Advancing the fight against Alzheimer's: Insights from Dr. Dieter Riethmacher on current research and future directions
September 21 marks World Alzheimer’s Day, which is dedicated to raising awareness about dementia and supporting those affected by it. In honor of this day, Kazinform News Agency correspondent conducted an interview with Dr. Dieter Riethmacher, Vice Dean for Research and Graduate Studies at Nazarbayev University, in which he discusses groundbreaking research initiatives targeting Alzheimer’s disease as well as sheds light on the latest advancements in early detection and the genetic factors influencing this complex disease.
What are the main areas of Alzheimer's disease research conducted at Nazarbayev University?
I cannot know for sure if I have a comprehensive overview, but I happen to know that Jeannette Kunz is involved in a CRP project that explores the connection between dementia (especially Alzheimer's disease) and the microbiome. Also, others have broader approaches, like investigating the influence of reactive oxygen species (ROS) and mitochondrial membrane integrity on the healthiness of cells or neurons, which impacts neuronal survival and could potentially lead to dementia.
Are there any new scientific developments in the field of preventing or slowing the progression of Alzheimer's disease?
Recent advances are new FDA-approved drugs. These are monoclonal antibodies against a putative toxic agent of Alzheimer's disease (a beta peptide). There is still a debate about how much they can actually do, but data suggest they may work in humans as well. Three of them have been approved in the last 2-3 years. There are other trials and research going on aiming at preventing the aggregation of the peptides, but there are still doubts that this route will lead to something. Preventing the generation of the peptides seems preferential. Also, inhibition of tau phosphorylation is one route of research, as neurofibrillary tangles (composed of hyperphosphorylated tau protein) are one hallmark of Alzheimer's, apart from plaques (composed of aggregated beta peptides).
What medical achievements in recent years can be considered major breakthroughs in the diagnosis and treatment of this disease?
Similar to answer two, I would say the generation and characterisation of these new antibodies and their clinical trials and FDA approval are treatment novelties; whether they will be breakthroughs, time will tell. Regarding diagnosis, there has been significant progress in brain imaging techniques that help to diagnose AD. However, the clinical pictures and careful investigation of physicians are still highly important. Therefore, progress and improvement of questionnaires and tests still helps to make diagnosis quicker and more reliable. Obviously, earlier diagnosis only truly helps when there will be powerful drugs available. Current drugs—maybe with the exception of antibodies—that actually may help to improve the disease manifestation only slightly slow the process down and make life slightly better for the patient for very limited time periods.
What are the most promising methods for early detection of Alzheimer's disease today, and are there technologies that allow predicting susceptibility to it in advance?
Medical history and observation from family members; brain imaging. Also, blood-based markers as well as liquor-based markers have turned out useful. As always, when new technologies emerge, some researchers are suggesting machine learning on MRI images may help to advance the time point of safe diagnosis, but it is currently still in the experimental phase.
Are there studies being conducted in the field of genetic predisposition to Alzheimer's disease, and how can this affect the prevention of the disease?
The vast majority of cases are sporadic forms of AD. From familial cases, we know that there are three genes involved: APP (amyloid precursor protein) and PSEN 1 and 2 (presenelin 1, 2). Also, the ApoE epsilon4 variant is currently considered a risk factor but may almost be considered a causative gene. Other than these, there are lots of associated genes, but clearly causative are only these 3 to maybe 5 genes.
According to the WHO, more than 55 million people are affected by dementia, with 10 million more cases adding up every year. Scientists predict this number will double every 20 years in the future to approximately 78 million in 2030. The insights shared by Dr. Riethmacher underscore the urgent need for continued research and collaboration in the fight against this disease, emphasizing that while advancements are being made, a comprehensive approach combining early detection, innovative treatments, and genetic understanding will be crucial in turning the tide against Alzheimer's.
