Diagnostics
PET scans are often used to diagnose Alzheimer’s disease, but they’re expensive for hospitals to run and less available in developing countries.
(PET) are used to diagnose Alzheimer’s disease and monitor its progression. As the disease can evolve slowly over many years, early detection can allow patients and their families to plan future care. While these tests are effective, they can take many months and eat up valuable healthcare resources – CSF testing and PET scans, for instance, are expensive to run, meaning accessing them can be difficult through some country’s healthcare systems.
A blood bond
The spotlight has fallen on blood-based biomarker tests that could remove some of the complexity surrounding an Alzheimer’s diagnosis, improving accuracy, reducing cost and cutting timelines for detection. Hannah Churchill, research communications manager at UK charity the Alzheimer’s Society, says that simple blood-based tests could one day be used to confirm the presence of disease-related proteins in the brain. Unlike PET scans, a blood test could be used at the point of first contact with primary care or GPs, without the need for scans using radiography devices. Dr Rosa Sancho, head of research at Alzheimer’s Research UK, agrees that biomarkers are reshaping the Alzheimer’s research landscape. “We might still be a long way from a single standard of dementia diagnosis, however, research on biomarkers to date has in turn given us a far greater understanding of the diseases that cause dementia and will help shape future drug development and more effective clinical trials,” she says. In particular, there has been a focus on what are known as the hallmark Alzheimer’s proteins, amyloid beta and tau. Crucially, blood tests that home in on these and other markers appear to offer a significant advantage in their ability to detect a build-up of proteins linked to Alzheimer’s years – even decades – before symptoms emerge.
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The research in this field is collaborative and global. Promising results have come from Washington University in St Louis, where researchers have developed a blood test that measures levels of amyloid beta proteins that misfold and clump together, forming aggregates called “oligomers”. These oligomers provide an early indication of Alzheimer's disease. Amyloid beta folding is also a focus for a network of researchers led by the German Cancer Research Centre. Another study came out of the Karolinska Institutet in Stockholm and showed that a protein called GFAP (glial fibrillary acidic protein) – a presumed biomarker for activated immune cells in the brain – can provide an early indication of Alzheimer’s. GFAP is also an area of research for Dr Lisa Vermunt and her colleagues at the Clinical Chemistry and Alzheimer Center Amsterdam at Amsterdam University Medical Centers in the Netherlands, whose paper on GFAP in autosomal dominant Alzheimer's disease was recently published in the journal Alzheimer’s & Dementia.
“We may still be a long way from a single standard of dementia diagnosis, but research on biomarkers has given us a better understanding of the diseases that cause dementia.”
Dr Rosa Sancho, head of research at Alzheimers Research UK
Long time coming Dr Vermunt says the fast-paced nature of blood- based Alzheimer’s diagnostics right now is the result of a marriage of science, technology and many decades’ worth of accumulated data. “I think the main reason for this growth is technological advancement,” she says, adding that scientists now have access to long data sets that are accelerating
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