Alzheimer's disease

Abstract:

A few years before the symptoms of Alzheimer's disease, the brain began to change and neurons began to degrade. Now scientists at the German Centre for neurodegenerative diseases (dzne) have reported finding a protein in the blood that can be used to accurately monitor disease progression long before the first clinical symptoms appear. New blood markers offer a range of possibilities for testing therapies. The study was conducted in collaboration with an international research team and published in the journal Nature Medicine.

"There is still no effective treatment for Alzheimer's, in part because the current treatment started too late," said Mathias juker, senior researcher at dzne In order to develop better treatments, scientists need more reliable methods to monitor and predict disease progression, such as changes in memory, before symptoms appear. Blood tests are better for this than expensive brain scans.

The latest development in this blood test focuses on the detection of so-called amyloid. In Alzheimer's disease, amyloid protein accumulates in the brain and also occurs in the blood. However, juker and his colleagues took a different approach.

"Our blood tests don't look at amyloid, but at its role in the brain, neurogenesis. In other words, let's look at the death of neurons. "

When brain cells die, their residues can be detected in the blood. "Normally, however, these proteins degrade rapidly in the blood and are therefore not suitable as markers of neurodegenerative diseases," explained juker. "The exception, however, is a small piece of so-called neurofilament, which is surprisingly resistant to this degradation." Blood tests are based on this protein. In the current study, scientists have shown that neurofilament accumulates in the blood long before clinical symptoms appear (i.e. already in the so-called preclinical stage), which is very sensitive to reflect the progress of the disease and can predict the future development.

The study is based on data and samples from 405 individuals analyzed by international research collaboration: "the dominant genetic network of Alzheimer's disease" (Dean). In addition to dzne, the research network also includes the hertie Institute of clinical brain research (HIH), Tuebingen University Hospital, Washington University School of medicine in St. Louis and other institutions around the world. The research network investigates families who have developed Alzheimer's disease in middle age due to certain genetic variations. Genetic analysis can very accurately predict whether and when family members will develop dementia.

Alzheimer's disease

Juker and his colleagues monitor the development of neurofilament concentrations in these people every year. They detected a significant change in blood 16 years before calculating the onset of dementia. "It's not absolute neurofilament concentration, it's time evolution, it's meaningful, it can predict the future development of the disease," juker said.

In fact, in further research, scientists have found that the changes in the concentration of neurofilament can accurately reflect the degeneration of neurons and predict the development of brain injury.

"We were able to predict the actual decrease in brain mass and cognitive changes that would occur two years later," says juker.

Although it has been proved that the change rate of neurofilament concentration is closely related to brain degradation, the correlation with toxic amyloid protein deposition is not so obvious. This supports the hypothesis that although amyloid is the cause of disease, neuronal degradation occurs independently.

Neurofilament not only accumulates in the blood in Alzheimer's disease, but also in other neurodegenerative diseases. Therefore, the test is only conditionally applicable to the diagnosis of Alzheimer's disease. "However, the test accurately shows the progress of the disease and is therefore a powerful tool for the study of new Alzheimer's therapies in clinical trials," said juker.

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