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A guest post by Indiana Lee
Neurodegenerative diseases have baffled and
frustrated researchers and clinicians alike for decades. Despite prodigious
advances in medical and biological science, Alzheimer’s Disease and related
dementias have defied the experts’ staunchest efforts to understand the
etiology of the disease or to intervene in its progression.

And that has meant that, for far too long,
there had been devastatingly few options for victims, families, and healthcare
providers. For too many years, patients, families, clinicians, and researchers
had been largely powerless in the face of the mysterious and merciless
adversary.
But that is changing. Every day, our
understanding of progressive dementias grows. At any given moment, new and
better diagnostic strategies are emerging. Now more than ever, we have an array
of treatment options to slow the cognitive decline — and countless more are
currently under development.
And that means that, though Alzheimer’s
remains a fearsome nemesis, there is hope on the horizon, with an army of
researchers leading the way.
An Understanding of Origins
Among the most exciting domains of Alzheimer’s
research, today is in the field of microbiology. A growing body of research is
supporting, and describing, the microbial mechanisms at work in the brains of
patients with Alzheimer’s and other dementias.

Of particular interest is the role of gut
bacteria in the progression of neurodegenerative diseases. According to recent research from the Human Microbiology
Institute, bacteriophages, which are viruses that invade and
replicate inside bacteria, appear to be implicated in the etiology of
Alzheimer’s and related diseases.
These findings also seem to align with studies
that have found that specific soy metabolites created by certain types of gut
bacteria are strongly associated with fewer white matter lesions in
the aging human brain. It is possible, therefore, that in the future,
clinicians may be able to evaluate patients’ gut biome to assess their level of
disease risk and perhaps even to intervene through dietary or pharmaceutical
means.
However, it’s not only gut bacteria that seem
to play a role. Research suggests that oral bacteria are also likely to contribute to
neurodegenerative disorders, especially in those with a genetic predisposition
to such diseases. Bacteria associated with gum disease, for example, are
strongly associated with increased levels of inflammation, which can be
damaging to the brain’s vascular system and may also contribute to the
formation of plaques in the brain. Additionally, these oral bacteria are also
highly likely to infiltrate the brain via the mouth’s circulatory system.
An Ounce of Prevention
This enhanced understanding of the complex
etiology of Alzheimer’s and related dementias is, of course, fundamental to our
efforts to mitigate risk factors and prevent or delay the onset of disease. For
example, maintaining excellent oral health can be an important tool
for avoiding pathological cognitive decline. Good, consistent oral care and the
early treatment of periodontal disease, studies suggest, are especially important to the formation
and proliferation of bacteria that can damage the brain.
Gene therapy is also proving to hold immense
promise both for prevention and for the treatment of these disorders. For
example, activation of p38gamma has been shown to significantly
improve enzymatic memory. This, some studies suggest, may not only slow disease
progression but may even reverse even severe memory loss.
Treatments on the Horizon
One of the greatest and most heartbreaking
frustrations of neurodegenerative diseases like Alzheimer’s has been the
appalling lack of effective treatment options for so many years. As our
understanding of the origins and progression of these disorders grow, however,
so too do the number of weapons in our arsenal.
In addition to gene therapies, managing the gut microbiome,
and ensuring superb oral health, there are also a rapidly growing number of sophisticated
and effective therapies. Most importantly, for the first time, emerging
therapies are increasingly capable not only of treating disease symptoms but of
slowing and mitigating disease evolution.
For example, therapies are being developed to prevent
the formation of beta-amyloid plaques using a range of targeted
therapies. These include the use of monoclonal antibodies to harness the power
of the immune system to clear plaques from the brain, or the deployment of Fyn
proteins to improve synaptic function.
In conjunction with the therapeutic approach,
research is demonstrating the efficacy of a more holistic strategy. Lifestyle management that centers on the
integration of diet, exercise, sleep, social interaction, and cognitive
stimulation is highly effective in reducing symptoms and delaying disease
progression.
The Takeaway
Neurodegenerative diseases are among the most
feared and tragic of human ailments. And what makes it even worse, perhaps, is
that for far too long there had been precious little that anyone could do about
it. There is, however, significant hope on the horizon. As our understanding of
the etiology and progression of these dreaded diseases grow, so too does our
ability to delay, prevent, mitigate, and even reverse their effects. And that
means that there may well soon come a day when no family is forced to face this
long goodbye.