Clue to Alzheimer’s Found in Brain Samples
For years, researchers have focused on the presence of amyloid plaques in the brain as a telltale sign of Alzheimer’s disease. However, some people who have the plaques do not develop the memory loss and cognitive problems seen in Alzheimer’s patients.
Researchers at Washington University School of Medicine think that smaller molecules of amyloid beta dissolved in the brain fluid appear more closely correlated with whether a person develops symptoms of dementia. Called amyloid beta ‘oligomers,’ they contain more than a single molecule of amyloid beta, but not so many that they form a plaque. In a recently published study, doctors found that cognitively normal patients with plaques and Alzheimer’s patients both had the same amount of plaque, but the Alzheimer’s patients had much higher oligomer levels.
“The plaques and oligomers appear to be in some kind of equilibrium,” says Dr. David Brody, associate professor of neurology. “What happens to shift the relationship between the oligomers and plaques? Like much Alzheimer’s research, this study raises more questions than it answers. But it’s an important next piece of the puzzle.”
SLU Studies Ritalin for Alzheimer’s Disease Patients with Apathy, Fall Risk
In other Alzheimer’s news, Saint Louis University researchers are studying the use of Ritalin—the commonly prescribed drug for attention deficit hyperactivity disorder—in Alzheimer’s patients who exhibit apathy or are at risk of falling.
“Apathy has a remarkable impact on a patient's functional impairment and may increase the risk of falls,” says Dr. Ahmed Baig, a co-investigator. “Falls are the leading cause of serious injury and death in the elderly.”
Researchers will study the efficacy of Ritalin because it is known to improve function in particular areas of the brain that are involved in the process of concentration, walking, balance and apathy. In previous studies, the use of low doses of this medication has been established as safe and well-tolerated in the elderly.
Major Alzheimer’s Disease Prevention Trial Set to Begin
While the causes and treatment of Alzheimer’s are important research topics, prevention is the ultimate goal. Researchers at Washington University School of Medicine are preparing to test the first potentially preventive drug therapies. In people with inherited mutations that cause early-onset Alzheimer’s, the study will seek to identify whether the drugs can improve Alzheimer’s disease biomarkers and effectively prevent the loss of cognitive function.
The trial will be conducted by the Dominantly Inherited Alzheimer’s Network Trials Unit (DIAN TU) at Washington University. The trials unit is supported by the DIAN, a National Institutes of Health-funded collaboration of world-leading Alzheimer’s research centers; the Alzheimer’s Association; and the DIAN Pharma Consortium, composed of 10 pharmaceutical companies that have been advising DIAN researchers on the planning of the trial.
Each drug chosen for the trial has a unique approach to counter the toxic effects of amyloid beta, the main ingredient of brain plaques found in Alzheimer’s patients. Each also has passed earlier clinical trials that evaluated safety and effectiveness of the drugs and whether they engaged their targets in patients.
Researchers Set to Explore the Effects of Concussions
Washington University researchers’ studies of the brain extend beyond Alzheimer’s disease. Dr. David Brody, associate professor of neurology, is beginning a study of the brain following repeat concussions. The project is one of 15 around the country selected by NFL Charities, the charitable foundation of the National Football League Owners.
The study will use a type of magnetic resonance imaging (MRI) to measure damage in the brain’s white matter after repetitive concussive brain injury. The white matter consists primarily of long nerve cell extensions called axons that serve as the brain’s wiring system.
Brody and his research team hope a better understanding of the effects of repetitive concussive brain injuries will lead to new preventive and treatment strategies.
Researchers Work to Improve Safety of Stem-Cell Transplants
Scientists at Washington University are working to improve the safety of stem-cell transplants used to treat people who have recurrent leukemia.
About 50 percent of leukemia patients who receive stem cells from another person develop graft-versus-host disease, a condition where donor immune cells attack the patient’s own body. The main organs affected are the skin, liver and gut. Now, the scientists have shown they can redirect donor immune cells away from these vital organs. Steering immune cells away from healthy tissue also leaves more of them available for their intended purpose: killing cancer cells.
“This is the first example of reducing graft-versus-host disease not by killing the T- cells, but simply by altering how they circulate and traffic,” says Dr. John DiPersio, the Virginia E. and Sam J. Golman Professor of Medicine. “Donor T-cells do good things in terms of eliminating the recipient’s leukemia, but they can also attack normal tissues leading to death in a number of patients. The goal is to minimize graft-versus-host disease, while maintaining the therapeutic graft-versus-leukemia effect.”
Resveratrol Supplementation Shows No Benefit in Healthy Women
When the news first broke that red wine contained a substance that could reduce cardio-vascular risk and improve insulin sensitivity, people toasted to their health. But in a new study, Washington University researchers have found that the substance, resveratrol, does not appear to offer these benefits in healthy women.
“Resveratrol supplements have become popular because studies in cell systems and rodents show that resveratrol can improve metabolic function and prevent or reverse certain health problems like diabetes, heart disease and even cancer,” says senior investigator Dr. Samuel Klein, director of Washington University’s Center for Human Nutrition. “But our data demonstrate that resveratrol supplementation does not have metabolic benefits in relatively healthy, middle-aged women.”
However, red wine drinkers may not be out of luck. “The purpose of our study was not to identify the active ingredient in red wine that improves health but to determine whether supplementation with resveratrol has independent, metabolic effects in relatively healthy people,” Klein says. “We were unable to detect a metabolic benefit of resveratrol supplementation in our study population, but this does not preclude the possibility that resveratrol could have a synergistic effect when combined with other compounds in red wine.”
Researchers Seek to Better Understand Life-Threatening Liver Disease
Researchers at Saint Louis University are preparing to investigate the natural history and progression of Alpha-1 Antitrypsin Deficiency, an inherited disease that can cause liver damage in children, as well as adults.
"Alpha-1 can cause life-threatening liver disease, and even cancer in some patients. But we can't predict in which patients it will develop or how fast liver damage will progress if it occurs," says Dr. Jeffrey Teckman, professor of pediatrics and biochemistry and molecular biology, and director of the division of gastroenterology and hepatology at SSM Cardinal Glennon Children's Medical Center. "This study will be helpful to understand how quickly it gets worse and what will be the science behind understanding that process."
Mobile Apps Make Reading Fun for Children with Dyslexia
Mobile apps and daily visual activities can encourage children with dyslexia to participate in reading exercises, says Lenin Grajo, instructor of occupational science and occupational therapy at Saint Louis University. “Reading has always been looked at as a skill you should be able to master,” Grajo says. “My approach focuses on participation. I look at how much you like doing a task, rather than how well you can do it.”
Kids with dyslexia have started using fun, interactive tablet and smartphone apps. “This is the multisensory approach that makes books very interactive,” said Grajo, who got his training in assessment of dyslexia and reading difficulties at Harvard University. “If you ask a child with dyslexia to read a book, they will say they can’t. But through these apps, children actually like doing these reading activities.”
The apps and routine activities form a strong foundation for dyslexic children, which enable them to develop their own strategies to read and write as they begin to like these activities.
“Once they are confident, they feel they can do these tasks without the help of a parent or teacher,” Grajo says. “As therapists, we are empowering and enabling them to be able to do what they couldn’t do earlier.”
Using Early Detection and Intervention to Reduce Sepsis and Septic Shock Deaths
Cases of an aggressive and life-threatening form of bacterial infection, known as sepsis, are declining at Mercy in St. Louis due to early recognition and intervention to stop the infection from progressing.
“If you don’t identify and treat sepsis quickly, it becomes untreatable and deadly,” says Dr. Robert Taylor, a Mercy critical care physician who has researched sepsis for almost two decades. “If we intervene early, we can dramatically improve the patient’s condition in a short period of time. As clinicians, we have the ability and the responsibility to turn this tide.”
During a nine-month period, Mercy closely tracked six specific patient ‘elements’ via a robust integrated electronic health record and by using Mercy SafeWatch—one of the largest electronic intensive care units (ICU) in the nation, which is wired to provide 24-hour vigilance to critically ill patients. With successful outcomes in reducing sepsis and septic shock, the program will be shared with more than 300 communities Mercy serves in Arkansas, Kansas, Missouri and Oklahoma.
SLU Researchers Study New Pneumonia Vaccine
Saint Louis University is participating in a multi-site, National Institutes of Health-sponsored clinical trial in older adults of a new vaccine designed to protect against one of the most common types of pneumonia and related diseases such as bloodstream infections and meningitis.
“We need to protect people against pneumococcal pneumonia. It’s a very nasty illness and can sometimes be fatal,” says Sarah George, the investigator of this trial at SLU’s Center for Vaccine Development. “As you get older, your immune system ages and you are at higher risk of getting pneumonia. And if you get pneumonia, you are at higher risk of being hospitalized or severely ill.”
A new pneumonia vaccine is better at preventing pneumonia if you haven’t had the old vaccine, George says. “We don’t know the best way of using the new vaccine effectively in people who received the old vaccine. We’re trying to find out what is the right dose of the new vaccine for people who already had the old vaccine.”