On Alzheimer's Disease

The  French play Le Père by Florian Zeller showcases   Andrei, an old man whose memory is clouded by  Alzheimer's disease(AD).  Le Père received  the 2014  Molière Award for best play. The play has been translated into and staged in several languages. Imaginatively conceived and performed,  audience can empathise with  the vulnerability and frustration of Andrei as his memories fade and/or  at times randomly light up.  We recently had the privilege of  watching it at Ranga Shankara, Bangalore. 

 Courtesy Wikipedia 

Experts say it all happens in the hippocampus,  the seat of  short and long term memory , learning and hence  cognition.   One of the earliest  signs of AD is the  accumulation of   clumps of β-amyloid protein (βA proteins)  in between neurons, and entanglements of tau protein (𝝉 protein) fibrils  within. Both these break up neural communication network, leading to memory loss, cognition deficiency etc.  So naturally the question arises, can we clean up this messy stuff that builds up outside and  inside ? Or better still, can we  find ways to stop its production? Perhaps then we can re-establish  normal neuronal activity and thus restore  memories and cognition?  

Drug companies have invested billions of dollars  to find out a suitable answer. Still over the last 20 years only 4 drugs have hit the market. One novel approach has been  to develop  monoclonal antibodies, which  can loosen up amyloid plaques and lyse them. Though looked promising during  initial stages,  many candidates in this line-up  failed in later stages. In a field where   failure rate of 99.6% is routine, scientists are not disheartened.   Further more, realisation has sunk in that multiplicity of factors could lead to  AD.  And  hence  a single magic drug will not arrest or reverse  the progress of the disease for all.   

Tailpiece:

According to the World Alzheimer Report 2018, currently 50 million people are suffering from AD and by 2050 this number would be 150 million.  If left untreated we might eventually  reach an alarming  situation with majority of the world population afflicted  with  semantic dementia as described by Garcia in One Hundred Years of Solitude.  Macondo  was first robbed off its sleep and then people lost   their vocabulary!  

REFERENCES:
1.World Alzheimer Report 2018
2.The antibody aducanumab reduces Aβ plaques in Alzheimer's disease

3. Aducanumab at Clinical Trials on Alzheimer’s Disease (CTAD)4.Biogen Halts Promising Alzheimer's Drug Trials Due to Disappointing Results
5.Initiation of Phase III clinical trial of BAN2401 in early Alzheimer's disease
6.Semantic Dementia in One Hundred Years of Solitude