Battling Alzheimer's using vaccinations, ultrasound

Vaccinations may help protect against Alzheimer’s disease

There now may be new steps a person can take to lower their risk of developing Alzheimer’s disease. Getting your recommended routine vaccinations may provide hidden health benefits, according to new research. In a study published in the Journal of Alzheimer’s Disease, researchers found that after receiving the tetanus/diphtheria vaccine and whooping cough (pertussis) vaccine there was a 30% reduction in the risk of developing Alzheimer’s disease. Similar results were observed in individuals who received the pneumococcal vaccine.

“The question not answered by the study is what is the mechanism whereby the vaccine would protect against dementia?” said Dr. Domenico Praticò, who is the Director of the Alzheimer’s Center at Temple University in Indiana. “For years, there was empirical observation suggesting that activation of our immune system could keep Alzheimer's disease at bay. Interestingly, some previous small studies on the effect of general vaccinations on dementia risk provided somewhat promising results,” said Dr. Praticò.

In the current study, the authors looked at more than 200,000 adults who received some or all of the common vaccines recommended by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) for older adults. This group was compared with a group of individuals who did not receive any vaccines.

“A possible answer to this important biological question is that the vaccines, by instructing the immune system to respond to a particular target could indirectly prepare the immune cells to respond more efficiently to any hypothetical insult to the brain,” said Dr. Praticò. “In other words, they may be better prepared for modulation of the inflammatory response within the central nervous system.”

The current study supports some recent epidemiological observations that exposure to infectious agents may be a possible risk factor for Alzheimer’s disease. Established risk factors for Alzheimer’s disease include genetics, diet and age. Dr. John Morley is a professor of medicine at Saint Louis University in Missouri and is an expert in this area. He said these findings are not surprising. “We have published a number of similar studies. We believe vaccines prevent inflammation in the brain, reducing the development of Alzheimers's disease,” said Dr. Morley.

Treating Alzheimer’s with focused ultrasound

Researchers at the West Virginia University Rockefeller Neuroscience institute (RNI) are optimistic about a new approach to Alzheimer’s disease. A first in-human study, which was published in the New England Journal of Medicine, demonstrated that focused ultrasound in combination with anti-amyloid-beta monoclonal antibody treatment can accelerate the clearance of amyloid-beta plaques in the brains of patients with Alzheimer’s disease.

Anti-amyloid-beta (Aβ) monoclonal antibody therapies, such as aducanumab, lecanemab, and donanemab, can reduce amyloid-beta plaques and slow the progression of Alzheimer’s. Until now, these promising antibody therapies had limitations in reaching the brain due to the blood-brain barrier (BBB). The BBB is a protective barrier between blood vessels and the brain that blocks harmful substances from getting into the brain. However, the BBB also limits the access of therapeutics. More than 98% of drugs do not readily cross the BBB.

RNI scientists used a focused ultrasound (FUS) system to safely and temporarily open the BBB to allow the anti-amyloid-beta antibodies increased access to targeted areas of the brain. The FUS MRI-guided treatment helmet with more than 1,000 ultrasound transducers were directed to specific brain regions with high amyloid-beta plaques.

In this first-in-human proof-of-concept study, three patients (two male and one female, aged 59 to 77) with mild Alzheimer’s disease received six standard monthly infusions of aducanumab antibody, immediately followed by FUS-mediated BBB opening in regions with high amyloid-beta plaques. The results demonstrated the safety of this approach and increased reduction of amyloid-beta plaques measured by PET scans.

“After six months of antibody treatment, we observed an average of 32% more reduction in amyloid-beta plaques in brain areas with blood-brain barrier opening compared to areas with no such opening,” said Dr. Ali Redai, who is the lead author of the study and executive chair of the RNI in Morgantown, West Virginia. “Focused ultrasound is a non-invasive outpatient procedure for BBB opening with great promise for improving drug delivery to the brain.”

The next phase of the clinical trial will begin this year to explore how to further accelerate amyloid-beta removal in a shorter time with focused ultrasound in combination with lecanemab antibody.

“This is an exciting time in the treatment of Alzheimer’s disease,” said Marc Haut, who is the director of the RNI Memory Health Clinic. “We are hopeful that the work we are doing may lead to improvements in outcome for many other patients and their families coping with Alzheimer’s.”

Dr. Maurice R. Ferre, who is the CEO and chairman of the board at Insightec, a global healthcare company dedicated to using acoustic energy to transform care, said only 1 to 2% of drugs can cross the blood-brain barrier, making progress difficult and patient safety challenging when using large systemic drug concentrations.

“The ability to disrupt the blood-brain barrier to effectively deliver treatment demonstrates the power and potential of using focused ultrasound technology when addressing complex neurological conditions," said Dr. Ferre.

Alzheimer's disease is a condition that affects 6.7 million Americans today, and promising new therapies are emerging to address this unmet medical need. This latest discovery opens up new avenues for research and provides renewed hope for patients and families.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.

 
 
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