neurodegenerative diseases

Rituximab and ocrelizumab are two antibodies with a similar mechanism of action that are used in the treatment of multiple sclerosis. Although the former had not shown benefits in primary progressive multiple sclerosis — which affects between 10% and 15% of patients — the latter is approved for this form of the disease. Now, a study conducted in France with more than 1,000 patients has found no benefits with either treatment, as they did not slow the progression of disability in these individuals. The results are published in the journal Neurology.

Men and women could develop Alzheimer’s disease through different mechanisms. Understanding these differences is essential to design specific interventions and to treat the disease effectively. In an article published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, a group of researchers, including myself, have highlighted the urgency of adding a sex and gender approach to the studies on this pathology.

Vision loss and having high cholesterol - the so-called ‘bad’ cholesterol - are risk factors for developing dementia, according to a meta-analysis published in The Lancet. Eliminating these risk factors could reduce dementia cases by 2% and 7% respectively, the study says. Both factors are in addition to 12 others previously mentioned in a 2020 report such as less education, physical inactivity, hearing loss, excessive alcohol consumption, obesity or poor social contact, among others. According to the research, almost half of all dementia cases could be prevented or delayed if these risk factors were controlled.

After the introduction of a shingles vaccine (Zostavax) in 2006, several studies suggested that the risk of dementia might be lower in people who had received the vaccine, although the results were inconclusive. In many countries Zostavax has been withdrawn and replaced by a much more effective vaccine (Shingrix). A study published today in Nature Medicine suggests that this new recombinant shingles vaccine, Shingrix, is associated with a greater reduction in the risk of dementia compared to Zostavax and vaccines against other types of infections.

In a new study in mice published in Science, researchers present CHARM, an epigenetic editor that can be used to silence prion protein throughout the brain. The tool offers a path to effective first-line treatment for patients with fatal prion diseases, as well as other neurodegenerative diseases caused by the toxic accumulation of unwanted proteins. 

A family of more than 1,000 members with origins in Colombia has a mutation called "paisa" that leads to the development of Alzheimer's disease. In 2019, an added mutation in the apoE gene called "Christchurch" was described as conferring strong protection to an individual carrying two copies of it. Now, a study has found that 27 family members carry a single copy and that it is also associated with some degree of protection. According to the authors, who publish their findings in the journal NEJM, the discovery could be used to develop new treatments for the disease. 

Researchers have found specific antibodies in the blood of patients years before they showed symptoms of multiple sclerosis. This group of antibodies was present in 10% of the 250 people who later developed the disease, and were part of a sample of over 10 million US military personnel. The finding could have potential for early detection of multiple sclerosis, says the research team in a paper published in Nature Medicine. 

According to a study published today by The BMJ, people with dementia who are treated with antipsychotics are at increased risk of serious adverse events such as stroke, blood clots, myocardial infarction, heart failure, fractures, pneumonia, and acute kidney injury, compared with those who do not take them, . These findings extend the harms previously associated with the use of these drugs on these patients. 

A monoclonal antibody called prasinezumab reduces the worsening of motor symptoms in people with Parkinson's disease who have rapidly progressive disease, according to an analysis of a phase 2 clinical trial published in Nature Medicine. These findings suggest that clinical efficacy of prasinezumab, which works by binding to alpha-synuclein protein aggregates, is seen after one year of treatment in such patients. According to the authors, more research is needed to determine whether the antibody can be effective in people with slower disease progression after longer periods of treatment. 

A phase 2 clinical trial in France has examined whether taking an oral anti-diabetic drug called lixisenatide - a GLP1 receptor analogue, similar to those also used for weight loss - also has an effect on the progression of Parkinson's disease. The results indicate that there is a modest but significant decrease in the progression of motor symptoms of the disease, although side effects were also observed. The results are published in the journal NEJM.