Monday, February 20, 2012 – 9:45 AM
Patrick L. McGeer, University of British Columbia, Vancouver, BC, Canada
An Overview of Therapeutic Targets for Defeating Alzheimer’s Disease
Alzheimer disease can be defeated. There is an urgency given the estimated incidence of 20,000 new cases per day. The biochemical targets that need to be hit are aggregates of beta amyloid protein and tau. These targets are known to be vulnerable to suitable inhibitory agents although none have yet reached the bedside. Once powerful ones are put into practice Alzheimer disease will become as rare as polio is today. New candidates can be easily screened in vitro and validated in vivo by testing in transgenic mice. Numerous candidates have already met these criteria but have gone no further because of the high cost of clinical trials. They include blockers of production and aggregation of beta amyloid protein, agents that clear it from brain, and agents that block its inflammatory stimulation. Some are drugs that have long been in use for other applications and others are components of herbal medicines. The fact that they are cheap is a strong disincentive to embarking upon high cost clinical trials. Moreover, expensive regulatory testing of new agents is beyond the reach of basic scientists. Success in defeating Alzheimer disease requires intervention with suitable agents before the disease sets in. Many millions of beta amyloid protein deposits are found in the brains of Alzheimer cases upon autopsy, indicating that many thousands accumulate in their brains each day. Every one is a focus of inflammation. The elements necessary to defeat Alzheimer disease are now at hand. Early diagnosis is now possible. Genetic evidence and biomarkers such beta amyloid protein levels in brain, CSF and even saliva can indicate impending disease. Promising agents have been identified. Skilled clinicians with desperate patients are available. These elements need to be combined in a series of clinical trials where changes in biochemical markers are followed. Funding of a collaborative consortium much akin to the Manhattan project which ended world war II is needed. Leaders with the differing skills required to take basic science discoveries to the bedside need to work together for the first time. As with the Manhattan project, Governments must step in to provide the necessary funds.