Alzheimer's & Dementia

Scientists uncover new pathway of Alzheimer’s disease progression

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Scientists have found that within the brain's white matter, which is made up of myelinated axons, a specific kind of cell death can accelerate cognitive decline
Scientists have found that within the brain's white matter, which is made up of myelinated axons, a specific kind of cell death can accelerate cognitive decline
Dr Stephen Back, left, and Philip Adeniyi discovered that microglia degenerates in the white matter of the brain of patients with Alzheimer’s disease and vascular dementia

Christine Torres Hicks/OHSU

Scientists have discovered how a unique kind of cell death, due to iron toxicity, creates a snowball effect that advances cognitive decline. With this finding, a whole new approach to treatment could be developed.

In the study, Oregon Health & Science University (OHSU) researchers have for the first time identified how ferroptosis, a type of cell death caused by a buildup of iron, destroys the brain’s immune cells in Alzheimer’s disease and vascular dementia.

“This is a major finding,” said senior author Dr Stephen Back, neuroscientist and professor of pediatrics in the OHSU School of Medicine.

Looking at post-mortem brain tissue from dementia patients, the team found that these immune cells, microglia, were being killed while trying to go about their routine business of cleaning out debris. However, in this case, the debris is made from pieces of iron-rich myelin, which forms the protective layer around nerves that can get damaged and break down during neurological distress. This triggers ferroptosis, or the death of the first-responder microglia cells, in the brain’s white matter.

“Everyone knows that microglia are activated to mediate inflammation,” Dr Back said. “But no-one knew that they were dying in such large numbers. It’s just amazing that we missed this until now.”

Dr Stephen Back, left, and Philip Adeniyi discovered that microglia degenerates in the white matter of the brain of patients with Alzheimer’s disease and vascular dementia

Christine Torres Hicks/OHSU

While suppressing ferroptosis has been tabled as a target for Alzheimer’s before, these new insights have huge potential for new therapeutics to slow the progression of neurodegenerative diseases.

“We’ve missed a major form of cell death in Alzheimer’s disease and vascular dementia,” Dr Back said. “We hadn’t been giving much attention to microglia as vulnerable cells, and white matter injury in the brain has received relatively little attention.”

The researchers believe their findings should point drug companies in the direction of developing compounds that limit microglial degeneration.

“That’s where the field will go next,” he said. “A discovery like ours will stimulate a lot of excitement in the pharmaceutical industry to develop therapeutically important compounds.”

They also note that intervention is key; cognitive decline is a slow road that usually begins after a period of low blood flow and oxygen to the brain due to stroke or chronic conditions like hypertension and diabetes.

“Dementia is a process that goes on for years and years,” Dr Back said. “We have to tackle this from the early days to have an impact so that it doesn’t spin out of control.”

The study was published in the journal Annals of Neurology.

Source: Oregon Health and Science University (OHSU) 

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2 comments
guzmanchinky
Well, I'm 53 and my mother died from dementia at 80 a few years ago so I am hoping this leads to better treatments soon...
Kpar
Iron toxicity, huh? I note this with interest, as it has been shown in studies decades ago, that regular blood donors have HALF the heart attack rate on non-donors. It was noticed that pre-menopausal women also have half the heart attack rate as men of comparable ages, but, after menopause, the rate for women is the same as the men. Then they looked at the rates for donors- men who donated regularly had the same rate as pre-menopausal women, and post-menopausal women who gave blood did not change their rate.

It gives the phrase "doing well, while doing good" a whole new meaning. I wonder if subsequent studies show that this might work to prevent Alzheimer's as well?