An Overview of Therapeutic Targets for Defeating Alzheimer's Disease

An Overview of Therapeutic Targets for Defeating Alzheimer's Disease

Alzheimer disease can be defeated. There is an urgency given the estimated incidence of 20,000 new

cases per day. The biochemical targets that need to be hit are aggregates of beta amyloid protein and

tau. These targets are known to be vulnerable to suitable inhibitory agents although none have yet

reached the bedside. Once powerful ones are put into practice Alzheimer disease will become as rare as

polio is today. New candidates can be easily screened in vitro and validated in vivo by testing in

transgenic mice. Numerous candidates have already met these criteria but have gone no further

because of the high cost of clinical trials. They include blockers of production and aggregation of beta

amyloid protein, agents that clear it from brain, and agents that block its inflammatory stimulation.

Some are drugs that have long been in use for other applications and others are components of herbal

medicines. The fact that they are cheap is a strong disincentive to embarking upon high cost clinical

trials. Moreover, expensive regulatory testing of new agents is beyond the reach of basic scientists.

Success in defeating Alzheimer disease requires intervention with suitable agents before the disease

sets in. Many millions of beta amyloid protein deposits are found in the brains of Alzheimer cases upon

autopsy, indicating that many thousands accumulate in their brains each day. Every one is a focus of

inflammation. The elements necessary to defeat Alzheimer disease are now at hand. Early diagnosis is

now possible. Genetic evidence and biomarkers such beta amyloid protein levels in brain, CSF and even

saliva can indicate impending disease. Promising agents have been identified. Skilled clinicians with

desperate patients are available. These elements need to be combined in a series of clinical trials where

changes in biochemical markers are followed. Funding of a collaborative consortium much akin to the

Manhattan project which ended world war II is needed. Leaders with the differing skills required to take

basic science discoveries to the bedside need to work together for the first time. As with the Manhattan

project, Governments must step in to provide the necessary funds.