
markedly lower. Their findings have been confirmed by two US teams. 
'There are already anti-body blood preparations which are used for 
particular diseases of the nervous system such as multiple sclerosis, 
which are known as immunoglobulins,' Dr. Dodel explains. 'We have now 
investigated whether these preparations contain anti-bodies against 
beta-amyloid and if these can be used to fight Alzheimer's.' His team 
did in fact find anti-bodies in one type of immunoglobulin medication 
which are very effective specifically against beta-amyloid. In a pilot 
study carried out on five Alzheimer's patients the team then studied the 
effect of the immunoglobulins on the progress of the disease. This 
involved giving the patients an immunoglobulin injection intravenously 
every four weeks throughout the six-month study. Before beginning and on 
completing the therapy the researchers determined the beta-amyloid 
content in the blood and the CSF fluid – the latter being the liquid 
which is present in the brain and spinal cord. 'On average the 
beta-amyloid concentra-tion in the fluid decreased in the course of the 
study by over 30 per cent, while the concentration in the blood rose 2.3 
times,' Dr. Dodel says. 'The immunoglobulins therefore seem to have the 
effect of flushing out the beta-amyloid from the brain' – how exactly 
this occurs is as yet unclear.

At the same time the team carried out various tests which enabled them 
to check the cerebral performance of dementia patients. After six months 
four of the five patients did slightly better than before in what is 
known as the ADAS-cog test (Alzheimer's Disease Assessment Scale, 
cognitive subscale). In the MMSE (Mini-Mental State Examination) test 
three patients improved. 'What is even more remarkable is that none of 
our test persons deteriorated,' Dr. Dodel explains. 'Without treatment 
Alzheimer's patients on average score seven to eleven points worse in 
the ADAS-cog test one year later, and even patients on medication score 
four to six points worse. In our study they improved on average by 3.7 
points.'

However, the sample was far too small to be able to draw firm 
conclusions about the effectiveness of immunoglobulin therapy, since the 
substance was not tested in comparison with a placebo. 'We only carried 
out a pilot study,' Dr. Dodel emphasises; 'in order to confirm our 
findings we definitely need to carry out a double-blind trial with 
larger patient numbers





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