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Four global research highlights from 2020
By Robin Brisbourne | Tuesday 05 January 2021
It won’t come as a surprise that 2020 was a challenging year for dementia research.
But scientists have been working hard to overcome the challenges, and are continuing to make discoveries that will ultimately mean more lives free from the impact of dementia
At Alzheimer’s Research UK we think about four key research goals.
- Understand the diseases that cause dementia.
- Diagnose people earlier and more accurately.
- Reduce risk, backed by the latest evidence.
- Treat dementia effectively.
Researchers around the world are working on these areas. Here are four key examples of progress from last year.
Understand
Proteins are the molecules responsible for the activity our cells. There are countless different types of protein in the human body, each with a specific role to play in the processes that allow us to live and function.
Proteins are made up of chains of more simple molecules called amino acids. These chains are folded in a specific way to form a specific protein.
Diseases like Alzheimer’s involve the build-up of abnormally folded proteins that cause damage to nerve cells in the brain. But every process that plays a role in these diseases boils down to a sequence of interacting proteins.
Understanding the formation of proteins is a key goal for many researchers. It helps them to better understand the molecular events that contribute to a disease and to design drugs that could help the brain get rid of harmful proteins.
It is possible to reveal the precise shape of a protein using expensive and time-consuming lab techniques. But in November, a company called Deep Mind made a huge step towards unlocking the structure of proteins using artificial intelligence.
With further development this breakthrough will have a big impact on many different areas of biological research and dementia research is no exception.
Dr Sara Imarisio, Head of Research at Alzheimer’s Research UK, said:
“Proteins are essential for living and during the diseases that cause dementia they go awry. Working with proteins, understanding their structure, looking at their effects on behaviour in the brain, and developing drugs to target them goes to the very core of what our scientists do. We still do not have a drug to slow or stop diseases like Alzheimer’s but new and powerful technologies able to accelerate progress gives people hope.”
Diagnose
The two proteins most commonly associated with Alzheimer’s disease are called amyloid and tau. Fragments of amyloid protein begin to clump together in Alzheimer’s, and this is followed by a cascade of other processes, including a build up of the tau protein inside nerve cells in the brain.
Doctors usually diagnose Alzheimer’s disease based on the symptoms that a person experiences. By this time the disease can have been underway in the brain for up to two decades, and as the symptoms of Alzheimer’s are similar to other forms of dementia diagnosing a specific disease can be very difficult. Expensive scans can give an indication of proteins building up in the brain, but these are not practical for wide-spread use.
Blood tests are relatively simple, cost effective and most people are comfortable providing a blood sample.
Researchers have been making steady progress towards more and more reliable blood tests for Alzheimer’s disease. The majority of these have focussed on the amyloid protein. This year a blood test for the tau protein has emerged as the most promising for widespread use.
Dr Rosa Sancho, Head of Research at Alzheimer’s Research UK said:
“We know that brain changes in Alzheimer’s disease can occur decades before symptoms start to show and the early stages of disease are likely to be the time when future drugs are most effective.
“These studies suggest that changes in levels of a specific form of tau, one of the hallmark proteins of Alzheimer’s, may be detectable in the blood in the very early stages of the disease.
“Further work will need to be carried out at a larger scale and with tests that are clinically feasible before they could be used by doctors making a diagnosis in the clinic.
Reduce risk
In July a new report from the Lancet Commission estimated that the number of dementia cases worldwide could be reduced by 40% if 12 risk factors for the condition could be eliminated. Excessive alcohol use, traumatic brain injury (TBI) and pollution are three new risk factors in its updated model for dementia risk.
Prevention is better than cure. As our genes play a big role in our risk, there is no sure-fire way to prevent dementia. But understanding risk factors, especially those we might be able to change, is an important part of the fight against the condition.
Dr Sancho, said:
“As new studies continue to develop the evidence base on dementia risk, the report has identified three new risk factors for dementia.“With no treatments yet able to slow or stop the onset of dementia, taking action to reduce these risks is an important part of our strategy for tackling the condition. Prevention strategies must be underpinned by robust evidence and while our understanding of dementia risk is growing, there is still much we need to know about the different risk factors for dementia.
Treat
Earlier in 2020 the US drug regulator, the Food and Drug Administration (FDA) announced that the potential Alzheimer’s drug, aducanumab, has been accepted for a priority review process. The drug, which has been developed by the pharmaceutical company Biogen, targets amyloid a protein that builds up in the brain in people with Alzheimer’s at an early stage in the disease. The priority review means that the FDA is aiming to decide about aducanumab early in 2021.
Samantha Benham-Hermetz, Director of Policy and Public Affairs from Alzheimer’s Research UK, said:
“Aducanumab must make it through a number of steps before it is approved. With so many people desperate for a new Alzheimer’s treatment to work, we need to be sure that the regulators are satisfied that this drug is safe and clinically effective.
We’ll keep you updated with any news about aducanumab throughout 2021.
Whether or not aducanumab is approved by the FDA, we will need to see new treatments coming through the development pipeline. Alzheimer’s Research UK’s Drug Discovery Institutes have been awarded funding for a further five years following a successful review process. These institutes will continue to seize on new understanding to identify new treatments approaches.
No single drug, biological discovery, lifestyle change or diagnosis technique will immediately bring a halt to the growing impact dementia has on individuals and families around the world. But Alzheimer’s Research UK and the global community of dementia researchers will keep chipping away at the frontiers of what we know across all four of our research goals.
Even in a very difficult year, dementia researchers have made vital progress that will pave the way to real changes to how dementia affects people’s lives. Thanks to your support we are entering into 2021 with a sense of optimism and a renewed determination to make breakthroughs possible.
