New IV drugs, blood tests, and the reelin protein are energizing the Alzheimer's research community.
New IV drugs, blood tests, and the reelin protein are energizing the Alzheimer's research community.
For people living with Alzheimer’s disease and at risk of developing it, the past two years have provided some hopeful news about the future of Alzheimer’s prevention and treatment.
First, the FDA approved two new intravenous drugs for early-stage dementia: Lecanemab, marketed as Leqembi™, in 2023, and in 2024, Donanemab, marketed as Kisunla™. The drugs remove sticky amyloid plaques, and scientists have proven that they slow the progress of cognitive decline, if only by a factor of about 27%.
Then, there are the new blood tests that rolled out this year, available to some people who show signs of cognitive decline. The tests identify sticky amyloid plaques and tau fibers in the brain. Previously, the only ways doctors could determine the presence of these physical markers of Alzheimer’s were through spinal taps or a PET scan–both much more expensive and uncomfortable than a blood test. And the new tests, which detect the abnormal protein ptau217, predict Alzheimer’s with 90% accuracy.
Five Ways to Support Your Cognitive Health TodayWe live in an exciting time for Alzheimer’s research, but we know preventative health and social support will always be the best medicine. Here are five ways to boost your brain health.
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“The trend now is to go toward a biological diagnosis of Alzheimer’s disease,” says Dr. Eliezer Masliah of the National Institute on Aging, “a diagnosis based on biomarkers rather than just on clinical symptoms.” One study found that blood tests predict Alzheimer’s with more accuracy than cognitive tests.
These new drugs and tests are exciting, and they’re already available to patients. But perhaps the most exciting recent Alzheimer’s news involves the discovery of how reelin, a protein produced in the brain, helps prevent the onset of Alzheimer’s disease. It may be years before we see treatments based on this new research, but for now, it’s energizing scientists.
All Eyes on Reelin
Three studies rocked the Alzheimer’s research community in the past 20 months. First, a 2023 study by Lopera et al. documented “the world’s second case with ascertained extreme resilience” to Alzheimer’s disease.
The case study concerns a man who carried a gene that was common among his family members–so common, in fact, researchers dubbed the gene Paisa after the region in Colombia where the family lives. Despite his strong genetic predisposition to developing Alzheimer’s disease in middle age, the man was diagnosed with dementia only in his 70s. After he died at the age 74, having donated his body to research, scientists discovered that his brain had all the hallmarks of Alzheimer’s, and in abundance: sticky amyloid plagues and tangled tau fibers. However, these telltale signs were mostly absent in the entorhinal cortex, a region of the brain responsible for memory that usually sees early effects of Alzheimer’s. When researchers investigated the man’s genome, they pinpointed a rare variant of the gene responsible for the production of a certain protein: reelin. Because of this variant, the man’s reelin proteins were able to reduce the presence of tau tangles.
As it happened, another group was already studying reelin’s effect on Alzheimer’s. A few months later, they published research on the brains of 427 people, concluding that those who had more of a reelin-producing neuron more successfully staved off cognitive decline.
In July, the same team published a study in Nature focusing on the brains of people who had normal thinking and memory to the end of life, but whose brains also presented amyloid plaques that usually indicate Alzheimer’s. These special people also produced more reelin than the average individual. The other important finding of this study was that Alzheimer’s disease goes after the neurons in the entorhinal cortex that produce reelin. Since reelin protects against the disease, the people who have an exceptional genetic ability to produce reelin have built-in protection against Alzheimer’s–even when other genes they carry would seem to prescribe the destiny of developing the disease.
David Merrill, MD, PhD, who wasn’t involved in the research, told Medical News Today, “This work paves the way for early detection and targeted therapeutic interventions.” For now, don’t trust any source claiming to be able to help you boost your reelin production. The best defenses against Alzheimer’s are still lifestyle changes and social support (see sidebar). But this new research focus on reelin is raising hopes for even more Alzheimer’s treatment and testing breakthroughs on the horizon.
