Alzheimer's disease: from basic science to precision medicine approach

Area of Science:

• Neuroscience
• Gerontology
• Pharmacology

Background:

• Alzheimer's disease (AD) is the leading cause of dementia in older adults.
• Current AD therapies targeting amyloid or inflammation have shown limited efficacy due to issues with timing, patient selection, and a lack of multitarget strategies.
• Effective biomarkers are crucial for evaluating treatment effectiveness.

Purpose of the Study:

• To propose the application of precision medicine principles for Alzheimer's disease (AD) research.
• To simultaneously validate treatment efficacy and biomarker reliability through personalized, biomarker-guided therapies.
• To enhance the development of innovative and personalized drug treatment protocols for AD.

Main Methods:

• Stratify individuals at risk or in early AD stages using neuropsychological tests, apolipoprotein E (ApoE) genotyping, biochemical analyses (plasma/CSF), neuroimaging (MRI/PET), and inflammatory/microbiota profiling.
• Conduct randomized, longitudinal, placebo-controlled studies with antiamyloidogenic and anti-inflammatory drugs.
• Utilize tailored treatment profiles (e.g., vascular, mitochondrial) based on individual patient stratification.

Main Results:

• The proposed precision medicine approach enables simultaneous verification of treatment efficacy and biomarker reliability.
• Individualized, biomarker-guided therapies offer a more targeted approach compared to current broad-spectrum treatments.
• This strategy facilitates the development of personalized drug treatment protocols with higher potential for efficacy.

Conclusions:

• Implementing precision medicine principles in AD research can accelerate the development of effective, personalized treatments.
• Stratification based on comprehensive patient profiles is key to successful biomarker-guided therapeutic strategies.
• Widespread adoption and data sharing of these criteria can significantly improve the chances of successful AD drug development.