A Natural Multi-Target Approach for Alzheimer’s Disease, Part I
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Level of expertise: Moderate
The announcement of the discontinuation of Biogen’s aducanumab Phase III study for Alzheimer’s disease (AD) drug development on March 21, 2019 is described as the last nail in the coffin of amyloid theory. It comes after a series of failures in AD drug development over the past three years targeting beta-amyloid in Phase III studies by major pharmaceutical companies including Merck, Pfizer, Eli Lily. Not only did the amyloid theory fail, but also the board single drug-single target approach is unlikely to result in a solution or prevention for Alzheimer’s disease. It is undoubtedly not good for millions of patients who suffer from this disease in America.
Over the years research has gained a significant understanding that AD is caused not by a single factor but multiple, including age, heredity, diabetes, smoking, heart disease, brain injury, hypertension, hyperlipidemia, depression, infection, oxidative stress, inflammation, poor sleep, amyloid plaques in the brain, etc. Forget about the single drug-single target approach, a growing consensus among scientists is just as Maria C. Carrillo, Ph.D., Alzheimer’s Association’s chief science officer, said on July 27, 2016: “In Alzheimer’s, the most likely scenario for successful future treatment is addressing the disease from multiple angles.” A multi-target approach through either a cocktail or a combination of multiple drugs seems to face significant challenges and is unlikely to be adopted. On the other hand, traditional herb medicines have been used for thousand years to delay or treat various diseases including AD/dementia. According to WHO Traditional Medicine Strategy (2014-2023), the traditional and complementary medicines (T&CM) play an important but often underestimated part of health care in many countries. Multiple herbs or components are commonly used in T&CM to provide synergistic therapeutic effects in disease prevention and treatment. The work theory is that the multiple components of T&CM target to affect multiple biomarkers and act on different layers of regulation in our body. A few published reviews indicated T&CM could provide effective treatment for AD/dementia, but lack of standardization and systematic studies on safety and efficacy prove to be major problems. With a long history in human use, T&CM has a potential role in the prevention and treatment of AD. That said, a safe and effective multi-target approach can be developed.
A promising natural dietary and multi-target approach could be an effective alternative to address the multifactorial nature of Alzheimer’s, which I will pose in my next writing with evidence of documented pre-clinical and clinical studies.