Alzheimer's vaccine clears plaque but has little effect on learning and memory impairment

clipped from today.uci.edu A promising vaccine being tested for Alzheimer’s disease does what it is designed to do – clear beta-amyloid plaques from the brain – but it does not seem to help restore lost learning and memory abilities, according to a University of California, Irvine study. The findings suggest that treating the predominant pathology of Alzheimer’s disease – beta-amyloid plaques – by itself may have only limited clinical benefit if started after there is significant plaque growth However, a combination of vaccination with therapies that also target related neuron damage and cognitive decline may provide the best treatment opportunity for people with this neurodegenerative disease “We’ve found that reducing plaques is only part of the puzzle to treat Alzheimer disease,” said study leader, UC Irvine neurobiologist Elizabeth Head. “Vaccines such as this one are a good first step for effective Alzheimer’s treatment, but complimentary treatments must be developed to address the complexity of the disease.”

Alzheimer's vaccine clears plaque but has little effect on learning and memory impairment

UCI study suggests that combination of therapies provides best opportunity for Alzheimer’s treatment

Irvine, Calif., April 4, 2008

A promising vaccine being tested for Alzheimer’s disease does what it is designed to do – clear beta-amyloid plaques from the brain – but it does not seem to help restore lost learning and memory abilities, according to a University of California, Irvine study.

The findings suggest that treating the predominant pathology of Alzheimer’s disease – beta-amyloid plaques – by itself may have only limited clinical benefit if started after there is significant plaque growth. However, a combination of vaccination with therapies that also target related neuron damage and cognitive decline may provide the best treatment opportunity for people with this neurodegenerative disease. Study results appear in the April 2 issue of the Journal of Neuroscience.

“We’ve found that reducing plaques is only part of the puzzle to treat Alzheimer disease,” said study leader, UC Irvine neurobiologist Elizabeth Head. “Vaccines such as this one are a good first step for effective Alzheimer’s treatment, but complimentary treatments must be developed to address the complexity of the disease.”

Head and colleagues studied for a two-year period in aging canines the effect of a vaccine that is currently under clinical development for treating patients with Alzheimer’s disease. The vaccine contains the beta-amyloid 1-42 protein and stimulates the immune system to produce antibodies against this same protein that is in the brain plaques. Dogs are used for such studies because beta-amyloid plaques grow naturally in their brains and they exhibit cognitive declines similar to those seen in humans.

After the aged dogs with beta-amyloid-plaque growth were immunized (which is similar to starting a treatment in patients with Alzheimer’s disease), the researchers found, in comparison with non-treated aged dogs, little difference in the results of behavioral tests that measure cognitive loss. Later, brain autopsies showed that although plaques had been cleared from multiple brain regions – including the entorhinal cortex, a region of the brain involved with learning and memory and primarily affected by Alzheimer’s – damaged neurons remained.

Head said this discovery helps explain why there was little difference in the behavioral test results between immunized and nonimmunized dogs. In addition, she added, it implies that after clearing beta-amyloid plaques from the brain, the next step is to repair these neurons. This approach will be critical for treating and reversing the effects of the Alzheimer’s disease.

Currently, Head and her colleagues are developing approaches to repair these damaged neurons and hope to test them clinically.

Head is a researcher with the UC Irvine Institute for Brain Aging and Dementia. Viorela Pop, Vitaly Vasilevko, Mary Ann Hill, Tommy Saing, Floyd Sarsoza, Michaela Nistor, Lori-Ann Christie, Saskia Milton, Charles Glabe and David Cribbs of UC Irvine; and Edward Barrett of the Lovelace Respiratory Research Institute in Albuquerque, N.M., assisted with the study. The National Institutes of Health supported the study, and the Lovelace Institute provided the canine study subjects.


About the University of California, Irvine: The University of California, Irvine is a top-ranked university dedicated to research, scholarship and community service. Founded in 1965, UCI is among the fastest-growing University of California campuses, with more than 27,000 undergraduate and graduate students and nearly 2,000 faculty members. The third-largest employer in dynamic Orange County, UCI contributes an annual economic impact of $3.6 billion. For more UCI news, visit www.today.uci.edu.

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Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 2,255 articles with more than 272,100 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Alzheimer's Society Comment On New Research Suggesting Caffeine May Help Reduce Alzheimer's Disease

By Bob DeMarco
Alzheimer's Reading Room

I stopped allowing my mother to drink coffee with caffeine a few years ago. Several months ago I read about this new research and started giving her one cup of caffeinated coffee a day.

A good example of how Alzheimer's caregivers are willing to try just about anything that might help.

I now drink one cup of caffeinated coffee a day. I use to drink decaf.

clipped from www.medicalnewstoday.com This is the best evidence yet that caffeine equivalent to one cup of coffee a day can help protect the brain against cholesterol. It sheds important light on why previous research has shown drinking coffee may reducing the risk of dementia. In addition to its effect on the vascular system, elevated cholesterol levels also cause problems with the blood brain barrier. This barrier, which protects the brain from toxins and infections, is less efficient prior to brain damage caused by Alzheimer's disease or strokes. Caffeine blocks disruption of blood brain barrier in a rabbit model of Alzheimer's disease (Xuesong Chen, Jeremy W. Gawryluk, John F. Wagener, Othman Ghribi, Jonathan D. Geiger). Published in Biomedical Central Alzheimer's Society

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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,300 articles with more than 9,000 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

A Retail Clinic for Healthy People

This is part of the model of the future. A variation on the retail clinics that are springing up all over the country.

I have friends that have used retail clinics to get health care for simple illnesses that are being passed around from person to person. This kind of sickness can be taken care of with a simple $4 prescription from Walmart. They charge you $25 for the exam, diagnosis, and prescription.

clipped from blogs.wsj.com Health care would be a great business if it weren’t for all the sick people. Richard McCauley, MD, may have fixed that. “If you cough, you’re in the wrong place,” he told the Ventura County Star His store, WellnessMart, sells things like screening tests, checkups and vaccinations. McCauley doesn’t take health insurance, but he’d be glad to sell you a health insurance policy. Nutrition counseling for a month costs $40, and vaccination for hepatitis A costs $89, the County Star says. Critics have suggested that many new health care businesses aim to skim off the simplest, healthiest patients, leaving complex, sicker patients for others to deal with. McCauley’s business certainly fits the bill. But he argues that the cost and difficulty of seeing the doctor means many healthy people go without basic preventive care. “Why is it that sick people and healthy people go to the same places for care?” he says.

Alzheimer’s Treatments Advance in Clinic

clipped from www.google.com Alzheimer’s is on the rise, but scientists are making progress on treatments they think may finally make a dent in the disease. But as Forbes reports, researchers still aren’t certain about the cause of the illness. That gap in knowledge means that a range of drugs that aim to clear the brain of amyloid plaque, clumps of protein fragments that are one of the hallmarks of Alzheimer’s, may never work. Some skeptics of the dominant amyloid hypothesis think the build-ups are “actually a response to injury that the brain secretes to protect itself, like a scar,” says Mark Smith, a neuroscientist at Case Western Reserve University. He tells Forbes that by removing it, “you will make the disease worse.”

Say Hello to ‘Dr. Nurse’

If you are a caregiver like me you will realize the importance of this new breed of nurses.

Physicians and the medical field are resisting this new change.

Not only are nurse doctors necessary they will be welcomed with open arms by our aging population.

clipped from blogs.wsj.com Nursing schools are making a push to award doctor of nursing degrees, a move that has some physicians and nurses worried, the WSJ’s Laura Landro reports. A fresh supply of well-trained primary care practitioners could help counter a physician shortage. The goal is to create “hybrid practitioner” who will have more skills and training than a nurse practitioner with a master’s degree But wait, nurse advocates say, there’s a nursing shortage too. “Nurse practitioners with master’s degrees are already filling the primary care shortages and providing quality, cost-effective care, many times in places that physicians are unwilling to practice,” says Wendy Vogel, a nurse practitioner specializing in oncology at Blue Ridge Medical Specialists in Bristol, Tenn. “Nurses with an advanced degree are not the same as doctors who have been to medical school,” says Roger Moore, incoming president of the American Society of Anesthesiologists.

Clinical Trial: Effect of LY450139 on the Long Term Progression of Alzheimer's Disease

This study will use several different tests to measure the effect of LY450139 on both A-Beta amyloid and amyloid plaques for some patients. The build up of amyloid plaques will be measured by a new brain scan that can take a picture of amyloid plaques in the brain.

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Purpose

Alzheimer's disease (AD) is a fatal degenerative disease of the brain for which there is no cure. AD causes brain cells to die. AD is thought to be caused by an excess of A-Beta amyloid, a sticky protein in the brain that forms amyloid plaques. At autopsy, AD patients are required to have these amyloid plaques in the brain in order to have a definitive diagnosis of AD. Inhibiting the enzyme gamma-secretase inhibits the production of A-Beta amyloid as measured in blood and spinal fluid in humans tested thus far and in blood, spinal fluid and brain in animals tested thus far. This study will use several different tests to measure the effect of LY450139 on both A-Beta amyloid and amyloid plaques for some patients. The build up of amyloid plaques will be measured by a new brain scan that can take a picture of amyloid plaques in the brain. Other tests will attempt to measure the overall function of the brain and brain size in some patients. In this trial, patients who initially receive placebo (inactive sugar pill) will at a certain point in the study be switched over to active drug, LY450139. In other words, all patients will eventually receive active drug. Each patient's participation will last approximately two years. Patients taking approved AD medications may participate in this study and continue taking these medications during the study. All patients who complete this study will have the option to continue receiving LY450139 by participating in an open label study.

Eligibility
Ages Eligible for Study: 55 Years and older
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

* Meets criteria for mild to moderate AD with Mini-Mental State Examination score of 16 through 26 at visit 1
* Modified Hachinski Ischemia Scale score of less than or equal to 4
* Geriatric Depression Scale score of less than or equal to 6
* A magnetic resonance imaging (MRI) or computerized tomography (CT)scan in the last 2 years with no findings inconsistent with a diagnosis of Alzheimer's disease
* If female must be without menstruation for at least 12 consecutive months or have had both ovaries removed.

Exclusion Criteria:

* Is not capable of swallowing whole oral medication
* Has serious or unstable illnesses
* Does not have a reliable caregiver
* Chronic alcohol or drug abuse within the past 5 years
* Has ever had active vaccination for AD


Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00594568

Contacts
Contact: There may be multiple sites in this clinical trial 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559


Locations and More Information

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Big Insurers Pay for Online Doctor Visits

clipped from blogs.wsj.com Doctors are finally starting to get compensated for online consultations with patients, but whether the practice will catch on is another story. Aetna recently took a three-state pilot project nationwide, and Cigna plans to start paying for Web visits next year, the Philadelphia Inquirer reports. Both companies contract with RelayHealth Patients typically pay the same co-pay whether they go to the doctor or have a Web consult. Insurers pay doctors less for the Web consult — typically $25 to $35, according to the Inquirer. But Lisa Rankin, a Florida doctor who has been using Web visits for a while, said they can substitute for simple questions that might otherwise be answered over the phone — and not reimbursed by insurance. “There definitely is a nice niche for it,” she told the Inquirer.