Wednesday, July 16, 2008

The AD Challenge: Hitting the Right Mark

by Jeongyeon Shim, FasterCures, Domestic Program Analyst

Last week, I attended "Early Detection of Alzheimer’s Disease: A Virtual Town Hall*,"organized by the Alzheimer Research Forum and the Alzheimer’s Study Group, sponsored by the Geoffrey Beene Foundation Alzheimer’s Initiative. Moderated by Dr. Harold Varmus, the meeting featured presentations from seven eminent Alzheimer’s researchers, highlighting the importance of an antecedent biomarker and providing an update of ongoing efforts, using media such as imaging, blood, or cerebrospinal fluid.

While the importance of biomarkers is well known, the importance of reliable and low-cost antecedent biomarkers for Alzheimer’s disease (AD) is paramount and should be appreciated in the context of the disease. First, AD is an irreversible neurodegenerative disease—once clinical symptoms appear, the neurons that govern the affected functions are permanently lost. This means that even if we had a cure that addresses the cause of the disease, it will not necessarily revive the lost functions for later-stage patients—unless we also find a way of regenerating lost neurons. Early treatment through early detection is not only ideal but critical in reducing the burden of the disease—preventing the clinical form of the disease.

In addition to its limitation in detecting clinical symptoms, the current AD diagnostics are not always accurate nor available. AD diagnosis based on clinical symptoms has an accuracy of over 90 percent when conducted by experienced clinicians. Unfortunately, this is often not the case for mild AD, when distinction with mild cognitive impairment (which does not progress to dementia) may not be as obvious. And, "experienced clinicians" are a scarce resource. Instead, primary care physicians, thrust on the frontlines of AD care, may not necessarily have the tools and training to recognize AD. With these factors, it is more important than ever to develop a reliable and widely-available diagnostic tool

We discussed Dr. Lee Goldstein’s effort to develop an eye exam to diagnose AD a few weeks ago. And last week, I was pleased to see that scientists are pushing forward multiple other efforts. Identification of multiple markers will allow us to choose a marker that best fits the purpose—whether it is for diagnosis, management of risk factors, or measurement treatment effectiveness. Such efforts exactly match FasterCures’ goal—to accelerate the process of discovery and clinical development of new therapies. We look forward to see many more such efforts, not only in AD but also in other diseases.
*The proceedings from the Town Hall will be made available at in the near future.

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