“When you treat someone with symptoms already, it’s like trying to put out a forest fire by blowing out the match,” Tanzi said. “It’s like cholesterol: You don’t want to wait until you have a heart attack to start taking a statin.”
Tanzi said that the aim is not to wipe out the amyloid-beta completely but just to dial it down because, after all, it is protecting the brain—at least at first.
“But we do fully support that you want to prevent or stop it in its very first stages, 10 years before symptoms, you hit the amyloid,” he said.
However, Tanzi said what would truly be ideal is to not have to touch the amyloid at all but to hit the microbes that trigger the amyloid. He and Moir, with backing from Cure Alzheimer’s Fund and Open Philanthropy, are mapping everything residing in the Alzheimer’s brain by looking at autopsies in Alzheimer’s patients and those who are just as old but didn’t have the disease.
Tanzi said it could lead to a test for young adults that would see if their brains are susceptible to the antibodies that cause the plaques. This would be true preventative treatment, an idea that’s long-been thought to be impossible in the Alzheimer’s world.
“The whole mindset is changing around Alzheimer’s to treat at the stage of pathology and not wait for the symptoms to occur,” Tanzi said. “You have to treat people before they have symptoms, like you treat HIV before it turns into AIDS and like cancer, you don’t wait until you have symptoms of cancer, you treat the tumor.”
Tanzi admits it’s unclear if this kind of preventative treatment will even work and, if it does, it’d be a long way out from clinical application. But still, in the face of a disease that’s been incredibly difficult to treat for 100 years, there’s hope. And this time, a new, different kind of hope.