The quest for the cure of this Alzheimer's disease has always been challenging and controversial in nature. There have been several debates and controversies during the recent years on this.
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It was reported by Science magazine in July 2022 that a seminal 2006 research paper published in the elite journal Nature, which fingered a subtype of brain protein called beta-amyloid as causing Alzheimer's, may have been based on fabricated data.
This came a year after the U.S. Food and Drug Administration had approved aducanumab in June 2021. Aducanumab is an antibody to beta-amyloid, approved for the treatment of Alzheimer's with incomplete and even contradictory data to assert its effectiveness. Physicians argue that it should never have been approved, while others say that at the very least, it at least deserves a chance.
When millions of people are in need of an effective treatment, why are researchers still struggling to find a cure for one of humanity's most pressing diseases?
Beyond Beta-Amyloid
For decades, scientific efforts to treat Alzheimer's have focused on ways to prevent damaging clumps of a protein called beta-amyloid from forming in the brain. Yet every drug and therapy tested so far that works on this principle has failed. To many researchers, it's time to think outside this box.
For the last three decades, at Toronto's Krembil Brain Institute, which is part of the University Health Network, they have been working on a new theory of Alzheimer's. This new theory of Alzheimer's disease, based on 30 years of research, purports that it is not a brain disease primarily, but one of the brain's immune system.
The immune system is integrated into every organ of the body and consists of cells and molecules that cooperate to repair damage and protect against infection. Just as this system works in the rest of the body, so it does in the brain. When trauma to the head or invasion by bacteria occurs to gain entry into the brain, the brain's immune system becomes activated to initiate repair and defend against such threats.
Alzheimer's as an Autoimmune Disease
Scientist believe that beta-amyloid is part of the normal immune system of the brain, not an abnormal protein. It constitutes a crucial element in the response to traumata and infections of the brain. Things go wrong because of similarities between the fatty membranes of bacteria and those of brain cells. Beta-amyloid can't distinguish these invaders from the very brain cells it's supposed to protect—and it launches a misdirected attack on the brain itself.
This chronic, misguided attack of the brain's immune system on its own cells could underlie the chronic brain cell dysfunction and progressive dementia that typify Alzheimer's disease. From this point of view, Alzheimer's can be described as an autoimmune disorder.
Unlike other autoimmune diseases, such as rheumatoid arthritis, in which steroid-based therapies can be effective, such treatments have no benefit for Alzheimer's. The brain is an exceptionally complex organ, and in our model, while beta-amyloid serves a protective function, it also contributes to the autoimmune process that scientist believe leads to Alzheimer's.
Although these conventional autoimmune disease treatments have so far failed to combat Alzheimer's, scientists are optimistic that other immune-regulating pathways in the brain can be targeted to result in new and effective treatment strategies.
Other Theories
Aside from the autoimmune hypothesis, a number of other theories are emerging. One group of researchers thinks that Alzheimer's is a mitochondria-based disease—the energy-producing structures in brain cells. Mitochondria take in oxygen and glucose and turn them into the energy needed for memory and cognition.
Others suggest that Alzheimer’s could result from a brain infection, with some pointing to bacteria from the mouth as a potential cause. There are also theories involving the abnormal handling of metals like zinc, copper, or iron within the brain.
It is heartening to witness the emergence of these new theories. With over 50 million people suffering from dementia worldwide and a new diagnosis every three seconds, the burden of Alzheimer's on individuals, families, and health-care systems is already enormous.
Alzheimer's is a public health crisis that calls for new ways of thinking and new ideas. Its better understanding, causes, and treatment call for relentless pursuits so that those living with it, and their families, may survive as much as possible, and a socioeconomic burden be alleviated from healthcare systems.
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