‘New clarity’ against Alzheimer’s

first_imgThe past year has been a hopeful one in the fight against Alzheimer’s disease. New findings have brought clarity to understanding the disease’s progress; new drugs to attack it are in trials.Rudolph Tanzi, the Joseph P. and Rose F. Kennedy Professor of Child Neurology and Mental Retardation at Harvard Medical School, last month was named to Time magazine’s list of the 100 most influential people in the world for his contributions to that fight, specifically his work uncovering the disease’s genetic underpinnings. Tanzi spoke with the Gazette about the past, present, and promising future of research into Alzheimer’s disease.GAZETTE: Where are we with Alzheimer’s, medically and scientifically?TANZI: We’re a lot farther along now than we were even last year. Back in 1986, as a Harvard student in the graduate school, my doctoral study was to discover the first Alzheimer’s gene, which is the gene that makes the amyloid. [There were also] two more genes that I discovered in 1995 called the presenilins — I say “discovered” but they’re always co-discovered; you always work with others.Those three genes and a fourth gene — all discovered in the ’80s and ’90s — all lead to excessive accumulation of beta amyloid in the brain. Beta amyloid makes up the plaque. This supported the original hypothesis of a fellow named George Glenner, who back in 1984 discovered what the amyloid was made of. I used his information about that protein to find the gene.The idea is that amyloid triggers the whole rest of the disease: the tangles that form inside the nerve cells and the inflammation that also kills a lot of nerve cells. But when we put the Alzheimer’s genes into mice, they got amyloid, they got some inflammation, and eventually they got some cognitive problems. You can say it was an Alzheimer’s model, but it really wasn’t because they didn’t get the tangles.The tangles are made up of the protein tau, which creates these twisted filaments inside the nerve cells and shuts the nerve cell down. In the mouse, the amyloid wasn’t leading to the tangles.So a lot of people said, “See, the genetics may say it’s the amyloid, but the mouse models say it’s not, because the amyloid didn’t lead to the tangles. So tangles must be coming by themselves.” Then there was a big argument: What causes the disease, the amyloid or the tangles?Some of us said they both cause the disease, but it starts with the amyloid because the genetics say so. But there were two problems. Amyloid didn’t lead to tangles in mice. And, second, in clinical trial after clinical trial, targeting the amyloid failed.People said, “It’s not amyloid, the hypothesis is wrong.” I kept saying, “No, the clinical trials are failing the hypothesis, the hypothesis is not failing the trial.”Either the drugs weren’t potent enough or they were toxic. But then some pretty good therapies were used, like these immunotherapies — these antibodies — and they failed. And so we started to worry a little bit because [the drugs] were removing some amyloid but [the subjects] still weren’t getting better.Then big news came from a study in Australia, where they tracked amyloid in people’s brains — people who were unaffected and people who had the disease.What came out of that study was that amyloid accumulates in the brain 15 years before symptoms. So in these trials, you’re treating full-blown Alzheimer’s patients for amyloid, but amyloid had already accumulated, started the disease, and done its job.It’s kind of like if you have a patient who has congestive heart failure or heart attack and they go to a cardiologist who says, “Here, just take this drug that will lower your cholesterol.” It’s too late. You had to have done that 15 years before.GAZETTE: So is the model of the disease now that the amyloid accumulates, it creates or in some way triggers the tau protein, and the tau makes the disease?TANZI: Yes, that’s exactly right, and that’s the second part of the story. Now pharmaceutical companies have started treating patients very early on in the disease. Reisa Sperling at Harvard is treating patients who don’t even have the disease yet, but imaging of the brain shows they have high amyloid so they’re at high risk of getting the disease.Secondly, Biogen just came out with a study where they treated patients with mild Alzheimer’s with an antibody called BIIB037. And when they removed the amyloid with the antibody, they actually got cognitive improvement. That was a first proof of concept that if you hit amyloid early enough, you can improve the disease.The Biogen antibody approach was based on a paper we published in 2005, where we showed that there are naturally occurring antibodies in the body, auto antibodies, to fight against amyloid.Then there was the other study we had last year, Alzheimer’s in a dish. It modeled Alzheimer’s for the first time, where you get both plaque and tangles. We were able to do this in a dish by mimicking the brain with a gel-like substance. That paper rested, finally, that 30-year [amyloid vs. tangles] debate.We showed that if you use human neurons made from stem cells and you grow it in a gel that mimics the brain, that indeed amyloid causes tangles. So now there’s no doubt. And if you stop the amyloid, you stop the tangles.You combine that with the new Biogen result and that’s why I say just in the last year, we finally have new clarity.GAZETTE: So are we at a threshold in our understanding of the disease?TANZI: Absolutely, I feel like this is the most exciting single year, between the Alzheimer’s in a dish and the Biogen result, since the discovery of the last major Alzheimer’s gene in 1995. So it’s the most exciting year in 20 years.The other exciting thing is the new genetic study. I run what is called the Alzheimer’s Genome Project, funded by a local foundation that’s just amazing, called the Cure Alzheimer’s Fund. Back in 2008, Time magazine called our first Alzheimer’s Genome Project paper one of the top 10 medical breakthroughs of the year.The gene we found back then, called CD33, we now know is the main switch that determines whether there’s inflammation in the brain as a result of all this pathology — the plaque, the tangles, the dying neurons. We know from autopsies people who died cognitively intact — no dementia in their 80s — yet with brains full of plaques and tangles. You ask what protected them: They didn’t have inflammation.We’ve done whole-genome sequencing of those brains. We’re finding variance in genes that control inflammation. That protected them. So now we know which genes are controlling inflammation. We’re setting up drug screenings using the 3-D model and other models to try to stop neuroinflammation despite rampant plaque and tangle pathology and neuronal cell death. We feel if we can do that, we can probably prevent a lot of Alzheimer’s disease.So just this year, we came to the realization that genes involved in the immune system control inflammation in the brain, and seem to be the final piece of the puzzle. First you get plaque, then tangles, then that inflammation really pushes you over the slippery slope into dementia. All this says if you have a drug cocktail where you stop amyloid, you prevent the tangles, you chill out inflammation, then you’ll stop this disease.GAZETTE: How likely is it that that sort of a cocktail will be developed? Are we five, 10, 20, we-don’t-know-how-many years away?TANZI: For amyloid, you have the Biogen antibody — we’ll see what happens, they’re going right to phase 3 [clinical trials].I also have two drugs in clinical trials. One, that stops the amyloid from aggregating, is called PBT2, from Prana Biotechnology, a company I founded in my lab. That drug aims to stop the aggregation of the amyloid in the brain so it can clear out. And then we have another drug that is just getting into clinical trials that stops the amyloid from being made, that’s called GSM, which stands for gamma-secretase modulator. So one of them basically turns off the spigot, the other unclogs the drain.I think Biogen will lead the way in terms of showing how to get amyloids out, but the antibodies they’re making are very expensive. So if you want to prevent this disease in 5 to 10 million people, as the baby boomers get older, it’s going to be tough for health care to cover.What they’re doing is opening the door with proof of concept. People like us are making little white pills that do the same thing. Hopefully — if we’re successful and it’s safe and it works — it will become what I would consider the statin for Alzheimer’s. I envision a day when you’re 40 years old, you get your brain imaged, if your amyloid looks like it’s too high for your age, then you start taking a drug that brings your amyloid back down.The second part is the tangles. What if you’ve already made some tangles? The problem is that the tangles spread through the brain. A dying neuron can spit out a tangle, which travels to a healthy neuron and causes a new tangle. In this scenario, it’s like amyloid is the match that lights the fire, but the tangle is the fire that spreads through the brain. And inflammation would be fanning the flames.A company called C2N based at WashU [Washington University, in St. Louis] just licensed to the pharmaceutical company AbbVie an antibody that stops the tangles from spreading. That is aimed for clinical trials over the next year or so. There you’re hitting the tangles.For the third part, inflammation, we just learned what the key genes are for neuroinflammation: CD33, and another gene called TREM2. Those are the main targets for stopping inflammation and those drug programs are just starting.In terms of a timeline, I think we’ll have drugs to stop amyloid that can be used for prevention in the next five to 10 years. And I think the amyloid antibody could also be in the next five to 10 years. The inflammation drugs, we could get lucky because we know exactly what we need to do, we need to stop this gene, CD33. So I think that’s maybe 10 to 15 years out.GAZETTE: So if you have Alzheimer’s now, there’s not a lot that is promising, but for prevention of future cases, we have a fairly short horizon?TANZI: For prevention, yes, it’s fairly short.If you have it now, your best bet is going to be these inflammation drugs, because the amyloid and the tangles have already done their job. Now it’s the inflammation that’s taking you out. Since we know the cells we’re targeting — they’re called microglial cells — we know what the [genetic] targets are, it could happen faster.But there’s another thing you can do even with everything going wrong. You can protect the neurons from dying even in the face of neuroinflammation. You would try to protect them against free radicals and oxidative stress, because that’s how inflammation kills.When your glial cells see a lot of dead neurons, the assumption by the glial cells is that this is an infection by a bacteria or a virus or a fungus. The inflammation allows you to shoot out free radicals like little bullets aimed at killing the infection. But in this case it’s actually killing the nerve cells, like friendly fire. So we need to chill them out; I call it a microglial chill pill. And we know that CD33 is the target, TREM2 is the target, so that can happen faster than you would think.GAZETTE: What did you think when you heard you were on Time’s list of influential people? Is it helpful to your work and to Alzheimer’s research generally?TANZI: My unit just threw me a big party, they brought in a big potluck lunch and it was great. I said, “You know, this is an honor not just for me but for Alzheimer’s research and for all of you, for everyone doing research against this disease.”I think it’s great, because it brings Alzheimer’s awareness up. Something like this acts as a vehicle to raise money, to raise support, to raise awareness. That’s what I’m most excited about.GAZETTE: How does funding for your research break down?TANZI: About 70 percent of my funding is federal and 30 percent private, with most of the latter coming from Cure Alzheimer’s Fund followed by Boston-area families.last_img read more

Promotion of the Book on Sports Champions of B&H to be held

first_imgThe promotion of the second, revised edition of the book “Sportskivremeplov.ba” written by Muhamed Bikić is to be held at the Motel Centar in Vareš today, starting from 18 o’clock, announced the author of this book.Guinness record holders Muhamed Kahrimanović and Edin Kajević are promoting the book about BH sports champions in Vareš.This interesting book was earlier promoted in Sarajevo, Bugojno, Breza, Mostar, Zenica, Plav, Travnik, Visoko, Zavidovići, Kakanj, Odžak, Ilijaš, Tuzla and Goražde.(Source: nap.ba)last_img

Boston bound: LeBron pushes Cavs to Game 7 vs. Celtics

first_imgVolcano watch: Island fissures steaming, lake water receding China population now over 1.4 billion as birthrate falls “It feels good just to be able to play for another game,” James said. “Like I’ve always said, Game 7 is the best two words in sports. … We should relish the opportunity and have fun with it.”This series, in which home court has meant everything, will have a fitting conclusion Sunday at TD Center, where the Celtics are 10-0 this postseason.“We have one game to be able to compete for a championship, and what more could you ask for?” James said. “If I’d have told you at the beginning of the season we only needed one game to make the NBA Finals, we’d take it.”George Hill added 20 points, and Jeff Green 14 for the Cavs, who lost Love in the first quarter after he banged heads with Boston’s Jayson Tatum.Terry Rozier paced the Celtics with 28 points, and Jaylen Brown had 27.ADVERTISEMENT Carpio hits red carpet treatment for China Coast Guard PLAY LIST 02:14Carpio hits red carpet treatment for China Coast Guard02:56NCRPO pledges to donate P3.5 million to victims of Taal eruption00:56Heavy rain brings some relief in Australia02:37Calm moments allow Taal folks some respite03:23Negosyo sa Tagaytay City, bagsak sa pag-aalboroto ng Bulkang Taal01:13Christian Standhardinger wins PBA Best Player award Winfrey details her decision to withdraw from Simmons film MOST READ James scored 46 points and preserved his reign atop the Eastern Conference for at least one more game as the Cleveland Cavaliers shook off losing All-Star Kevin Love with a head injury and beat Boston 109-99 on Friday night to force a decisive climax to this back-and-forth series.James, playing in perhaps his final game for the Cavs in Cleveland, delivered another sensational performance — he added 11 rebounds and nine assists while playing all but two minutes — to avoid elimination and delay any decisions about where he’ll continue his remarkable career next season.FEATURED STORIESSPORTSGinebra beats Meralco again to capture PBA Governors’ Cup titleSPORTSAfter winning title, time for LA Tenorio to give back to Batangas folkSPORTSTim Cone, Ginebra set their sights on elusive All-Filipino crown“Greatness,” Cavs coach Tyronn Lue said. “Gave it his all. We needed that, especially with Kevin going down. He delivered. He carried us home as usual.”The king is not dead, and he still has a chance to make his eighth straight NBA Finals. Cavs All-Star Love sustains head injury in Game 6 LATEST STORIES As Love stayed down, the Cavs huddled around him. He was helped off and walked to the bench unsteadily before heading to the locker room for further treatment and evaluation.The Cavs announced an hour later at halftime that Love wouldn’t return. His status for Game 7 is uncertain.The real possibility that James was playing his last game in Cleveland hung over the game — and this city — in the hours leading to tip-off. Everyone had an opinion on what James will do next and that discussion filled the sports talk radio airwaves, bars and barber shops.The 33-year-old has said several times since coming home in 2014 that he wants to retire with the Cavaliers, but fans are uneasy because he can opt out of his $35.6 million contract this summer and test free agency.And, of course, he left once before in 2010, bolting for Miami.James has said he’ll sit down with his family after the season ends to plot his next move, and he’s already being courted in Philadelphia, Los Angeles and New York who can only dream about adding him to their rosters.For now, though, he’s only going to Boston.TIP-INSCeltics: Own a 37-0 record when leading a series 2-0. … Dropped to 1-4 in Game 6s over the last four postseasons. … Coach Brad Stevens praised James for his consistency, and ability to exceed expectations. “Nobody else has what he has on his shoulders playing the game,” he said. “I think that the way in which he’s done that and all of the years now that he’s made The Finals and gone deep into the playoffs, it’s unbelievable.”Cavaliers: Improved to 6-2 in elimination game since 2015. … James’ teams are 5-2 in Game 7s. … This was the seventh 40-point game for James this postseason. Michael Jordan also had seven, one off Jerry West’s record set in 1965. … James passed Karl Malone (2,062) for sixth place on the career postseason rebounds list. Don’t miss out on the latest news and information. Nadine Lustre’s phone stolen in Brazil Dave Chappelle donates P1 million to Taal relief operations Steam emission over Taal’s main crater ‘steady’ for past 24 hours The Celtics were still within seven in the final three minutes before James made consecutive 3-pointers, punctuating the second by pounding his chest with both fists and screaming along with 20,562 others.Just for good measure, he added a three-point play and then was taken out of the game to a rousing ovation and chants of “Cavs in 7!”“Just a lot of heart, a lot of grit, being resilient,” James said.Boston’s improbable run through the postseason without injured stars Kyrie Irving and Gordon Hayward will now take the Celtics back home, where they play with more intensity, togetherness and before fans hungry to see an 18th title banner raised to their arena’s rafters.Love went out with a head injury in the first quarter, forcing Lue to juggle his rotations and keep James on the floor longer than he wanted to. The three-time champion played the first 35 minutes without a break and then endured the final eight while nursing a sore lower leg.Backed by a sea of towel-waving fans wearing white “Cleveland Whatever It Takes” T-shirts, James did just that to push the series to Boston, where he has had some of his biggest moments on the renowned parquet floor.In 2014, he had 45 points, 15 rebounds and five assists in Game 6 for Miami, which went on to win Game 7 and the NBA title. He also scored 45 in a Game 7 loss for Cleveland in 2008, and now has a chance to boost his stunning resume further if he can get the Cavs to a fourth consecutive Finals.James has also had some bitter memories in Boston. He lost Game 6 in the East semifinals in 2010 to the Celtics and was soon on his way to joining the Heat.The game began ominously for the Cavs as Love was forced to leave following his violent collision with Tatum.Love and Tatum were away from the ball and didn’t see each other until it was too late. They banged heads and both immediately dropped to the floor with Love raising his left arm as if to signal he needed help. Jury of 7 men, 5 women selected for Weinstein rape trial Lights inside SMX hall flicker as Duterte rants vs Ayala, Pangilinan anew Sports Related Videospowered by AdSparcRead Next In fight vs corruption, Duterte now points to Ayala, MVP companies as ‘big fish’ Cleveland Cavaliers’ LeBron James (23) drives as Boston Celtics’ Marcus Smart (36) defends during the second half of Game 6 of the NBA basketball Eastern Conference finals Friday, May 25, 2018, in Cleveland. (AP Photo/Ron Schwane)CLEVELAND — LeBron James chose Boston as the place he’ll play next.Game 7 is on. And any talk about James’ future is on hold.ADVERTISEMENT View commentslast_img read more