In recent debate over the FDA’s approval of the Alzheimer’s drug aducanumab, we’ve heard a lot about the “amyloid hypothesis.” In that context, it’s refreshing to learn about a model of Alzheimer’s neurodegeneration that doesn’t start with the pathogenic proteins amyloid or Tau.
Instead, a new paper in Alzheimer’s & Dementia from Emory neuroscientist Shan Ping Yu and colleagues focuses on an unusual member of the family of NMDA receptors, signaling molecules that are critical for learning and memory. Their findings contain leads for additional research on Alzheimer’s, including drugs that are already FDA-approved that could be used preventively, and genes to look at for risk factors.
“It’s not just another rodent model of Alzheimer’s,” Yu says. “We are emphasizing a different set of mechanisms leading to neurodegeneration.”
Iâ€™d like to highlight a paper in PLOS One from anesthesiologists Shan Ping Yu and Ling Weiâ€™s group that was published earlier this year. [Sorry for missing it then!] They are investigating potential therapies for stroke, long a frustrating area of clinical research. The â€œclot-bustingâ€ drug tPA remains the only FDA-approved therapy, despite decades of work on potential neuroprotective agents.
Yuâ€™s team takes a different tactic. They seek to bolster the brainâ€™s recovery powers after stroke by mobilizing endogenous progenitor cells. I will call this approach â€œstem cells lite.â€
PTH appears to encourage new neurons in recovery in a mouse model of ischemicÂ stroke. Green = recent cell division, red = neuronal marker
It is similar to that taken by cardiologistÂ Arshed Quyyumi and colleagues with peripheral artery disease: use a growthÂ factorÂ (GM-CSF), which is usually employed for another purpose, to get the bodyâ€™s own regenerative agents to emerge from the bone marrow.
In this case, Yuâ€™s team wasÂ using parathyroid hormone (PTH), which is an FDA-approved treatment for osteoporosis. They administered it, beginning one hour after loss of blood flow, in a mouse model of ischemic stroke. They foundÂ that daily treatment with PTH spurs production of endogenousÂ regenerative factors in the stroke-affected area of the brain. They observed both increased new neuron formation and sensorimotor functional recovery. However, PTH does not pass through the blood-brain barrier and does not change the size of the stroke-affected area, the researchers found.
The conclusion of the paper hints at their next steps:
As this is the first report on this PTH therapy for ischemic stroke for the demonstration of the efficacy and feasibility, PTH treatment was initiated at 1 hr after stroke followed by repeated administrations for 6 days. We expect that even more delayed treatment of PTH, e.g. several hrs after stroke, can be beneficial in promoting chronic angiogenesis and other tissue repair processes. This possibility, however, remains to be further evaluated in a more translational investigation.