Stem Cells Not the Priority for Alzheimer's
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Friday, June 11, 2004
NEW YORK Despite the high profile that Nancy Reagan and
others have given the idea of using embryonic stem cells to treat
Alzheimer's disease, advances are likely to come faster from other
approaches.
Experts cite other more promising efforts that in five to 10
years may be used to fight the disease that led to President
Reagan's death.
"I just think everybody feels there are higher priorities for
seeking effective treatments for Alzheimer's disease and for
identifying preventive strategies," said Marilyn Albert, a Johns
Hopkins University researcher who chairs the Medical and Scientific
Advisory Council of the Alzheimer's Association.
Stem cells from human embryos can form all types of cells, and
the hope is that they one day could be used to replace cells
damaged from such conditions as diabetes, spinal cord injury or
Parkinson's disease. But experts say Alzheimer's, by the very
nature of how it attacks the brain, would pose a far more daunting
challenge to that approach.
"There's an awful lot going on right now that perhaps holds a
little bit more immediate promise for trying to slow the disease,
or even cut off its development," said Marcelle Morrison-Bogorad,
associate director of the National Institute on Aging's
neuroscience and neuropsychology-of-aging program.
She and Albert cited, for example, efforts to attack the buildup
of clumps of protein called amyloid in the brain, and methods for
spotting the disease early. That research will probably pay off in
five or 10 years, earlier than any expected advances from stem
cells, Albert said, because so much has to be learned about how to
make stem cells useful against the disease.
"All the more reason we should start [stem cell efforts] now,
because it's going to take a long time," she said.
About 4.5 million Americans have Alzheimer's, a progressive
brain disorder that gradually destroys memory and ability to learn,
reason, communicate and do everyday activities. Patients die on
average eight years after symptoms appear, although the disease can
linger for 20 years.
"What you're dealing with here is a mind in disarray,"
Morrison-Bogorad said. Connections between brain cells are being
lost, neurons are dying and becoming dysfunctional, the amyloid
plaques are building up between brain cells and protein tangles are
showing up within cells. And there's inflammation.
"It's just a mess in there," she said. "But the mess means
there are so many targets for intervention."
The amyloid plaques have emerged as a favorite target, and
scientists and drug companies around the world are studying ways to
prevent or destroy them.
One high-profile approach is a vaccine that primes the body to
attack amyloid. Studies on animals were encouraging, but in 2002 a
study on people was halted when several vaccine recipients
developed brain inflammation. Last year, researchers reported that
the vaccine did appear to reduce the accumulation of plaques in one
study participant.
Work is continuing now on a safer vaccine, because the available
evidence suggests "this is an important avenue to pursue," Albert
said.
Another popular approach seeks to keep the brain from making the
abnormal form of amyloid that creates the plaques. It's a high
priority at "every major drug company," Albert said.
The overall focus on amyloid makes her optimistic.
"Everybody's working on it," she said. "What we've learned
from the past is that if everybody works really hard at something
that is sensible, they're likely to make a lot of progress. So
there's just enormous optimism that in five years, or certainly 10
years, we'll have much more effective treatments."
Another key research area is finding a way to predict who will
get Alzheimer's before symptoms appear. Because the disease
develops over many years, much damage has been done by the time
it's diagnosed. So scientists want to identify people at an earlier
stage for the day when more effective treatments become available.
In the same vein, scientists want to find ways to track the
progress of the disease in people being treated, so they can
quickly tell if the treatment is helping.
So researchers are doing long-term studies to see if different
kinds of brain scans, mental tests and spinal or blood tests can
predict development or progression of the disease.
Lifestyle factors too, such as taking anti-inflammatory drugs
and vitamins like E and C, are being studied to see if they can
help prevent Alzheimer's or delay it.
Researchers are also exploring the use of cholesterol-lowering
drugs. A relatively recent idea, Albert said, is that things like
keeping cholesterol and blood pressure low and staying physically
active may help. Those steps are well-known for countering heart
disease, she noted.
But it's becoming clearer, she said, that "if you do things
that are good for your heart, they'll be good for your brain."
© 2004 Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.
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