New treatments for Alzheimer’s
Alzheimer’s is notorious for the number of failed attempts to find treatments for the disease. Research over decades is yet to find any treatment that reliably works.
Early in 2018 the world’s largest drug manufacturer, Pfizer, pulled out of all research into the disease, following a number
of setbacks in their research programmes. The most recent drug licensed to treat the disease has had full funding under Medicare refused, sounding the commercial death knell for the drug.
Now scientists have discovered that the brain’s own design may provide new ways to treat the disease – and possibly a host of other conditions too.
The body’s internal cleaning system
The human body is able to clean itself from the inside. Nearly all waste products are cleared from organs by the lymphatic system. Excess fluids, proteins, minerals and other detritus are carried to the lymph nodes, filtered and broken down.
However, the brain has no lymphatic system. Scientists had believed that brain cells broke down waste inside the brain itself. But a few years ago researchers discovered the brain has its own cleaning system. The discovery was called the “glymphatic system” (because it involves glia brain cells).
The team that discovered the glymphatic system at the University of Rochester, USA, showed that cerebrospinal fluids were passing through the brain using the pulses from heartbeats to push them through the organ. The fluid was then carrying waste products along the way for disposal via the lymphatic system.
Researchers posed the question “could the glymphatic system prevent Alzheimer’s?” and the answers are starting to become clearer. The discoveries are starting to open up new targets for possible drug therapies.
Cleaning away disease
Alzheimer’s is caused by the build-up of two proteins in the brain called Amyloid-beta and Tau. They form plaques that stop brain cells working and eventually lead to cell death. That process causes Alzheimer’s disease.
The plaques are normally cleared from the brain by the glymphatic system, but the process slows down in older people and those with Alzheimer’s. That means that improving the performance of the glymphatic system may be a way of treating the disease.
The importance of sleep
Strangely the glymphatic cleaning process only works when people are asleep. The brain waves associated with deep sleep patterns trigger the fluid to start moving through the brain, cleaning as it goes.
If deep sleep helps to clear away the proteins that cause Alzheimer’s, it adds greatly to the importance of getting a good night’s rest. A single bad night of sleep can increase the amount of plaque left in the brain. Steps towards better sleep may help greatly.
Drugs which affect normal patterns of sleep like beta-blockers (notably Bisoprolol) may stimulate the glymphatic system. Studies
are starting to show that Alzheimer’s incidence may well be reduced in some populations taking the drug. Treatments for insomnia show similar promise.
The US Army is even investigating whether caps can improve glymphatic flow during sleep. The aim is to improve soldiers’ performance in combat by improving their rest in war zones, which is often difficult to obtain.
New avenues to explore
Getting drugs into the brain is incredibly difficult because of the blood-brain barrier, which blocks getting chemical compounds into the brain.
Circumventing that problem by infusing drugs directly into cerebrospinal fluid and waiting for them to wash through the brain during sleep, may therefore offer new ways to treat a host of conditions, not just Alzheimer’s.
Treating Parkinson’s, brain injuries and a host of other diseases that are difficult to tackle may well be possible by harnessing the
power of the brain’s own cleaning system. Any drug company that does manage it in the coming years will be certain to clean up too.