Alzheimer’s Disease (AD) is a degenerative illness characterised initially by memory loss and that ultimately leads to death through the loss of bodily functions. The level of care needed means it is not only a devastating diagnosis for patients and their families, but also has a very high cost for society.
Alzheimer’s is incurable: however, progress is being made in finding potential new drug treatments and better ways to diagnose the illness.
Nancy Ip is a neuroscientist and currently Morningside Professor of Life Science at The Hong Kong University of Science and Technology. At a Chamber webinar on 13 January, she shared the findings of her latest research and also answered questions from members.
“As we all know, Hong Kong has the longest life expectancy in the world,” Ip said. “But this means that the prevalence of age-related degenerative disease will also increase.”
Alzheimer’s mainly affects people aged over 65, and the older you get, the higher the risk. About 50% of people over 85 suffer from AD, and one in three seniors dies as a result of Alzheimer’s or other dementia, Ip explained.
“Globally, there are around 50 million AD patients, and this will triple by 2050, which is very alarming,” she added.
Alzheimer’s has three stages: mild, with the first signs of memory loss and language problems; moderate, with long-term memory loss; and severe, where full-time care is needed.
Currently five FDA-approved drugs are available, however, these are for symptomatic relief only and cannot stop the progression of the disease. As the global population ages, there is a huge need for new treatments and strategies.
“If we could delay the disease onset by five years, this would have a great impact,” Ip said. “To delay onset or slow down progress of the disease would reduce the number of patients greatly by 2050.”
Professor Ip then explained her team’s work on two different types of drug treatment. The first is related to their research on synapses. When a particular receptor in the brain is over-activated, it impairs learning and memory. Looking for ways to inhibit this receptor, the team identified a compound called rhynchophylline, which is used in Traditional Chinese Medicine. Their subsequent research found that mice with AD that had been treated orally with rhyncophylline demonstrated improved memory. The second treatment involves the immune system. Injecting a protein called interleukin 33 (IL-33) was also found to reverse the memory loss of mice with AD.
“Both these treatments have been licenced and are under pre-clinical evaluation,” Ip explained. “The findings in the laboratory have great potential to be translated from mouse to human.”
However, even if successful, it will be some time before such treatments are available. As with any drug candidate, tests need to be done to establish the safety and stability, even before they proceed to human trials, which themselves can take years.
Another element of Ip’s work is finding better diagnostic tools for AD. Currently, patients usually consult their doctor when they are already suffering from memory loss. To identify patients earlier means new ways of testing need to be found.
“It is critical for us to identify key biomarkers for the pre-clinical stage. This will allow us to develop better treatments and monitor progression.”
Good news is that recent advances in technology have enabled Ip and her team to identify such biomarkers for AD, including genetic risk.
“In addition to genetics, the environmental factors are very important,” Ip explained. “These include how well you sleep, your diet, physical activity, history of head trauma, stress, and how active you are in terms of social engagement.”
Although a lot of research has been done into Alzheimer’s, Ip noted that previously there had been little data on people with Asian ancestry. So Ip has researched Mainland Chinese and Hong Kong people, and identified a number of genetic mutations that has enabled her and her team to study the risks for ethnically Chinese people.
They are also developing diagnostic tools based on blood protein biomarkers that will allow for earlier diagnosis and to monitor the effectiveness of drug treatments.
Using a mix of genetic testing, blood protein testing and brain imaging will enable testing of patients before they show symptoms, and eventually to deliver individual treatments. These tests are not yet available to the public, but Ip said she hoped blood-based diagnostic testing should be available within five years.
“AD can be seen as an invisible pandemic,” Ip concluded. “Given the number of AD patients globally, we need to find an effective cure in the near future, otherwise the societal burden and the economic burden will be huge.”