Dementia Vaccines ACS Facility Services - in Hornell NY, 14843

Dementia Vaccines ACS Facility Services - in Hornell NY, 14843

A simple blood test, may in the future, help diagnose Alzheimer’s early. Image credit: Oleksii Syrotkin/Stocksy.

  • Alzheimer’s disease is the most common form of dementia, and the number of people with the condition is increasing rapidly.

  • Treatment is most effective if started in the early stages, so research is focusing on early diagnosis.

  • Scientists can detect biomarkers for Alzheimer’s disease in cerebrospinal fluid (CSF), but CSF sampling involves a lumbar puncture that can be distressing and take several days to recover from.

  • Now, a study has detected Alzheimer’s disease biomarkers in the blood, potentially leading to easier, earlier tests for Alzheimer’s disease.

Dementia currently affects around 60 million

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 people worldwide, and the number is projected to rise to more than 150 million by 2050. Alzheimer’s disease, the most common form of dementia, causes 60-80% of cases.

Available treatments work to relieve the symptoms, which may include:

  • memory loss: problems taking in and remembering information

  • cognitive deficits: difficulty with reasoning, complex tasks, and judgment

  • problems recognising people or things

  • problems with spatial awareness

  • difficulty speaking, reading, or writing

  • personality or behavior changes.

Important to diagnose Alzheimer’s early

Alzheimer’s disease is characterized by amyloid plaques and tau tangles

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 in the brain, which researchers believe cause symptoms by interfering with the function of nerve cells.

Newer disease-modifying treatments, the monoclonal antibodies lecanemab, donanemab and aducanumab

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, demonstrably clear plaque build-up, and may help slow down cognitive decline

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.

These treatments are most effective

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 if undertaken early in the course of the disease. Scientists searching for ways to diagnose Alzheimer’s disease early have found biomarkers

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 in cerebrospinal fluid

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 (CSF) that indicate the disease.

However, to sample CSF a clinician must perform a lumbar puncture

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, an invasive procedure that involves inserting a needle into the spine.

New research from The Global Alzheimer’s Platform Foundation has suggested that these biomarkers can also be detected in blood samples.

The research, which appears in Alzheimer’s & Dementia

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, the journal of the Alzheimer’s Association, suggests this may lead to simpler, earlier tests for Alzheimer’s disease.

Dr. Heather M. Snyder, Ph.D., vice president of Medical and Scientific Relations at the Alzheimer’s Association, which published the study, explained to Medical News Today:

“Blood tests are simpler, less invasive, less expensive and more accessible than imaging scans and spinal taps, which makes their use in research — and eventually in the doctor’s office — very attractive. And they have the potential to be very valuable tools for engaging more diverse populations in Alzheimer’s research.”

“That said,” she continued, “the current Alzheimer’s blood biomarker tests are not yet FDA [Food and Drug Administration] approved. Without that rigorous review, the marketing claims and news coverage are generating confusion.”

How researchers can detect Alzheimer’s in fluid samples

CSF is the fluid that surrounds the brain and spinal cord, so it contains proteins that serve as biomarkers

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 for changes in the brain.

Research

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 shows that biomarkers linked to beta-amyloid and tau are present in the CSF of people with mild cognitive impairment and early Alzheimer’s disease, as well as in those with the later-stage disease.

People who go on to develop Alzheimer’s disease may have decreased levels of beta-amyloid-42 in their CSF long before they show symptoms. This is linked to the build-up of amyloid plaques

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 in the brain — as amyloid is deposited in the brain, the level of soluble beta-amyloid-42 in the CSF decreases.

Conversely, increased levels of tau protein

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 in CSF are associated with Alzheimer’s disease development. Research suggests that tau levels increase not only during neurodegeneration later in Alzheimer’s disease progression, but may happen before symptoms of the disease are noticed.

Researchers devise a blood biomarker test

Participants in the recent study were aged between 60 and 85 years. The majority were non-Hispanic white, but there were smaller groups of Hispanic, non-Hispanic Black and other ethnicities.

The researchers divided them into three groups:

  • cognitively healthy — no self- or partner-reported memory loss or concerns

  • mild cognitive impairment — minimal to mild functional impairment but with preservation of independence in functional abilities, or a diagnosis of mild cognitive impairment based on the National Institute on Aging (NIA)-Alzheimer’s Association (AA) criteria

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  • mild Alzheimer’s disease — a diagnosis of probable Alzheimer’s disease based on the NIA-AA criteria, or screening results conforming to mild Alzheimer’s.

All participants made three visits to the laboratory. On the first, they underwent cognitive testing and blood sampling; the second was for PET scans to assess amyloid in the brain — or CSF sampling where this was unavailable. On the third visit they underwent more blood sampling.

The researchers found no relationship between beta-amyloid–40 or t-tau in the blood and amyloid positivity from PET scans. However, there were strong relationships between blood levels of beta-amyloid–42, p-tau181, p-tau217, and amyloid positivity.

The researchers recorded lower values of beta-amyloid-42, and higher values for p-tau181 and p-tau217, across all three groups for those whose PET scans showed amyloid.

The average concentration of all three biomarkers was significantly less for non-Hispanic Black participants than for non-Hispanic white participants.

“[This study] suggests that p-tau217, p-tau181 and [beta-amyloid-42/beta-amyloid-40] ratio were significant predictors of amyloid positivity in all three race and ethnic groups in the study population. This is consistent with what we have seen in other studies, and adds to our understanding of the potential utility of Alzheimer’s blood tests.”

– Dr. Heather Snyder

Could blood biomarkers be a diagnostic tool for Alzheimer’s?

Dr. Clifford Segil, D.O., neurologist at Providence Saint John’s Health Center in Santa Monica, CA, does not believe that blood tests can be used to diagnose Alzheimer’s disease:

“There is no clinical usefulness of using a blood test to determine if [it] correlates with brain amyloid burden as there is no clear correlation between high amyloid brain burden and cognitive issues. Many patients with severe memory loss have low brain amyloid and many patients with no memory loss have high amyloid brain deposits.”

However, Dr. Snyder was more positive.

“There is a growing body of evidence — published in the scientific literature, with more to be reported in July at the Alzheimer’s Association International Conference (AAIC) in Philadelphia — that certain blood-based Alzheimer’s disease biomarkers are essentially equivalent with detection methods in cerebrospinal fluid (CSF) and imaging (PET, MRI),” she told us.

So, not a replacement for the range of other tests needed for a confirmed Alzheimer’s diagnosis, but perhaps a simple blood test could highlight the need for further investigation in people who are showing symptoms that might indicate Alzheimer’s disease.

Finally, Dr. Emer MacSweeney, CEO and Consultant Neuroradiologist at Re:Cognition Health, not involved in this study, expressed optimism about the future potential of this research, saying:

“This study represents a pivotal advancement, offering crucial insights and paving the way for faster and more accurate Alzheimer’s diagnosis, which is imperative for treating the disease with new-generation medications.”

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By Katharine Lang on March 4, 2024 — Fact checked by Amanda Ward

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Dementia vaccines: What are they, and when could they become available?

Vaccines are arguably one of the greatest inventions of medical science of all time. Now, researchers are looking to take vaccine technology one step further to protect against neurodegenerative diseases like dementia. In this Special Feature, we asked experts about what is currently under development, how a dementia vaccine would work, and how quickly we may see one becoming available to the public.

 

Dementia is an umbrella term referring to a range of disorders that affect the way in which a person’s brain works, causing symptoms including memory loss, behavior changes, and difficulty speakingpeople around the world have dementia, with about 10 million cases added each year.There are some Food and Drug Administration (FDA)-approved drugs for Alzheimer’s disease aimed at either changing disease progression or helping lower some symptoms of the condition. However, there is currently no cure for Alzheimer’s disease or most cases of dementia.

Is a dementia vaccine even possible? 

Researchers are now looking at the possibility of protecting a person from developing dementia through a vaccine.

Traditional vaccines, such as vaccines for the flu and shingles, train the body’s immune system to fight off specific viral infections.

“More and more, there’s an appreciation of the immune system being relevant in the central nervous system, both in terms of driving a disease state, but also potentially recovering from or even preventing a disease from happening, including something as complex and devastating as dementia,” said Dr. David A. Merrill, a psychiatrist, and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, CA.

He gave the example of recent evidence showing a person getting the flu or pneumonia vaccine might decrease their risk of developing dementia.

“It’s spurring the idea ‘could immune system activation or support actually help stave off the dementing process or nerve degenerative disease process?’,” Dr. Merrill continued.

“The starting point of the theories or hypotheses about Alzheimer’s didn’t start with ideas about the immune system, but it’s ending up that perhaps the treatments can and should involve helping or addressing immune system function with aging,” he told us.

What would a dementia vaccine do? 

According to Dr. Michael G. Agadjanyan, vice president and professor of immunology at The Institute for Molecular Medicine in Huntington Beach, CA, vaccines against neurodegenerative disorders

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 are like subunit vaccines

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 — using only a piece of the pathogen — and recombinant vaccines

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 using DNA technology to raise antibodies against the most immunogenic peptide segments.

Dr. Heather Snyder, vice president of medical and scientific relations for the Alzheimer’s Association, said it is an exciting time in Alzheimer’s disease research, with over 100 potential therapies being tested at various stages of the research process, and many more being developed.

“There has been some research exploring active immunization, such as vaccines, to ‘protect’ individuals from Alzheimer’s,” she detailed. “These are vaccines that are being developed to target the biology related to Alzheimer’s.”

“They are, in some cases, leveraging the biology of decades of vaccine-related development more broadly in medical care. There are also different types of delivery systems and different types of biology that may be targeted with a vaccine for a potential therapy,” she explained.

Dr. Agadjanyan explained that dementia vaccines would generate immune responses against pathological molecules in the body associated with dementia, including:

“In Alzheimer’s disease, the following processes develop in the brain tissues,” Dr. Agadjanyan explained to Medical News Today.

“[Beta-amyloid] plaques are formed from beta-amyloid protein. Inside the neurons of the brain, neurofibrillary tangles are formed from hyperphosphorylated tau protein. These accumulations of beta-amyloid and tau protein lead to the destruction of neurons and the development of inflammatory processes,” he said.

“As a result, neurons and the connections between them vanish, and memories, the ability to create them, and other human cognitive functions — thinking, the ability to concentrate on a task, logic, etc. — go with them,” he continued. “After a person receives a diagnosis of Alzheimer’s disease, they rarely manage to spend more than five to seven years in this world.”

Dr. Agadjanyan said that current scientific data suggest that aggregation of beta-amyloid is the critical feature for initiating Alzheimer’s disease followed by accumulation of pathological tau and, downstream, inflammation, oxidative stress, and neurodegeneration.

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