February 15, 2008
A patient with Alzheimer's disease showed a clearer mind within minutes of receiving injections of an arthritis drug, according to a case report that appeared in the medical journal Neuroinflammation. The patient, an elderly physician, was able to walk better and showed clearer thinking after the treatment. The findings were reported by doctors at the University of Arkansas Medical Services and the University of California, Los Angeles.
A small 2006 study of 15 patients from the same research team indicated that the drug, known as Enbrel (also called etanercept), may have some benefits for easing symptoms of Alzheimer's. Those results, while promising, were not as dramatic as the current case report.
The case received a lot of attention in television reports, sparking hopes of a new and even miraculous-seeming Alzheimer's cure. However, it's important to note that this was a single case report involving one patient. Further testing on large groups of patients will be needed to determine if the drug, an inflammation-fighting remedy sometimes prescribed for severe forms of rheumatoid arthritis and other conditions, is truly safe and effective over the long haul for treating Alzheimer's.
Over the years, many news reports have touted the apparent effectiveness of a new Alzheimer's drug. All too often, hopes of a breakthrough are dashed with follow-up testing.
In this latest treatment, doctors injected Enbrel into the base of the neck, where it could seep into the cerebrospinal fluid that bathes the brain and spinal cord. The researchers speculate that the drug may fight inflammation and act to diminish levels of a natural brain chemical called tumor necrosis factor alpha, or TNF-alpha.
High levels of TNF-alpha have been detected in the cerebrospinal fluid of patients with Alzheimer's. In excess, TNF-alpha may interfere with the communication between brain cells, impairing thought and memory and other vital cognitive functions, the researchers propose.
In the current case, the man with Alzheimer's showed improvement within 10 minutes of receiving the drug. His awareness continued to improve during the hours that followed.
"It is unprecedented that we can see cognitive and behavioral improvement in a patient with established dementia within minutes of therapeutic intervention," said Sue Griffin, Ph.D., director of research at the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences in Little Rock. Dr. Griffin wrote a commentary that accompanied the published report.
"Even though this report predominantly discusses a single patient," Dr. Griffin said, "it is of significant scientific interest because of the potential insight it may give into the processes involved in the brain dysfunction of Alzheimer's."
The new research sheds light on a class of proteins in the body called cytokines, which play a role in immunity. Cytokines, which include TNF-alpha, also facilitate communication between cells, especially cells of the immune system.
Additional testing will be required to determine the role of TNF-alpha and other brain chemicals in the development of Alzheimer's disease. The Fisher Center for Alzheimer's Research Foundation continues to fund vital research into the underlying causes of Alzheimer's and the search for a cure.
W. Sue T. Griffin: Commentary: "Perispinal etanercept: Potential as an Alzheimer therapeutic." Journal of Neuroinflammation 2008, 5:3 (10 January 10, 2008)
Edward L. Tobinick, Hyman Gross: Case Report: "Rapid cognitive improvement in Alzheimer's disease following perispinal etanercept administration." Journal of Neuroinflammation, 2008, Volume 5:2 (January 9, 2008)
University of Arkansas School of Medicine