June is Alzheimer’s and Brain Awareness Month. It’s estimated that nearly 7 million Americans are living with Alzheimer's dementia.
The University of Virginia recently launched the Harrison Family Translational Research Center, a new center focused on the disease headed by John Lukens.
Morning Edition Host Phil Liles recently spoke with Lukens about recent advances in medicine, treatments and what’s on the horizon.
The following had been edited for length and clarity.
Phil Liles: Dr. Lukens, what is the aim of this new center?
John Lukens: The aim in the new center is to accelerate the discovery of novel therapeutics to treat Alzheimer's disease and other neurodegenerative diseases — advancing the discovery of novel therapeutics, and advancing and getting them to the patients sooner.
Our plan is to bring together a collection of innovative and interdisciplinary researchers. So, basic science services that are going after identifying new pathways that are important for the diseases, as well as clinicians, scientists and caregivers to ensure that those discoveries can easily be transitioned over into clinical trials and new therapeutics for those patients.
You've been with UVA for a decade. Tell us about your most recent discoveries.
Most recently, we've been interested in trying to figure out how we can harness the immune system to treat various neurologic disorders. In particular, we're trying to figure out ways to use the immune system to eliminate things that can cause neurons to undergo a cell death.
Neurons are basically what carry our memories, and also control our ability to walk and eat and talk as we age or following injury. There's buildup of certain proteins that can cause damage to those neurons.
And we, and others, have discovered that there are cells in the brain known as microglia. They are the major waste disposal cells in the brain, and they help both to remove those neurotoxic materials and also to kind of surround it, almost form a fortress around it. That neurotoxic material doesn't interact with the sensitive neurons, which are critical to pretty much every aspect of our life.
Are you aware of researchers in London that created a method that can predict dementia nearly 10 years before the onset of dementia?
That work — and others that are trying to find early onset biomarkers — are really critical to us being able to achieve our goals sooner.
The problem in the field right now is, by the time we're treating most patients, they've lost so many neurons that it's hard to go back. So, if we can identify how to intervene earlier, we can actually use some of the treatments that we and others are starting to develop at a time where they can have their greatest impact.
Early biomarkers to identify patients that are going to go on to develop things like Alzheimer's disease, ALS and Parkinson's are really key to having the most success in terms of treating these patients.
Let's talk about treatment. This month, a U.S. Food and Drug Administration advisory panel approved a drug that could slow the progress of Alzheimer's.
It's key right now. It's kind of one of the major reasons why 10 years ago I pivoted into the neurological space.
Since we really don't have anything that targets the root cause, everything that we're prescribing — up to a certain point — is just addressing some of the symptoms that are associated, not really the things that are perpetuating disease and cell death. To now have new treatments that are coming online that could slow this is just huge.
And that's where the field needs to go.
When could patients have access to this drug?
Some of the drugs, they have access to now. Now, there's new and improved versions that target more specifically the most toxic forms of the amyloid beta. They have a more potent impact. And what you're also seeing is people developing or adding those to other therapies to see if they can get a synergistic effect of those treatments.
What's next in the field of Alzheimer's research.
There's a lot of exciting areas, in my opinion.
In terms of looking at the field of Alzheimer's, it really wasn't until about 10 or 15 years ago that we really comprehended and completely understood the role of inflammation and the immune system [in the disease]. That really came from advancements in genetics and then also imaging. We've recently identified many of the genetic risk factors for Alzheimer's disease, and it's interesting that many of them are immune or inflammation associated.
This is an area that really wasn't considered all that heavily in the field. There's been a lot of preclinical and early phase one and two studies looking at targeting the immune response.
Then on the imaging side, there's this new recognition that you can identify areas and pockets of inflammation in the [Alzheimer’s] brain. It’s an opportunity to identify patients earlier for these diseases — and also, assessments in terms of seeing how effective and safe the treatment is.
There’s quite a bit in terms of lifestyle changes.
We've known that exercise and sleep are really important components, in terms of aging to protect the aging brain. And we're starting to get a better sense of how that works at a molecular and cellular level. That provides some opportunity to accelerate those types of tried-and-true methods to help the aging brain stay young.
If people want to learn more about Alzheimer's research at UVA, where should they go?
There's a couple of resources on the internet, obviously our website. That has a nice overview of some of the cutting-edge work that trainees in our lab are doing on a daily basis and also gives you some idea of why they came into research.
Then there are multiple other resources associated with UVA's website. There's an Alzheimer's Disease Research Center. And if people want to get involved with patient studies, early clinical studies, that would be the major conduit to get into those and that's associated with the UVA Brain Institute website.
