Open-sourcing Alzheimer's disease diagnosis
In the middle of all that disappointing news about failed treatments targeting the beta-amyloid peptide involved in AD, here's some silver lining. A lot of people think that the real reason all these drugs are not fighting AD is not because they are ineffective per se but because they are administered too late, long after the disease has manifested itself. Thus the logical step toward making these therapies more effective would be in detecting AD earlier. In the last few months, a slew of articles has detailed several techniques for diagnosing AD early which look promising, from better brain imaging to spinal taps. An article in today's New York Times looks at the integrated effort that has spawned these developments. It turns out that the effort has come about from several government agencies, universities, non-profit organizations and imaging and pharmaceutical companies collaborating to find early biomarkers for AD. Biomarkers are unique chemical or biological signatures that signal the onset or presence of a particular disease. They can range from specific proteins to small organic molecules that are uniquely associated with that disease. One of the biggest endeavors in medicine today is to find biomarkers that are produced very early during a disease's development, when the disease has not yet become full blown and when the chances of targeting it with drugs is the highest. The joint initiative cited in the article has pooled together several million dollars from each contributor. As everyone wisely realized, AD is much too complex to be tackled by single research entities (what disease isn't?). As one participant said:
"We all realized that we would never get biomarkers unless all of us parked our egos and intellectual-property noses outside the door and agreed that all of our data would be public immediately.”"Parking their egos" outside would be necessary for the diverse and large studies required to gain insight into true AD biomarkers.
“The problem in the field was that you had many different scientists in many different universities doing their own research with their own patients and with their own methods,” said Dr. Michael W. Weiner of the San Francisco Department of Veterans Affairs, who directs ADNI. “Different people using different methods on different subjects in different places were getting different results, which is not surprising. What was needed was to get everyone together and to get a common data set.”The problem is of course is that it can be tricky as hell to distinguish true biomarkers from spurious ones (the old problem of distinguishing correlation from causation). It would take some time to zero in on those biomarkers that truly signal the onset of the disease. But this bit of news is gladdening for two reasons; firstly because it indicates that people are perhaps moving away from the obsession with targeting amyloid (which nonetheless continues to be a fascinating entity), and more importantly because it indicates that there are still people willing to park their egos outside the door and publicly collaborate to address a very complex medical challenge. Hopefully this endeavor should provide inspiration for tackling other diseases.
But that would require a huge effort. No company could do it alone, and neither could individual researchers. The project would require 800 subjects, some with normal memories, some with memory impairment, some with Alzheimer’s, who would be tested for possible biomarkers and followed for years to see whether these markers signaled the disease’s progression.
Labels: Alzheimer's disease