Treating Alzheimer’s Before It Begins
Once a person starts experiencing symptoms of Alzheimer’s disease, it’s already too late to provide effective treatment.
In the lab at Zinfandel Pharmaceuticals, researchers are looking for ways to turn back the clock by identifying potential patients earlier. This would help more than just the people with the disease, but lessen the burden on family, friends and society.
“Alzheimer’s is a growing societal burden, and frankly, a significant unmet medical need,” said Dr. Dan Burns, senior vice president and chief operating officer at Zinfandel Pharmaceuticals.
By identifying the Alzheimer’s risk before symptoms are present, doctors can slow the neurodegenerative decay caused by the disease.
“We are hopeful that our work will start to change the paradigm and we can delay the onset of symptoms in people who are at risk so they can have more productive and independent years,” Burns said.
Zinfandel was started in 2011 by Allen Roses, a renowned geneticist who discovered a genetic link to Alzheimer’s disease in the early 1990’s while working at Duke University.
Through Dr. Roses’ research, Zinfandel was able to identify a genetic marker that indicates risk for developing neurocognitive decline, Burns said.
“We use straightforward genetic testing to identify people we believe are at either high risk of developing the onset or at low risk for the next five years,” Burns said. “You can treat some people with the investigational drug and some people on placebo and you can look at the difference between the two arms.”
Roses and Zinfandel identified two genes that they consider risk markers for developing Alzheimer’s; the APOE gene and TOMM40 gene.
Zinfandel works with Takeda Pharmaceuticals, Japan’s largest drug company, and one of the fifteen largest in the United States, to conduct trials and develop a medicine to delay the onset of Alzheimer’s in patients who show risk markers.
“The challenge with Alzheimer's is you want to try and impact the course of the disease before you start seeing the symptoms,” Burns said. “It’s a neurodegenerative disease which means nerve cells are dying.”
Beginning treatment after nerve cells have already died has shown little success, Burns said.
North Carolina BioTech and the Triangle
Everyone who works at Zinfandel came from the Triangle’s “heritage pharmaceutical industry,” Burns said.
The Triangle’s high concentration of contract research organizations make it extremely attractive to companies like Zinfandel. IQVIA, formerly Quintiles, is one of the largest CROs in the world and headquartered in Durham.
Burns also pointed out the “legacy universities” in the region as promoting talent in the Triangle.
“Around here, you don’t need to go far to find talent,” Burns said.
A byproduct of the increased use of genetics in drug testing and clinical research has been the burgeoning direct-to-consumer genetics industry. The past few years have seen a rise in individuals interested in learning about their ancestry and health through genetics. 23andMe is a company offering genetic testing and analysis starting at $99.
UNC Department of Genetics professor Dr. Kirk Wilhelmsen sees some value in consumer genetic testing, but warns against reading too far into results.
“I’m excited that people want to know about things like this, but in general, I think a lot of the work being done for prediction isn’t as rigorous as it needs to be,” Wilhelmsen said.
Different genetic testing companies will give you different results, according to Wilhelmsen.
“Among my friends, we sometimes call it recreational genomics, since it’s kind of like getting your fortune told,” Wilhelmsen said.
Genetic testing kits are marketed as a way to arm consumers with information they can use to make healthier choices. However, Wilhelmsen recommended that people make choices to mitigate risk of disease regardless of genetics.
“Many people, after they found out they had an increased risk of diabetes, or things like that, they don’t do anything about it,” Wilhelmsen said.
The Alzheimer’s Association provides a list of tips for helping to reduce the risk of developing Alzheimer’s. Regular physical exercise, maintaining strong social connections and making your home “fall-proof” are effective ways to lower the chance of experiencing symptoms in your lifetime.