Maybe Alzheimer’s isn’t a Brain Disease?

So I guess you saw that latest failure of an Alzheimer’s drug (verubecestat from Merck)?

Scratch yet another Phase III Alzheimer’s drug hopeful. Of 244 drugs tried out for Alzheimer’s between 2002 and 2012, only one was approved and it is of tiny effectiveness anyway. It’s got a 99.6% failure rate in this area.

As you probably know, the reigning thesis is that Alzheimer’s is caused by plaque. All of these drugs had plaque elimination as the target. Hmmm, a 99.6% failure rate suggests that everyone is totally wrong. How can so many smart people be spending so much money on drugs to attack this target in the face of such continuing massive failures?

Doesn’t this sound like the definition of insanity – continuing to do the same thing again and again and to expect a different result?

This reminds me of another famous case of medical group-think. Remember the unknown Australian family doctor (Dr. Barry Marshall) who suggested in the 1980s that stomach ulcers were not due to stress and the overproduction of gastric acid, but in fact caused by a bacterium, h. pylori? The US medical establishment rejected that finding for some 10 years before finally deciding he was right (they had no choice because the ulcers were found to go away once you eliminated the bacterium with antibiotics).

BTW the same Dr. Barry Marshall later went on to receive a Nobel for his discovery. Just shows you right?

Is Alzheimer's and the misguided focus on plaque yet another tragic case of group-think in the medical profession?

Alzheimer’s researchers are now starting to wake up so they’re focusing on a new target, namely tangles of tau. Maybe this time they’re right. But what if they’re not? Another 20 years of fruitless research with millions more people having contracted Alzheimer’s, destroying innumerable families in the process?

So I can’t be suggesting there’s an explanation out there that everyone has missed, can I? I mean, surely if there were a good one, the medical profession would have jumped on it right? Hmmm, like they didn’t with stomach ulcers?

Yep, there is one. I’m not saying it’s right mind you. I’m just saying that there’s one which has been suggested by the alt-medicals that seems cogent but has been ignored by the establishment.

The thesis is that Alzheimer’s is actually a form of diabetes. The respected UK science journal, “The New Scientist” has published several articles on this theory over the past few years, see this one for example “Are Alzheimer’s and diabetes the same disease??” Yep, you got it right; the idea is that it’s a different form of common diabetes. It’s associated with glucose metabolism that has gone wrong. So it’s being called diabetes type 3.

In other words, in this telling, Alzheimer’s isn’t a disease of the brain. It’s a disease of the entire metabolism. The brain is just collateral damage. Maybe that explains why people taking drugs that remove plaque have no impact on improving cognition.

And now even the popular press is hopping on the bandwagon, as you can see from this article in the New York Times. So it’s not as if this is a crazy idea from the alt-right or the UFO crowd. So why aren’t the medical researchers doing it? It’s not as if they’re so successful so far that they can ignore out-of-the-box ideas right?

And while I’m about it, I’ve got another beef. It’s that everyone in the world seems to think that the brain is composed of neurons, and that’s one of the reasons Alzheimer’s researchers have focused on plaques gumming up neurons.

Ever heard of glial cells? They are also in the brain. The irony is although we know there are a lot of them; we still don’t know what the ratio of glial cells is to neurons. It used to be thought it was up to 10 times as many glial cells as neurons. The latest estimates are 1:1, but actually we don’t know.

We don’t even understand what the glial cells really do. The prevailing thesis is that they just mop up the wastes that the brain creates in its operations. But maybe they actually play a role in thinking and cognition. Again we don’t know.

Now where’s this going? Well, for a start, are glial cells somehow involved in Alzheimer’s? Do they get affected too? If so, how? Etc., etc. Sure would be nice to know. Maybe that’s something else we are missing in the war on Alzheimer’s.

BTW when I had a stomach ulcer in the 1980s I took standard Zantac as recommended by my local family doctor. It didn’t work. Being Australian (well, before I became American, that is) I had read about Dr.  Marshall and thought it was worth a shot since my GP had no other ideas. It worked immediately.

I told my GP about it. He told me it was all B/S.

For good measure he also told me there was no way an Australian country doctor could find an explanation and a cure for stomach ulcers that the entire US medical research establishment hadn’t been able to find.

That’s what I think about when I think of the lack of progress on Alzheimer’s and diabetes type 3.