Precision medicine in Alzheimer's disease -- tailoring prevention and treatment to a patient's unique risk profile -- surfaced as a key theme at the NIH National Institute on Aging (NIA) .
"Alzheimer's disease is a heterogeneous disorder. We are learning more about genetic and environmental risk factors, and we need to start differentiating Alzheimer's patients based on genetics, environmental exposure, and clinical history," Eliezer Masliah, MD, head of the NIA neuroscience division, told 51˶."This might be more effective than a one-size-fits-all type of approach, which is where we are right now."
At the summit, experts from government, academic institutions, industry, and non-profit organizations proposed to guide future research in Alzheimer's disease and related dementias, building on previous frameworks that had been developed in and .
"This is a critical time in Alzheimer's research, with new opportunities to build upon what we have learned," said Richard J. Hodes, MD, NIA director, in a statement. "We must continue to foster creative approaches that leverage emerging scientific and technological advances, establish robust translational infrastructure for rapid and broad sharing of data and research tools, and work with funding partners and other stakeholders to cultivate and sustain an open science research ecosystem."
The summit emphasized a "big push to understand people with Alzheimer's in a multidimensional way" and focused on research to develop new therapeutic targets, Masliah said. "There's been an overemphasis in the past on targeting amyloid beta protein and tau. Now we are funding research in a gamut of targets in 140 Alzheimer's clinical trials."
At the meeting, experts discussed research about neurotrophic growth factor (NGF), brain-derived neurotrophic factor (BDNF) gene therapy, the neuroprotective effects of allopregnanolone, the brain-gut microbiota axis in Alzheimer's, and research about the and cognitive decline, as well as the of exercise in people with mild memory problems.
Researchers also examined new research about the environment and neurotoxicants. "For a long time we have been hearing about heavy metals, but now there is more evidence that shows air pollution may be linked to increased risk of cognitive impairment," Masliah said.
The summit recommendations have been adopted by the , and will be used to update in the . The recommendations included developing a better understanding of Alzheimer's causes, enabling precision medicine research, improving the research infrastructure, supporting novel therapeutics, and building a new research ecosystem based on open science.
The key to developing precision medicine in Alzheimer's disease will be data sharing, Masliah noted. To understand Alzheimer's in a multidimensional way requires more than "one person working in isolation in a lab," he said. "We need tremendous sharing of data among many, many different groups according to precision medicine ideals. Open access is a very important component."