Researchers at the University of Colorado Anschutz Medical Campus are conducting a clinical trial to determine if Leukine, a drug typically used for bone marrow transplants, can reverse memory loss in Alzheimer's patients. Huntington Potter, director of the Alzheimer's and Cognition Center at CU Anschutz Medical Campus, leads the research, exploring connections between Alzheimer's, Down syndrome, and rheumatoid arthritis.
Understanding Alzheimer's and Dementia
Dementia is a broad term for cognitive decline affecting memory and daily activities. Alzheimer's disease is the most common cause of dementia in the elderly. According to Potter, distinguishing between different types of dementia is crucial for effective treatment. Vascular dementia, for example, requires treatments focused on lowering blood pressure and cholesterol, while Alzheimer's-specific drugs target amyloid plaques.
Diagnostic Approaches
Diagnosing Alzheimer's involves neuropsychological tests, family interviews, and medical tests, including blood and cerebrospinal fluid analysis. Brain scans can also help differentiate Alzheimer's from other conditions like frontotemporal dementia. Short-term memory problems and difficulties with executive functions, such as managing finances, can be early indicators for family members.
Current Treatments and Their Limitations
Currently, there are three FDA-approved drugs—aducanumab, lecanemab, and donanumab—designed to remove amyloid from the brain. These monoclonal antibodies have shown effectiveness in reducing amyloid plaques, but they only slow cognitive decline rather than reversing it. "The disappointment has come from the fact that instead of reversing Alzheimer's disease, they're merely able to slow the decline in the cognitive problems, and that's good. That's a major step forward, but it comes with caveats," Potter noted.
These drugs also carry risks of side effects, including brain bleeding and swelling, known as Amyloid Related Imaging Abnormalities (ARIAs). Patients with the APOE4 gene are more susceptible to these side effects, necessitating careful risk-benefit assessment before treatment.
Leukine: A Novel Approach
Potter's research focuses on Leukine (GM-CSF), initially studied for its potential to protect against Alzheimer's in individuals with rheumatoid arthritis. A previous three-week clinical trial showed improvements in blood biomarkers of brain damage in patients treated with Leukine. A longer, 24-week trial is currently underway, supported by the NIH. "Leukine has been FDA-approved for 30 years, and it essentially has no side effects of a serious nature that either we found in the Alzheimer patients or that have been found in the 30 years of its use," Potter explained.
Lifestyle and Risk Reduction
Lifestyle interventions, such as exercise and a healthy diet, can reduce the risk of converting from mild cognitive impairment (MCI) to Alzheimer's disease. "Exercise and a good diet, general healthy behavior is able to slow things down and reduce the risk of conversion from mild cognitive impairment to Alzheimer's disease," Potter stated. These behaviors also benefit cardiovascular health, aligning with the Alzheimer's Association's recommendation: "What's good for your brain is good for your heart and vice versa."
Connection to Down Syndrome
People with Down syndrome, who have three copies of chromosome 21 (where the main Alzheimer gene resides), develop amyloid deposits earlier, offering insights into Alzheimer's development. This connection has significantly influenced the understanding and treatment of Alzheimer's disease in the general population.
Future Outlook
Potter remains optimistic about future treatments, projecting potential breakthroughs within the next five years, driven by increased knowledge and ongoing clinical trials.
