Could this Alzheimer's vaccine cut dementia cases in half?

Robert Hohler, owner of Companions of London, writes about whether a new alzheimer's vaccine could help treat dementia. 

Alzheimer's disease (AD) is a chronic neurodegenerative disease — one that starts slowly and progresses over time. It is the most common form of dementia, and the first signs of Alzheimer’s include difficulties with language, mood swings, disorientation, loss of motivation, problems with self-care and behavioural issues. As the condition escalates, family members and friends see the patient retreat into themselves and withdraw from society. This disease is traumatising for the individual and everyone around them — the typical life expectancy following diagnosis is generally three to nine years.

Alzheimer’s is a global epidemic affecting 47 million people around the world — a figure that is predicted to rise to 76 million by 2030. The disease has claimed some notable people, such as Ronald Reagan and Rosa Parks. Although research into the condition persists, we are still relatively uncertain as to its cause. We currently assume that 70% of the risk is genetic, with other risk factors including head injuries, hypertension and depression. The disease is associated with plaques in the brain, and although there are no current treatments that stop or reverse the progression of Alzheimer’s, there are some that can temporarily improve the signs and symptoms of Alzheimer’s.

The promise of an effective new Alzheimer’s vaccine

Although there is currently no cure, this might soon change. Recently, an experimental vaccine was created by researchers at The University of Texas Southwestern Medical Center, which they hope could stave off Alzheimer’s disease.

The vaccine showed promising results in the animal testing phase. As revealed in Alzheimer’s Research & Therapy, testing in mice revealed the vaccine can safely and effectively prevent plaque buildup in the brain. Following tests on mice, monkeys and rabbits, researchers now hope they can begin the process of carrying out human trials. If this vaccine proves itself to be effective and safe in humans, it is believed the vaccine could halve the number of dementia cases while extending the lives of Alzheimer’s patients by preventing the disease from developing. As Doris Lambracht-Washington, a professor of neurology and neurotherapeutics, states,

“If the onset of the disease could be delayed by even five years, that would be enormous for the patients and their families.”

How does the vaccine work?

The vaccine works by causing the body to produce antibodies, which inhibits the buildup of amyloid and tau — two proteins that are commonly associated with Alzheimer’s. The vaccine does this by using the DNA from these proteins to teach the body’s immune system to combat the disease. The vaccine is injected into the skin because a previous vaccine caused brain swelling after being injected into muscle.

As pointed out by Dr Rosenberg, founding Director of the Alzheimer’s Disease Center at University Texas Southwestern, time is definitely of the essence when it comes to treatment,

“The longer you wait, the less effect it will probably have [...] Once those plaques and tangles have formed, it may be too late.”

Ongoing search for an effective Alzheimer’s treatment

This isn’t the only promising vaccine in the pipeline as Alzheimer’s has posed an ongoing problem for scientists. It’s been said that the brain is “the last great frontier in science” — it’s a complicated and delicate organ, and one that poses a lot of challenges for medical researchers. Alzheimer’s is a multi-factor disease, which means effective treatments will likely require a cocktail of drugs. The road to a cure has so far been marked by a long list of clinical failures,  but there are a number of drugs progressing through phase one and phase three clinical trials that might prove to be the long-awaited breakthrough.

Other drugs of note are ORY-2001, which inhibits the two enzymes in the brain (LSD1 and MAOB) responsible for promoting DNA damage and preventing repair. The drug is said to prevent brain inflammation, which is known to be a huge factor contributing to mental decline.

Another solution might be BAN2401, a new antibody compound that inhibits the build-up of toxic protein and reportedly significantly slows down mental decline. If all goes well, BAN2401 might be generally available by 2023.

AADvac1 is another vaccine that stimulates the body’s immune system to attack proteins that destabilise the structure of neurons. A Phase 2 clinical trial of 185 volunteers with mild Alzheimer’s disease began in March 2015 and is expected to conclude in February 2019.

Barriers standing in the way of Alzheimer’s treatments

Contributing to the lack of progress in discovering a cure for Alzheimer’s is the very nature of the disease itself. For years, the condition remains asymptomatic. Neurological symptoms only make themselves known once the disease has progressed and irreversibly damage the brain — as such, it is nearly impossible to treat. As there are no reliable methods to determine whether someone is in the early biological stages of the disease, there’s no way to stop the condition in its tracks. Early, definitive diagnostic tools for the detection of Alzheimer’s are either painful or expensive, so doctors aren’t inclined to test their patients unless they have very strong suspicions their patients have the condition — doubts that are based on symptoms associated with cognitive decline.

Another hurdle to effective detection and treatment is that many doctors aren’t sufficiently trained to diagnose Alzheimer’s early. This, of course, leads to missed diagnoses and delayed treatment. Once the condition has finally been diagnosed, the disease has worsened. Add to this a general shortage of diagnostic and imaging equipment, restriction when it comes to access to specialists and extensive waiting times leave Alzheimer’s sufferers with a battle to fight before they even get correctly diagnosed.

Though this might sound bleak, patients with Alzheimer’s disease should remain hopeful. We are progressing and making great strides towards an effective treatment every day. Conditions that were once a death sentence are now easily manageable, and people are living longer than ever. Such news should reassurance families that possibly one day soon they will have an effective weapon to fight this terrible condition.