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Alzheimer's Cure Elusive Despite Progress

Ronald Reagan's struggle shows how far we've come, how far we have to go.
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WebMD Feature

Former President Reagan's long struggle with Alzheimer's disease is over at last. But his fight continues.

Sadly, Alzheimer's disease can't yet be cured. Not even for the strongest women and men. Not even with the best medical care on earth. Yet medical progress offers more reason for hope than for despair.

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"A world without Alzheimer's disease ... is within our reach," says Sheldon Goldberg, president of the Alzheimer's Association, in a news release mourning Reagan's death.

Anyone who's followed the Reagan family's ordeal -- and that of America's 4.5 million other Alzheimer's patients -- knows what the disease looks like. People affected by Alzheimer's gradually lose their memories. They become disoriented and confused. Their ability to reason or even to think is affected.

What's happening is that brain cells are losing their connection to other brain cells and die. It's not entirely clear why. Thick plaques of a protein called amyloid clog the brain, and brain fibers become hopelessly tangled.

Is amyloid the cause of Alzheimer's disease or the effect of a deeper process? There's only one way to find out: Get rid of the gunk and see whether Alzheimer's patients get better.

A Glimpse of the Future of Alzheimer's

Getting rid of plaque seems like a pipe dream. But that's just what happened to some of the patients enrolled in a clinical trial of an anti-plaque vaccine.

The trial had to be stopped because one in 20 subjects developed life-threatening swelling of the brain. But when some of these subjects died of other causes, autopsies showed something nobody had ever seen before.

"It really does look like this treatment is removing amyloid plaque from the brain," Bill Theis, PhD, recently told WebMD. "In other reports, the people in the trial who made more anti-plaque antibodies had more maintenance of memory function."

Theis, Alzheimer's Association vice president for medical and scientific affairs, promises that this July we'll hear more about the results of this extraordinary trial during the association's annual meeting. However, it's unlikely that the vaccine itself will ever be a realistic Alzheimer's treatment unless somebody figures out how to eliminate its deadly side effects.

Nevertheless, the study results -- and findings from animal studies -- strongly suggest that it's a good idea to attack plaque, says Sam Gandy, MD, PhD, director of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia.

"I am pretty convinced amyloid is bad even if it is true that another insult is more commonly the initiating factor," Gandy tells WebMD. "I feel confident that removing amyloid is a good idea."

Tomorrow's Plaque Fighters

Gandy says that scientists are in hot pursuit of three anti-amyloid ideas.

First is the anti-plaque antibody approach. Using a vaccine and allowing the body to make antibodies seems too dangerous. But what if you could raise plaque-busting antibodies in the laboratory? Theoretically, you then could find a dose that cuts plaque without killing the patient.

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