Upcoming Vaccines?

Antibodies can be designed to gobble up foreign objects other than viruses. Beta amyloid is a protein that accumulates into plaques in Alzheimer's, and a vaccine can be made by creation of a synthetic form of beta-amyloid. This can stimulate the immune system to create antibodies that attack amyloid. Training the body’s immune system to stimulate an attack against beta amyloid without causing brain inflammation might be possible. David Holtzman and other researchers at Washington University successfully cleared plaque in parts of the brain by injecting mice with an antibody. Along with clearing out the plaque, they said the nerve cell swelling went down and "normal structure" was recovered.

There are several current approaches to the creation of a plaque-destroying vaccine. The most innovative was developed and tested by the Elan and Wyeth Corporations. They are at it again with a refined approach that might work without the side effects (inflammation of the central nervous system) that stopped their previous attempt. Look for stories from Elan and Wyeth, such as those about humanized monoclonal antibody Bapineuzumab ACC-001. Families of patients in their clinical trials were reporting positive changes to the news but that's risky stuff to trust. However, if the results reported soon are good, the pressure for accelerated studies will increase. Otherwise, this would be 5 years or so out in terms of availability. Nancy Barbas at the University of Michigan is involved in new phase 2 immunoptherapy clinical trials. This is financed by Elan and Wyeth. Worth looking into.

Keep an eye out for work by Marc Weksler and Cornell Medical Center as well as Sid Gilman at the University of Michigan Medical Center. The search for a safe way to clear amyloid protein is receiving huge attention.

Also look for research by Einar M. Sigurdsson at NYU. He has succeeded in animal studies to create a vaccine that seems to remove abnormal tau protein, the other mechanism that might be the mediating cause of Alzheimer's disease.

Participants might still be wanted for a study of Immunoglobulin (IVIg) in the treatment of mild to moderate stage Alzheimer's disease (AD) because IVIg contains antibodies against amyloid beta.

10/26/04 - Breaking news on oral vaccine that might not have the side effects of the first Elan attempt.

1/18/02- DUBLIN, Ireland, and MADISON, N.J.- Elan Corporation and Wyeth-Ayerst Laboratories, the pharmaceutical division of American Home Products Corporation today reported on developments in the Phase 2A clinical trial of AN-1792, an experimental immunotherapeutic for the treatment of mild to moderate Alzheimer's disease. The companies have decided to temporarily suspend dosing in this Phase 2A study after four patients in France were reported to have clinical signs consistent with inflammation in the central nervous system.
In Nature Medicine (April, 2003), James Nicoll and his research team reported on the autopsies of people who were in this first vaccine trial. The one who got the vaccination were "devoid of A plaques" but had the tangles and other cortex components that are characteristic of AD and were evident in all the autopsies of unimmunized AD patients. There were other dimensions of confirmatory results that indicated reduction of plaque by vaccine. These plaques are a central component of AD, so their elimination is very impressive.

Recently other approaches have been taken to develop a vaccine. It has been argued (Khalid Aqbal) that Alzheimers is caused by a mechanism (the hyperphosphorylation of tau, causing tangles) different from the one that would be attacked by the vaccine (plaques made of beta amyloid protein fragments). The plaque protein might even be a repair protein, like scar tissue, that responds to, rather than causes, the damage. The tau vs plaque debate is probably the hottest debate in Alzheimers research.*

* Amyloid is a generic name for protein fragments that aggregate (collect or clump together) in a specific way to form insoluble deposits referred to as plaques that build up outside of neurons. Tangles are insoluble twisted protein fibers that build-up inside neurons.