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| GAINING ON A KILLER? | |
 July 1999 
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A
recent study found a vaccine that may make it possible to treat and even
prevent Alzheimer's. Dr. Steven DeKosky, head of the Alzheimer's Disease
Research Center at the University of Pittsburgh, answers your questions.
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Scientists have reported a possible breakthrough in the prevention and treatment of Alzheimer's Disease. The study, released today in the magazine Nature, found a vaccine that appears to prevent and, in some cases, reduce the buildup of plaque in mice brains. The plaque is similar to buildup found in the brains of people who suffer from Alzheimer's. Roughly 4 million Americans suffer from the debilitating effects of Alzheimer's disease. The disease has already struck one in ten of those 65 and older and that number jumps to nearly 50 percent by age 85. As people suffering from Alzheimer's grow older, they begin to show signs of the disease, including bouts of dementia, loss of memory and eventually death. How important is this discovery? How do these findings relate to humans? Can we expect a vaccine to be available to the population? Your questions will be answered by Dr. Steven DeKosky, head of the Alzheimer's Disease Research Center at the University Of Pittsburgh and chairman of the Scientific and Medical Advisory Council of the Alzheimer's Association. |
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Susann
Monroe of Santa Monica, CA, asks: When and where will the tests take place? What are the qualifications for individuals who may wish to participate in the tests? Dr.
Steven DeKosky responds: It has not been determined where the first tests of the immunization will take place. The immunizations have been shown to be harmless to mice. They must be shown to be harmless in another species of animal, likely monkeys, before humans will be given immunizations. The first studies will be done in patients who have mild to moderate Alzheimer's disease just to assess the safety of immunization. Janice
Brooks of Austin, Texas, asks: How quickly will you know whether this vaccine will work in humans and at what stage of Alzheimer's would it be used? Dr.
Steven DeKosky responds: The first question is to determine whether the vaccine is safe for repeated use in humans. To show that it slows the progression of AD, it will likely take at least a year of treatment of each patient to see if it has an effect on slowing disease progression. The first tests would probably be done in patients with mild to moderate AD. I presume this question relates to when the FDA would approve the use of such an immunization for any individual (much as a prescription drug would become approved and available everywhere). There is no good way to know that at this point, other than that it would take at a minimum four years or so before it would likely have enough proof of both safety and effectiveness to have the FDA consider approving it. The second question: In the mice that were tested, the immunization did show an ability to stop the additional accumulation of amyloid plaques in the brain and even decreased or reversed the deposition that had already occurred. We do not know what the effect of this would be on the complicated behavioral and memory changes which occur in patients with AD. If it does have the effect for which we hope, it might well slow down or perhaps slightly improve patients with mild to moderate disease. It would not likely improve patients who already had severe dementia. It will probably be initially tried in humans to assess safety; larger trials to assess effectiveness are probably at least 1.5 to 2 years away. David
Smith of Merrimack, NH, asks: I associate "vaccine" with "prevent." Will this vaccine reverse the progression of this disease? Can it actually bring back a person who has already been diagnosed with senile dementia/ Alzheimers? Dr.
Steven DeKosky responds: Severe dementia will likely not be reversed with this treatment. The animal studies show some regression or improvement in the amount of the amyloid deposited in the brain. Whether that will "translate" into reversing the disease in humans can only be determined by trials in humans. Hubert
Schlafly of Greenwich, CT asks: Who are the leading foundations or organizations that have contributed money to help implement this possible breakthrough? Dr.
Steven DeKosky responds: Elan Corporation, and specifically their laboratories in south San Francisco, California (formerly Athena) was the private corporation which developed the immunization procedure. Vann
Smith of San Francisco,CA asks: Is there a cross over effect with Parkinson's related plaques? Dr.
Steven DeKosky responds: There is not a cross over with Parkinson's pathology. Robert
Japenga of Simsbury CT asks: Do you have a Web page where we can follow the results? Dr.
Steven DeKosky responds: For information concerning any progress to be publicized concerning the results of the trial, interested readers should consult the 800 number set up by Elan Pharmaceuticals.* In addition, information on this and other aspects of science can be found at the Alzheimer's Association Web page (www.alz.org) or their 800 number (1-800-272-3900). *Editor's Note: You can get information about the research and leave your contact information for future studies by calling the Elan Pharmaceuticals line (1-800-894-7308) or consulting thir Web page at http://206.205.105.115/alzheimer/default.html. I have been told that my mother (age 90) has "Alzheimer's type" dementia. How can we find out if it is true Alheimer's Disease? Dr.
Steven DeKosky responds: Although diagnostic accuracy approaches 90%, the only absolute way to know if someone has Alzheimer's disease is with an autopsy after death. My grandmother died of Alzheimer's at the age of 78. My husband grandmother and aunt also died of Alzheimer's. I am worried for my children. How strong is the genetic factor? Dr.
Steven DeKosky responds: We know there are genetic factors that influence the likelihood (or perhaps the age at which) one will get Alzheimer's disease in late life. We don't know enough about this yet. If there is Alzheimer's disease in the family, the chances of a person in the next generation down getting the disease is increased but is not 100%. By the time your children reach the age of risk, I hope we will know much more about the genetic risks as well as ways to combat the disease. |
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