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t m c » p u l s e | a u g u s t 2 0 1 9 24 Multifaceted problem, multidisciplinary solution One of the most exciting developments in Alzheimer's research has been identifying biomarkers in the brain, blood, urine and cerebrospinal fluid proteins that detect the disease before symptoms manifest. Currently, Alzheimer's patients are diag- nosed based on signs and symptoms of cognitive decline, but by that point, the disease has already been destroying brain tissue for decades. "Identifying the Alzheimer's pathology years before the onset of the clinical symptoms is really a huge advance- ment," said Eliezer Masliah, M.D., director of the Division of Neuroscience at the National Institute on Aging (NIA). Researchers are also working on developing vaccines to prevent Alzheimer's. At the University of New Mexico, scien- tists recently engineered a drug using virus-like particles that eliminate tau tangles in mouse models. At Harvard Medical School, Cynthia A. Lemere, Ph.D., is working on an amyloid- targeting vaccine to prevent the disease. However, because the scientific community has not yet reached a consensus on the precise pathology and causes of Alzheimer's, it's unlikely that a vaccine will become a reality anytime soon, said Jim Ray, Ph.D., head of the Neurodegeneration Consortium at The University of Texas MD Anderson Cancer Center's Institute for Applied Cancer Science. Instead of searching for a vaccine, Ray and his lab are work- ing on a number of drug discovery projects focused on neuroin- flammation and promoting a beneficial immune response in the brain. "The brain has its own private immune system, separate from the blood-borne system that protects the rest of the body, and the cells that safeguard the brain are called microglia," Ray explained. "As we have begun to understand what genes lead Alzheimer's to run in families, we have identified a whole new slate of genetic risk factors. These new genes almost entirely map onto the microglia of the brain. We're learning that the microglia reaction to the aging of the brain must be appropriate or there is a risk that Alzheimer's pathology will take hold and begin to spread." In addition to genetics, a growing body of Alzheimer's research has shown that lifestyle factors—physical, social and mental activity—may play a key role in reducing the risk of cognitive decline. "One of the reasons we're looking at lifestyle changes is because Alzheimer's disease occurs over a continuum," said