This LiveScience[1] article is an easily read summary that also mentions a critique of the approach.
Given the unfortunate history[2][3] of falsified Korean scientific research, it would be prudent to withhold judgment until these results have been reproduced in other labs around the world.
1. http://www.livescience.com/53019-epps-chemical-washes-away-a...
2. http://www.nytimes.com/2009/10/27/world/asia/27clone.html?_r...
3. https://www.washingtonpost.com/news/to-your-health/wp/2015/0...
Every few years there is a paper that claims that we now finally know what causes the disease, and every time it's something different, and every time you never hear of a followup.
It's about 3 decades later now, and as far as I can tell, there is still no actual progress in the way of treatment. An alzheimer's diagnosis still means the same as it did in the 80's or in the 60's for that matter.
About this cure that is just around the corner. It came too late for my grandparents generation, it came too late for my parents' generation, it came too late for my generation, I wouldn't be surprised if it came too late for my children's generation. I don't believe in it any more.
Keep in mind that they still haven't really decided whether salt is bad for you or not, or what the real effects of dietary cholesterol are. Widespread conditions that should be much easier to research and understand than Alzheimer's are still very controversial.
https://en.wikipedia.org/wiki/Scientific_misconduct#Notable_...
Do you feel the same way about US scientific research?
BTW, I am not even talking about Fox News and alike. NYT, you are in the list. The journalistic integrity of your articles has been dropping like a rock.
[1] http://www.dailyprogress.com/lifestyles/health/former-vcu-ca...
[2] http://www.indiawest.com/news/global_indian/probe-reveals-fo...
[3] http://www.japantimes.co.jp/news/2015/12/03/national/science...
[4] http://www.ctvnews.ca/health/toronto-researchers-alleged-to-...
[5] http://news.xinhuanet.com/english/2015-09/17/c_134632381.htm
http://www.sigmaaldrich.com/catalog/product/sigma/54465?lang...
Looks interesting research but I'm sure this stuff probably can't be that good for you!
It is interesting the way in which various groups leap upon some research reports but not others. The challenge is always having the context for the broader state of research to understand whether it is meaningful or new or not.
The present mainstream view of Alzheimer's is that amyloid (and tau) clearance is the way to go. Immunotherapies are the most developed tool, but that is so far proving to be hard - it is too early to say whether failures in clinical trials are because it is hard or because amyloid clearance isn't as useful as thought in this condition. Which could be for any number of reasons including that amyloid-related biochemistry is the problem, but clearing a particular variant or stage of its aggregation doesn't touch that problem area.
Amyloid levels in the brain are in fact highly dynamic on a very short timescale. That Alzheimer's develops slowly supports the view that the condition is a slow degeneration of natural clearance mechanisms, such as the filtration performed by the choroid plexus, or the more recently investigated peristaltic passage of fluid out of the brain by other channels. E.g.:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245362/
On that latter point, the Methuselah Foundation just a few days ago seed funded a startup company that will investigate whether reversing the degeneration of peristaltic fluid passage with aging will improve clearance and thus stop the progression of Alzheimer's. It's based on as yet unpublished work by Doug Ethell at GCBS Western who presented at Rejuvenation Biotechnology 2015 ( http://www.sens.org/files/conferences/rb2015/RB2015-Program.... ), and has the merit that it should be a fast failure if the theory is wrong, unlike many of the other efforts in Alzheimer's research.
[0] http://www.nature.com/nrn/journal/v12/n2/abs/nrn2967.html [1] http://www.nature.com/nrneurol/journal/v9/n12/full/nrneurol....
Of course this is only small part of the paper and I have no training to appreciate it more.
If Alzheimer was simply a deficiency of nutrients, I wouldn't think this way, but if it really is a protein that "can be cleared", why did it get there in the first place?
The test for alzheimers for the first study (previously reported but summarized again) was to quantify how much the mice deviates from solving a maze that they have been trained to solve.
In the first they injected amyloid beta aggregates into mouse brains and found that EPPS administered orally at 30 mg/kg and 100 mg/kg restores the ability of the mice to efficiently solve the maze.
Next they tested toxicity quantified the amount of EPPS that passes the brain/blood barrier. For toxicity they found no signs of toxicity at 2000 mg / kg (20x dosage). For blood/brain barrier, as you go up in blood concentration you should go up in brain concentration if there is a good penetration from blood to brain. If the barrier is high then you immediately get high blood and low brain concentrations. The point where there is no longer a significant increase in brain concentration when increasing blood concentration is used to determine effective dosage concentrations. They found that at 100 mg/kg they were starting to see increased blood/brain ratios so they targeted 10-100 mg/kg for the next study.
MAIN STUDY (which included identifying the dosage level) used mice that were engineered to "get Alzheimer's" starting around 5 months of age because they produce a human gene (transgenic) that is a precursor to form the AB plaques. This transgenic model is established and the mice showed the expected amyloid beta plaques and had difficulty solving the maze at 10.5 months as expected.
Starting at 10.5 months they gave oral doses of EPPS at 10 mg/kg and 30 mg/kg and monitored maze solving along with several additional tests: likelihood to freeze when presented with negative input (fear conditioning) and ability to find hidden platforms when swimming (water maze). Both tests improved significantly to the wild-type (no Alzheimer's) level when taking EPPS. They also did dose dependency at .1 1 and 10 mg/kg. There was a steady improvement at higher doses.
They also took slices of the mouse brain and tested whether or not the neurons responded differently to electrical stimulation. They found no difference in wild-type (WT, non-genetically altered) or transgenic (TG, altered) response to electrical stimulation with and without EPPS. This hints at no difference in neural activity with or without EPPS. They also gave EPPS to WT for the behavioral tests and did not see a difference (although that was not shown in the behavioral test figures).
They also took slices of the brain and stained them with a fluorescent dye to show the Alzheimer's associated plaques. There is a significant quantifiable reduction in plaques in the treated mice.
They used several other techniques to confirm that they were actually AB plaques and they disaggregated by a specific site of activity. I won't go into those specifics, but to say that this was a VERY well designed and executed study across multiple lines of inquiry and all of the lines of inquiry point to the same conclusion:
EPPS rescues hippocampus-dependent cognitive deficits in APP/PS1 mice by disaggregation of amyloid-b oligomers and plaques
And that's why it's a Nature article.
I'm think more in terms of computer simulation?
[1] https://duckduckgo.com/?q=ginkgo+biloba+alzheimer+site%3A.ed...
I'd take any health risks over dementia, personally, and I'm sure most would, too. Looking forward to the FDA blocking this on "safety" grounds.
2000mg/kg = 2, right?
Like 2kg of medicine for every one kg of body mass? That seems impossible to consume. Even 0.1 kg/kg seems really, really high.
Or is mg here used for micrograms rather than milligrams? So it's actually 2000 μg/kg.
It kind of scares me that people think they can buy untested chemicals online and self-medicate with them. But then again I'm not into the whole "Bath Salts" scene which is all about that.
It kind of scares me other people would presume to dictate what I can and can not put into my own body.
The diagramme showing how much memory is recovered is figure one. White is before the administration of the "Alzheimer's protein" (AB protein), black is without the new clearing chemical, blue is with it, and then the different blue columns showing different concentrations. Fig 1c is prophylactic treatment (clearing molecule administered before, during and after the AB protein), Fig 1d is clearing molecule administered alongside AB protein. The impairment seems to more or less recover fully back up to where it was originally, in all four combinations of timing and clearing molecule concentration.
But bear in mind:
* The mouse model for Alzheimer's seems to be very, very simplified - as far as I can see they literally inject big doses of these proteins directly into the brain in order to induce Alzheimer's like symptoms, that doesn't mean this is equivalent at all to the complex chemical processes underlying Alzheimer's. AB proteins are observed in Alzheimer's patients, but they are also observed in healthy patients, and other proteins are also seen in Alzheimer's patients, some of which are recently thought more likely to be the underlying driver of the disease.
* All of this occurs over a very short period of time. Someone who has developed symptoms of Alzheimer's will have had the disease process occurring for many years beforehand. Recovery a few days after administration of the protein doesn't mean that damage would be recoverable years later.
Edit: I'm actually just looking at the first experiment, they also do longer term trials with a mouse model which has been genetically altered to over-expresses the AB protein. Arguably this is still a very over-simplified model, but it does more to address the time question. They say Alzheimer's symptoms usually develop at 5 months, then they administer the clearing molecule at 10.5 months for 3 months. Those experiments shows about half the deficit being recovered relative to normal age-matched mice.
It's one of the major deficits in ADHD, to the extent that clarifies what the effects might be.
MARGARET
Let me ask you this...Red meat has been found to cause cancer in white rats. Maraschino cherries have been found to cause cancer in white rats. Cellular phones have been found to cause cancer in white rats. Has anyone examined the possibility that cancer might be hereditary in white rats?
DR. GRIFFITH
Let me tell you something, I'm not 100% sure we've ruled that out.
Source: Used to work in mouse research on addiction (alcohol, cocaine, nicotine, etc).
Edit: This link gives even more specifics on the similarity: https://www.genome.gov/10001345 -- 30% is probably accurate, but in terms of function, it's even higher.
Also bear in mind that mouse models are merely part of a large set of animal models that we use: https://en.wikipedia.org/wiki/List_of_model_organisms#Verteb...
http://www.businessinsider.com/scientists-make-old-mice-youn...
The real problem with medicine is that there's no easy way to have "agile" and rapid iteration in humans. Drugs, for example, take decades and billions to get to market.
Your core question is a good one and fundamentally raises the question of causality (which came first, the A-beta or Alzheimer's disease, AD? See ref. 1 for a 'simple' discussion).
Interesting evidence comes from people with genetic mutations that decrease the levels of the precursor to A-beta (the protein associated with Alzheimer's plaques). People with these mutations are less likely to develop AD, suggesting that A-beta is related to the root cause of AD. The OP supports this evidence, as removing A-beta plaques ameliorates some memory loss.
As a final, unrelated note, I don't know much dermatology but I haven't gotten the sense that our response to uroshiol is considered protective. Unlike A-beta, uroshiol is directly causative of its associated clinical symptoms[3].
1. http://www.mayoclinic.org/diseases-conditions/alzheimers-dis... 2. http://www.ncbi.nlm.nih.gov/pubmed/22801501 3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC294319/
What could possibly be worse? What are we seeing from non-Alzheimer sufferers that's so terrible? I don't think there's any evidence here that there's some benefit to it. Its a horrible disease.
My dad went from occasional forgetfulness to completely falling apart in less than two years. He would get lost routinely, couldn't remember names, had no idea what time or day it was, and developed sundown syndrome where once 6pm hit he completely went mad. He would be angry at nothing and scream at the mirror. He would rant and ramble about his past or strange conspiracy theories. Towards the end, he lived in some weird nightmarish state almost all the time. Sundown syndrome became his norm. He died of cancer before it progressed past that point, but man, this disease is not just losing memories. It pretty much destroys your brain and acute dementia has a link with immune system dysfunction, so it eventually kills you, usually by pneumonia.
I doubt there's any benefit. Evolution isn't this wonderful process. Its a lot of crap thrown at the wall and enjoying the stuff that works and dealing with what doesn't. There's no mastermind or clockmaker here. There are a lot of things that go wrong with human health that has no benefit.
Since dementia is a disease that happens at a late age, there doesn't need to be a reason why it is there. It happens a long time after reproduction, so its effect on evolution is minimal, worse it could even be evolved as a mechanism to curb older specimens in the species.
Average (arithmetic mean) life expectancy was a lot lower because it was heavily skewed by infant mortality. Up until very recently, many more babies died within their first few years of life. We've dramatically improved our ability to produce and distribute food and medicine, which has had a profound effect on infant survivability. But we haven't actually lengthened the average life expectancy of an adult who survives the first few years of childhood by all that much.
Point is, plenty of people have been living into their 70s, 80s, and 90s for as long as we've existed as a species. That said, the prevalance of diseases like Alzheimer's might be a fairly modern aberration, perhaps owing to lifestyle, environmental, and dietary factors.
> The dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer’s disease in older people
> The GEM study—the largest of its kind to date—was a randomized, double-blind, placebo-controlled clinical trial of 3,069 community-dwelling adults aged 72 to 96,
> Compared with placebo, ginkgo did not lessen cognitive decline. Researchers found no evidence of an effect on cognitive decline in general, or on memory, attention, visual-spatial construction, language, or executive functions. There were no differences by age, sex, race, education, or baseline cognitive status.
http://www.mayoclinic.org/diseases-conditions/alzheimers-dis...
It's pretty clear that Gingko DOES work. Low doses (120mg), don't. But that's why I linked to the plethora of research to look into the matter.
Finally, source four just makes me laugh because it's clear as day from UMM, that Gingko does work. Also, there are many many more sources that speak to the benefits of Gingko for cognitive repair and slowing down decay. Please don't limit this discussion to the five I listed, hence why I originally linked to search results.
Sources (with brief snippets of importance):
[1] http://www.ncbi.nlm.nih.gov/pubmed/26268332 "Ginkgo biloba is potentially beneficial for the improvement of cognitive function, activities of daily living, and global clinical assessment in patients with mild cognitive impairment or Alzheimer's disease."
[2] http://www.ncbi.nlm.nih.gov/pubmed/12244890 "Metaanalysis in the indication--demential disorders--comparing Ginkgo biloba versus acetylcholinesterase inhibitors have shown a similar clinical efficacy of both therapy regimens with an additional drug safety benefit for Ginkgo. Due to the clinical efficacy the WHO accepted Ginkgo biloba as an antidementiv drug and add it in January 2000 into the recent ATC-Classification Index."
[3] http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072541/ "The studies showed that people who took the higher dose of the ginkgo extract (240 mg per day) were better able to perform daily activities again, like doing household chores or washing themselves."
[4] http://umm.edu/health/medical/altmed/herb/ginkgo-biloba "Ginkgo is widely used in Europe for treating dementia. At first, doctors thought it helped because it improves blood flow to the brain. Now research suggests it may protect nerve cells that are damaged in Alzheimer disease. Several studies show that ginkgo has a positive effect on memory and thinking in people with Alzheimer disease or vascular dementia."
[5] http://www.ncbi.nlm.nih.gov/pubmed/12519586 "Overall there is promising evidence of improvement in cognition and function associated with Ginkgo. "
The way the media reports on research (not just medical) is really messed up.
The scientific community needs to get its own act together before criticizing the popular media. Few other scientific disciplines are less reliable than medical research, and even fewer are more important.
Might have something to do with wanting simple answers. I notice this happening on HN.
If I add a new post where it's a general science article I post both the general article and the original academic paper. HN readers choose the general over the technical article most times except when it comes to HN technical areas of interest. The level of reader understanding may influence article choice.
A lot of terminal people have, historically, had pretty terrible things done to them on the guise of "well they were going to die anyway!"
I for one welcome medical and academic oversight of experimental treatments. Terminal people are especially in need of protection as they will grasp to any hope no matter how slim or misguided.
But there have been some doozies in Korean science, especially the stem cell guy who really embarrassed and shamed his country with the extent of deception he practiced. Brilliant, but also crazy.
My point is that it was a generalization against korean scientists and a few instances is not representative of an entire group. Your point seems to be that the korean instances are somehow higher profile, but if that was the case then UK research science would be the worst because the vaccine/autism scandal has probably had the most far reaching after effects and infamy.
Also somewhat owing to the recognition of Alzheimer's as a disease state (coincident with amyloid beta plaques) rather than just part of "getting old". The difference between "more prevalent" and "better identified" is difficult to determine.
Correct, though largely (not entirely, but very largely) because the proportion of people living past age ~3 has skyrocketed. Correct for that factor, and our life expectancy is actually lower than it was in, say, mid-Victorian England.
(Note, as well, that I'm referring to life expectancy and not, say, the potential maximum human lifespan).
Have you worked on software for NASA Mars probes in the past?
2kg = 20000000mg.
Hope that clears that up.
No, 2000mg/kg = 0.002
> Like 2kg of medicine for every one kg of body mass?
No, 2g for every kg of body. And that's some safe limit, not therapeutic dose.
> Or is mg here used for micrograms rather than milligrams?
No, it's milligrams.
Ratio of U.S. to ROK scientists is about 6:1.[2]
OK, so # of scientists isn't 10:1. But in terms of scientific activity, the U.S. is far and away more productive.
1. http://www.scimagojr.com/countryrank.php 2. http://chartsbin.com/view/1124
It's almost as if you are saying that some fraud is to be expected and is therefore fine when actually any fraud is wrong.
Admittedly it seems like a bit of a gamble to just start popping drugs whether they've been studied or not, but people spend lots of money on "natural" supplements which are at least usually reasonably safe but are even less likely to work.
There's not much worse than having your mind die while your body is still alive.
Just to pick another unrelated chemical example that is well known, 30ml of methanol will kill you but 10ml will make you permanently blind.
How is this relevant?
People tend to vary wildly in choices and opinions. Who knew!?
But some people think their choice or opinion is somehow the "correct" one and should be imposed on everyone ;-)
I know there's very good reason to be wary of mouse models, but in cases (as this appears to be) where the physiological mechanism of disease is both (a) understood and (b) the same from mouse to human, a little less skepticism may be warranted.
We should be far more concerned about side-effects of a drug intended to treat acne or erectile dysfunction than for drugs targeting life destroyers such as cancer and Alzheimer's.
At some threshold of disease viciousness, society (and the FDA) should relax substantially on the risk-aversion, because the patient is already facing the worst-case scenario.
That said, regardless of whether or not they're proven/approved/tested, drugs are never magic bullets. The ones used to treat the most serious chronic diseases always come with serious risks and profound side-effects. I don't expect that to change anytime soon.
In the future, medical clinicians won't have to guess as much because adult stem cells can now be created from red blood cells, allowing personalized medication with a petri model of actual patient tissue, to screen problems like interactions and allergies before administration.
"Statins are beneficial, but some have questioned whether their benefits are due to their ability to lower cholesterol or to their anti-inflammatory effects, or both. There are two competing hypotheses, the LDL hypothesis and the statin hypothesis. A new study in The New England Journal of Medicine sheds some light on that controversy and tips the balance in favor of the LDL hypothesis."
https://www.sciencebasedmedicine.org/update-on-cholesterol-a...
For example, Ben Goldacre. He is cynical about 'Big Pharma', and has written about it in one of his books[0]. At the same time he appears to support efforts to open up private medical research -- he recently cofounded AllTrials[2] along with the BMJ, Cochrane, PLOS, and a few other high-profile reputable sources[3].
[0]: https://en.wikipedia.org/wiki/Bad_Pharma [1]: http://www.cochrane.org/ [2]: http://www.alltrials.net/ [3]: http://www.phc.ox.ac.uk/news/ben-goldacre-joins-oxford-unive...
It's also now possible to do clinically-useful testing of targeted treatments using genetically-edited control tissue cultures against unedited tissue cultures.
The point is that it's better to test something that is as close to the patient as possible, not guess with other species or even other people whom express genes differently.
FYI: making a new mouse models requires lots of chopping off heads of mice whom don't possess the desired gene. While transgenic, highly-edited living models might be nice, there's probably a more humane/simpler/reproducible way to do the exact same thing.
No they aren't. Transgenic mouse models are a $billion industry. We do not understand biological mechanisms nearly enough to not use live animal models. We are not even able to recreate single cell organisms with our level of knowledge and engineering.
>>FYI: making a new mouse models requires lots of chopping off heads of mice whom don't possess the desired gene. While transgenic, highly-edited living models might be nice, there's probably a more humane and simpler way to do the exact same thing.
Ah, the real root of your argument. Do you even know what the word humane means? I work in a labroatory and the animals are treated better than the people. Yes, a lot of mice are killed.. but for a reason. You say there's probably a simpler way to do the exact same thing, but there simply isn't. I wish more people were actually educated in this matter, but emotional responses tend to get more results.
This is a fair point, but the rest... well ... still manages to miss the above argument. Side-effects aren't observed in a vacuum, but efficacy is still observed in laboratory conditions, so we really can't comment on whether (or how) this molecule affects other systems.
While there are some drugs that are clearly effective, there are big problems in Big Pharma's approach to clinical trials, including burying half the trials' results and poor experiment design. And once a drug makes it to market, expanding that market without testing becomes a priority. Do you think Risperdal was a one-off, or is it a representative case study of how drugs are marketed by at least a major part of Big Pharma?
But if the animals in question are not part of the study at all, I don't see how it matters much. Maybe there's a little mouse guillotine. Maybe one person on the team owns a reptile pet that is very well fed. The reason why rodent models are used in the first place is that they're mammals, easy to care for, breed, and handle, and no one really cares if they die by the millions.
If they were outside the lab, they would likely get poisoned or crushed by snap traps. (That's better than what a cat would do.) Cuteness won't save you from my wrath if you eat my food and then poop in whatever you left behind. At least the ones that died in the labs had real jobs, instead of living hedonistic freeloader lifestyles inside someone else's couch.
But regardless, you're rationalizing your own biases and agendas on outdated techniques and racing to the bottom with a disrespectful, ad hominem approach. How pleasant and humane of you. Maybe you should look to the future instead of attacking what isn't in your narrow focus, because you come across as a troll.
Watch this, and learn something: https://youtu.be/ilVjSnE5t44