Hints of a Therapeutic Vaccine for Alzheimer's?

as an adjuvant to stimulate a vigorous immune response or placebo in two injections separated by 1 month. The ␤-amyloid/placebo status of the patients is still unknown to the authors. What was assayed was the antibody In this issue of Neuron, Hock et al. report the cognitive production of the patients. Serum samples were taken functions of a small number of Alzheimer's disease from the patients before and 12 months after treatment, patients that participated in a clinical trial of immuniza-and ␤-amyloid immunoreactivity was assayed on fixed tion with ␤-amyloid. Patients with serum antibodies brains from a mouse model of AD that produces against ␤-amyloid plaques showed a diminished cog-␤-amyloid plaques. This test is called the tissue amyloid nitive decline and slowed disease progression. Dan-plaque immunoreactivity (TAPIR) assay. gerous meningoencephalitis was present in some pa-Patients who produced antibodies in the TAPIR assay tients, as has been previously reported. showed less cognitive decline over the course of 1 year than those who did not produce antibodies. This correla-Many mechanistic insights into the etiology and patho-tion was found for several standard tests, including the genesis of Alzheimer's disease have been gained in re-Mini Mental State Examination (which combines assays cent years. As with other polygenic disorders, a minority of several aspects of cognitive status, including orienta-of cases appear directly linked to specific gene mutation , attention, recall, language, and the ability to follow tions, and it has been hoped that the biological insights simple commands), Disability Assessment for Dementia gained from those cases can be leveraged to address (which assays basic self-care and instrumental activities the sporadic cases, which are the majority. A central of daily living), and the visual delayed recall test from idea that has emerged in this fashion has been that the Wechsler Memory Scale. Thus, the clinical benefits dysfunctional processing of the amyloid precursor pro-appear to cover a wide spectrum of cognitive functions tein APP drives disease pathology in familial Alzheimer's that are attacked in Alzheimer's disease, from memory disease (FAD) and perhaps even late-onset Alzheimer's to daily self-care. disease (LOAD). In this issue of Neuron, Hock et al. In the evaluation of the clinical significance, the au-(2003) report a significant reduction of the cognitive de-thors are presenting data on prevention of disease pro-cline in patients with Alzheimer's disease who partici-gression or even disease arrest by using the MMSE pated in an immunization protocol involving aggregated scores. A …