Alzheimer’s disease: medical developments and political controversies

Alzheimer’s disease: medical developments and political controversies

Alzheimer’s disease: medical developments and political controversies

 

First, a word about Alzheimer’s disease (AD). It’s an awful disease. It causes about two thirds of all cases of dementia; A slowly worsening decline in the ability to think clearly and remember things. According to the Alzheimer’s Association, more than 6 million Americans are currently afflicted with Alzheimer’s disease and they’ve projected that number to double over the next thirty years.

 

Alzheimer’s disease causes the brain to atrophy (waste away). On a microscopic level, toxic tau proteins cause amyloid plaques and neurofibrillary tangles to accumulate in and around the cells (neurons) of certain parts of the brain .

 

New research on causation of Alzheimer’s:

 

No one is sure exactly what causes AD. But, in 2019, Pennsylvanian scientists reported on the association between the very common virus that causes cold sores (Herpes Simplex Virus 1 (HSV-1)) and Alzheimer’s Disease. It turns out that even after the external manifestations of herpes virus disappear, the virus remains in the cells of our central nervous system, specifically in regions of the brain that are impacted by AD in elderly individuals. Although HSV-1 typically remains dormant, it can be reactivated during periods of immunosuppression or stress (physiological and psychological). HSV-1, in some cases, triggers the brain accumulation of amyloid beta deposits and hyperphosphorylated tau (two proteins commonly found in the neurons (brain cells) of AD patients) and may be a contributing factor to AD.

 

California researchers, in 2021, discovered that the Tau protein, which may be responsible for Alzheimer’s disease is more complex than previously understood. Alzheimer’s is associated with neuron (brain cell) damage, which may be caused by an intracellular buildup of plaques and tangles. It turns out that there are multiple versions of the Tau protein and some of them may be more toxic to the brain than others.

 

New methods for earlier AD diagnosis:

 

You can’t cure something until you know it’s there. Currently, there’s no cure for AD. But earlier diagnosis may lead to new understanding of what may be done to treat AD or prevent it from progressing. 

 

They say that the eyes are the window to your soul. In 2020, Californian researchers reported that your eyes, specifically the retina (the back of your eye), may reveal whether you are at risk for developing Alzheimer’s disease. The scientists searched for telltale signs using retinal amyloid imaging. 

 

Texan researchers have developed an MRI that is so powerful that it can display what is going on inside of cells (as if it were a microscope). The scientists using the new MRI can detect sub-cellular changes in the brains of people with early Alzheimer’s disease. The doctors report malfunctioning mitochondria (a part of the cell that generates energy) in the neurons (brain cells) of Alzheimer’s patients.

 

New developments in treatment and prevention of AD:

 

–Can intermittent fasting decrease your risk of Alzheimer’s disease?

Californian researchers, in 2021, reported that the body has a self defense mechanism against Tau proteins (which may build up in the neurons of people affected by AD). Through a process called autophagy, defective proteins within cells may be cleansed from neurons and their components (amino acids) recycled. In certain Alzheimer’s patients the power of autophagy wanes. It turns out that intermittent fasting may super-charge autophagy (eating up the bad Tau proteins) because it makes the remainder of the body crave the amino acids locked up inside the Tau proteins. If you’d like to learn more about the potential brain benefits of intermittent fasting please read https://marcarginteanumd.com/intermittent-fasting-may-be-good-for-your-brain/

 

–Can better nutrition decrease your risk of developing AD?

The answer is an unequivocal, “Yes.” 

Here’s just a taste of the evidence:

 

In 2017, Italian scientists reviewed ample evidence and reported that dietary factors, such as consumption of omega 3 fatty acids and avoiding fried foods with saturated fatty acids reduces the risk of developing AD.

 

Flavonoids are found in certain plant based foods and drinks. They may benefit the central nervous system by three mechanisms: reducing free radicals (which can oxidize and damage cells), decreasing neuronal (brain cell) inflammation and increasing blood flow. Several large studies, the most recent of which was published in 2020 and evaluated by Harvard scientists, demonstrated a clear association between increased flavonoid intake, improved thinking and decreased likelihood of Alzheimer’s disease and other dementia. If you’d like to learn more about the benefits of proper nutrition on the brain please read https://marcarginteanumd.com/brainy-smoothie/

 

Substantial evidence has accumulated that long term environmental exposure to aluminum may be associated with Alzheimer’s disease. 

 

A 2019 report by Canadian and American researchers determined that long term aluminum exposure may be associated with Alzheimer’s disease. The scientists had analyzed the aluminum content of more than 500 brain samples that had been submitted to their laboratory.

 

In 2021, British and American scientists reported their findings after they studied brain tissue from normal people and compared them to the brains of people affected with neurodegenerative and neurodevelopmental diseases. The researchers determined that there may be a significantly elevated content of aluminum in certain brains. This association (patients with these maladies have more aluminum in their brains than normal) has been reported in patients with Alzheimer’s disease. 

 

Spanish scientists in 2021 reported that drinking beer, in moderation, may help prevent neurodegenerative disease like Alzheimer’s disease. The researchers hypothesized that the hops and silicon in beer may protect your brain against toxic effects of aluminum. If you’d like to learn more about the toxic effects of aluminum on the central nervous system please read https://brain2mind.substack.com/p/how-you-cook-it-matters-too

 

Can exercise decrease your risk of Alzheimer’s disease?

Let’s start by agreeing that brain shrinkage is the worst kind of shrinkage there is. 

A half hour a day of aerobic activity may reverse brain atrophy. 

What are you waiting for? 

Get off the couch.

 

Multiple rigorous studies have confirmed that exercise, especially aerobic exercise, decreases the risk of developing AD. One study, published by Washingtonian scientists in 2010, specifically studied a group of people at high risk for cognitive decline. The researchers reported that 45 minutes of exercise for four days each week effectively staved off dementia. Californian researchers, in 2021, suggested that exercise may ward off AD by boosting autophagy (the process discussed previously, whereby the body cleans up and recycles defective Tau proteins from within the neurons)

 

Scientists have reported that regular exercise increases your brain’s production of BDNF (Brain Derived Neurotrophic Factor). BDNF is a protein that is produced by the brain. It is a member of a family of proteins that is beneficial to the central and peripheral nervous system. By supporting the growth and maturation of new nerve cells, BDNF is thought to promote brain health, and higher levels of it correlate with improved cognitive performance. If you’d like to learn more about BDNF please read https://marcarginteanumd.com/bdnf/

 

Swimming may be particularly beneficial to the brain. In an animal study published in 2020, an international team of researchers reported that swimming improved mood and memory function. The scientists believed that swimming supported brain cells (neurons) growth, health and communication (increasing neurotransmitter molecule serotonin).

 

Healthy heart, healthy brain: 

In 2021, Swedish scientists reported that having a heart that beats too fast (resting pulse rate greater than 80 beats per minute) may increase your risk for Alzheimer’s disease and other dementias. The researchers studied more than 2000 people over more than a decade and discovered that people with an elevated pulse rate were much more likely to develop dementia and rapid cognitive decline than were those with a lower resting heart rate (60 to 69 bpm). The researchers also confirmed the previously known science that people who suffer from cardiovascular disease (such as heart failure or atrial fibrillation) are independently at a greater risk of developing dementia.

 

–Can improving your sleep habits decrease your risk of developing AD?

In 2020, French scientists reported that sleep apnea may cause brain damage. The researchers studied the sleep patterns and brain characteristics of more than one hundred people. They reported an association between breathing disorders during sleep and the accumulation of toxic proteins (amyloid) in the brain and brain inflammation. The locations of amyloid deposition were similar to those seen in Alzheimer’s  disease. 

 

Another group of Icelandic and Australian scientists reported that sleep apnea may be linked to Alzheimer’s disease. In 2020, the researchers reported that a toxic protein (amyloid beta), which is associated with dementia, caused plaques and tangles in the brains of people who suffered from sleep apnea in the years that precede AD. Volunteers with sleep apnea donated their brains to science after death. Microscopic evaluation of the brain tissue revealed atrophy (wasting away) of the hippocampus (a part of the brain that is associated with memory and emotion) associated with the plaques and tangles. If you’d like to learn more about the benefits of sleep for the brain, please read https://brain2mind.substack.com/p/music-and-your-brain

 

–Can music help fight AD?

A 2021 Canadian study determined that listening to familiar music may improve cognitive function in early Alzheimer’s disease. The scientists evaluated 14 patients with early cognitive decline. The patients listened to music that was well known to them. Neurological testing revealed a resultant improvement in memory. The researchers reported that the neurologic improvements may be due to activity in the nodes of a music-related network: connections between bilateral basal ganglia (a part of the brain responsible for motor control and motor learning), right inferior frontal gyrus (a part of the brain responsible for attention, motor inhibition and imagery, social cognitive processes) and temporal lobes (a part of the brain responsible for auditory and memory processes) If you’d like to learn more about the beneficial effects of music on the brain please read https://brain2mind.substack.com/p/music-and-your-brain

 

New drugs and controversies:

 

There are quite a few promising new drugs coming down the pike to help in the fight against AD:

 

In 2021 scientists at Eli Lilly were testing a Donanemab on human volunteers with Alzheimer’s Disease. The researchers designed the drug to specifically target toxic proteins (amyloid) that accumulate in the brain and cause dementia. They hope that clearance of amyloid plaques will lead to improvement in dementia.

 

In 2021 researchers in Boston began human trials with a nasal spray aimed at fighting AD. The scientists have recruited more than a dozen people with early signs of cognitive decline and plan to spray several doses of an experimental medicine into their noses. The doctors hope that the medicine, Protollin, (by stimulating the patients’ immune system and activating their white blood cells (immune calls)) can safely and effectively fight AD.

 

Unfortunately, there have been some political shenanigans and other controversies, which surround some of the recent advances in the fight against AD:

 

Why would anyone be angry about the Food and Drug Administration (FDA) approving a drug to treat Alzheimer’s disease? Especially when it was the first new drug approved in the last 20 years? A pharmaceutical company called Biogen developed a drug called aducanumab (Aduhelm) to fight the disease. They were granted FDA clearance in June 2021; a stamp of approval that indicates that the drug is both safe for patients and effective in fighting AD. 

 

Sounds like a reason to celebrate. A new weapon for doctors to use in the battle against a terrible scourge. But, as of Mid June of 2021, three members of a prestigious FDA panel had resigned in protest. One of those members, Dr. Aaron Kesselheim, a professor of medicine at Harvard Medical School, said the agency’s decision on Biogen “was probably the worst drug approval decision in recent U.S. history.”

 

What gives?

 

Maybe it’s just the latest example of the politicization of medicine and science: On several occasions in 2021, Joe Biden claimed, “You know, if we don’t do something about Alzheimer’s in America, every single, solitary hospital bed that exists in America … every single one will be occupied in the next 15 years with an Alzheimer’s patient.” (Multiple fact checkers have debunked these outlandish claims.)

 

But maybe the damage was done and the political pressure on the FDA panel caused them to toss the scientific evidence into the political winds. The share price of Biogen surged after the drug approval, but the faith in government agencies and scientific experts plummeted in the wake of this latest controversy. Not surprisingly, the FDA has not responded to a request for comment.

 

And, guess what happened a short time later? According to Zero Hedge reports, there may have been funny business between the FDA and the makers of Aduhelm. “Acting Commissioner Janet Woodcock asked the independent Office of the Inspector General to investigate how staff from the agency interacted with Biogen in the run-up to the June 7 approval of Aduhelm. The complaint cited reporting that the agency worked uncomfortably closely with Biogen executives to get the drug to market. Most suspiciously, this included an off-the-books meeting and an unprecedented decision to approve Aduhelm through a regulatory shortcut.”

 

And Biogen’s Aduhelm woes go even further than potential regulatory mischief. As of November, 2021, the FDA was investigating a death that occured in a person who had been prescribed Aduhelm. The 75 year old woman reportedly died from complications related to brain swelling, which is a known side effect of the drug.

And lest you think that the only embattled actor in the Alzheimer’s world is Biogen, Cassava is not without suspected peccadilloes. In 2021 the Wall Street Journal reported that the Securities and Exchange Commission (SEC), the body that governs behavior of publicly traded companies, opened an investigation into Cassava. There have been allegations that Cassava manipulated research results of its experimental Alzheimer’s drug. “Cassava’s experimental drug, called Simufilam, aims to restore a protein, filamin A, that its scientists say is misshaped in the brains and blood of Alzheimer’s patients. In its contorted state, according to Cassava, the protein triggers a toxic process that leads to the buildup in the brain of another protein called amyloid, which is a hallmark of Alzheimer’s disease.”

 

https://www.google.com/amp/s/www.dailymail.co.uk/health/article-10234615/amp/FDA-investigating-death-woman-suffered-brain-swelling-participating-Aduhelm-trial.html

 

https://youtu.be/Z19ZkJPQlQo

 

https://www.wsj.com/articles/cassava-sciences-alzheimers-sec-investigation-11637154199?st=3u3o05cgrbn513t&reflink=share_mobilewebshare

 

https://thehill.com/changing-america/well-being/medical-advances/583830-scientists-say-they-might-have-discovered-the

 

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https://www.zerohedge.com/markets/biogen-slides-fda-calls-investigation-approval-controversial-alzheimers-drug

 

Printed december 2021