Alzheimer's research: recognize the diseases earlier with a new blood test

Alzheimer's research: recognize the diseases earlier with a new blood test

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Blood test shows the course of Alzheimer's long before the first clinical signs

The number of people who develop Alzheimer's is increasing worldwide. The neurodegenerative disease is still incurable. According to experts, this could also be due to the fact that previous therapies are starting too late. That could change in the future. Because with a new blood test, traces of Alzheimer's can be discovered long before the onset of the disease.

Incurable disease

In Germany alone, around 1.2 million people suffer from dementia, the majority of them from Alzheimer's. There are around 47 million dementia patients worldwide. And there are more and more: According to the World Alzheimer's Report, another dementia diagnosis is made every 3.2 seconds. The disease is not yet curable. According to experts, this could also be due to the fact that the previous therapies started late, partly because the disease is often diagnosed late. A team of researchers is now reporting that Alzheimer's traces can be found in the blood long before the onset of the disease.

Early diagnosis is important

As with many other diseases, it is important in Alzheimer's to diagnose the disease as early as possible.

Although the disease cannot yet be cured at the moment, there are indications that a delay in the course of the disease can be achieved with an early diagnosis.

A new blood test could be helpful for therapy research.

Nerve cells are slowly broken down

Years before the first symptoms of Alzheimer's disease appear, the brain changes and nerve cells are slowly broken down.

Scientists at the German Center for Neurodegenerative Diseases (DZNE), the Hertie Institute for Clinical Brain Research (HIH) and the University Hospital in Tübingen are now showing that a protein present in the blood can be used to precisely track the course of the disease long before the first clinical signs appear.

As stated in a joint press release, this blood test offers new opportunities in therapy research.

The study was carried out together with an international research team and published in the journal "Nature Medicine".

Previous therapies started too late

"The fact that there is still no effective therapy for Alzheimer's is probably due to the fact that the previous therapies started much too late," said Mathias Jucker, researcher at the Tübingen DZNE site, at the HIH and head of the current study.

To develop better treatments, scientists need a reliable way to track and predict disease progression before symptoms such as memory disorders begin.

A blood test is much better for this than, for example, expensive brain scanners that make dementia visible earlier.

Some progress has recently been made in developing such blood tests. Japanese and Australian researchers reported a new test for the early detection of the disease last year.

And German scientists have also developed a blood test for the early detection of Alzheimer's.

As stated in the current communication, most of these methods are based on the detection of so-called amyloid proteins. With Alzheimer's disease, these proteins accumulate in the brain and also occur in the blood.

However, Jucker and colleagues take a different approach. “Our blood test doesn't measure the amyloid, but what it does to the brain, namely neurodegeneration. In other words: the death of nerve cells, ”said Jucker.

Traces in the blood

When brain cells die, their remains can be detected in the blood. "Normally, however, such proteins in the blood break down quickly and are therefore not very suitable as markers for a neurodegenerative disease," explained Jucker.

"However, an exception is a small piece of a so-called neurofilament, which is surprisingly resistant to this breakdown."

The blood test by Jucker and his colleagues is based on this protein.

In the current study, the scientists show that the filament accumulates in the blood long before clinical symptoms appear - i.e. in the so-called preclinical phase - that it very sensitively reflects the course of the disease and enables predictions to be made about future developments.

According to the information, the study is based on data and samples from 405 people, which were collected as part of an international research network - the "Dominantly Inherited Alzheimer Network" (DIAN).

In addition to the DZNE, the HIH and the University Hospital Tübingen, the Washington University School of Medicine in St. Louis (USA) and other institutions around the world are also involved.

This network examines families in which Alzheimer's disease occurs in middle age due to genetic changes. Genetic analysis allows very accurate predictions about whether and when a family member will develop dementia.

The harbinger of dementia

In these individuals, the scientists followed the development of the filament concentration from year to year and found that up to 16 years before the calculated onset of dementia symptoms there were noticeable changes in the blood.

"It is not the absolute value of the filament concentration, but its development over time, which is really meaningful and allows predictions about the further course of the disease," said Jucker.

In further studies, the researchers showed that the change in neurofilament concentration reflects the neuronal breakdown very precisely and allows good prognoses about how the brain will develop in the next few years.

"We were able to make predictions about the loss of brain mass and cognitive impairments that actually occurred two years later," said Jucker.

So while it turned out that the rate of change in filament concentration and the breakdown of brain tissue correlated closely with one another, the connection with the deposition of toxic amyloid proteins was far less pronounced.

This observation supports the assumption that amyloid proteins are a trigger of the disease, but the neuronal degradation takes place independently in the further course.

Tool for therapy research

Not only in Alzheimer's, but also in the course of other neurodegenerative diseases, neurofilaments accumulate in the blood.

The test is therefore only of limited use for diagnosing Alzheimer's.

"However, the test shows the course of the disease very precisely and is therefore an excellent tool for researching new Alzheimer's therapies in clinical studies," said Jucker. (ad)

Author and source information

Video: Reimagining Medicine: The Worlds First Blood Test to Detect Alzheimers Disease (May 2022).


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