[HN Gopher] Alzheimer's cases tied to no-longer-used medical pro...
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       Alzheimer's cases tied to no-longer-used medical procedure
        
       Author : leeny
       Score  : 91 points
       Date   : 2024-01-29 21:39 UTC (1 hours ago)
        
 (HTM) web link (www.statnews.com)
 (TXT) w3m dump (www.statnews.com)
        
       | m3kw9 wrote:
       | I thought it was still early in 2024 and we have this news but
       | good to know you need to actually transplant brain matter to get
       | it
        
       | Terr_ wrote:
       | 4 hours ago: https://news.ycombinator.com/item?id=39179368
       | 
       | Recycled comment follows.
       | 
       | ___________
       | 
       | To highlight:
       | 
       | > The authors and other scientists stress that the research is
       | based on a small number of people and is related to medical
       | practices that are _no longer used_.
       | 
       | Also that there is zero-reason to believe in any person-to-person
       | spread:
       | 
       | > The study does not suggest that forms of dementia such as
       | Alzheimer's disease can be contagious.
       | 
       | Lastly, a fun vocabulary word [not in that article]: "Iatrogenic"
       | - An illness caused by medical examination or treatment.
        
         | admissionsguy wrote:
         | Another one is "nosocomial" - (disease) originating in a
         | hospital
        
         | dekhn wrote:
         | Don't forget nosocomial- infections acquired in a healthcare
         | setting.
        
       | rajup wrote:
       | My understanding was the beta-amyloid hypothesis itself is under
       | some amount of scrutiny and may not truly explain Alzheimer's.
       | Wonder if this finding adds more evidence for the amyloid
       | hypothesis.
        
         | Mistletoe wrote:
         | I thought CJD was caused by a prion. Was it in the growth
         | hormone prep from the cadavers?
        
           | treyd wrote:
           | Yeah that's correct. The article mentions a few cases of
           | people who died from transmitted CJD that may have also
           | received some beta amyloid or tau proteins that could have
           | catalyzed development into Alzheimer's if only they didn't
           | die from CJD, which seems to develop more quickly through
           | that route. If Alzheimer's is truly is some kind of prion-
           | related disease, which the research is suggesting.
        
           | kibibu wrote:
           | From the article:
           | 
           | > In the interim, scientists had discovered that that type of
           | hormone treatment they got could unwittingly transfer bits of
           | protein into recipients' brains. In some cases, it had
           | induced a fatal brain disease called Creutzfeldt-Jakob
           | disease, or CJD -- a finding that led to the banning of the
           | procedure 40 years ago.
        
         | m3kw9 wrote:
         | Not sure why scientists has to pin point a single cause where
         | as you have different vectors that can cause the same disease
         | is also plausible
        
           | pedalpete wrote:
           | Or that we've been lumping multiple different types of
           | cognitive decline as a single disease.
        
           | arcticfox wrote:
           | They don't, but my surface understanding is that the
           | medicines that effectively nuke beta amyloid have no effect
           | overall. Which would mean it's not even one of many causes,
           | it seems to not be a cause at all.
        
       | m-i-l wrote:
       | Slightly more clickbaity title than the BBC's "Medicine stopped
       | in 1980s linked to rare Alzheimer's cases"[0] which also says
       | "The findings do not mean Alzheimer's is infectious - you cannot
       | catch it from contact with people who have it... The researchers
       | say all of the people in their study had been treated as a child
       | with cadaver-derived human growth hormone, or c-hGH, that was
       | contaminated with brain proteins that are seen in Alzheimer's
       | disease... used to treat at least 1,848 people in the UK between
       | 1959 and 1985".
       | 
       | [0] https://www.bbc.co.uk/news/health-68126907
        
       | bjourne wrote:
       | Afaict, this is not an entirely new finding. For example, this
       | page (https://www.nature.com/articles/d41586-018-07771-6)
       | references a 2018 article about the issue of Alzheimer's being
       | transmitted (or rather "seeded") through growth hormone extracted
       | from cadavers. Perhaps the new article provides additional
       | evidence or perhaps the other article only suspected a casual
       | link and this one proves that there is one. I haven't read it
       | thoroughly.
       | 
       | What I find interesting and scary is the "seeding" part. The
       | small amount of growth hormone injected to the children cannot
       | itself have caused Alzheimer's. But it must have caused some
       | rewiring of the brain to make it accumulate more plaque which
       | over a period of many decades slowly decreased their brain
       | performance. If this effect is synthesizeable then one can easily
       | imagine many countries using it to develop terrifying biological
       | weapons.
        
         | diob wrote:
         | It mentions brain proteins contaminating it, makes me think of
         | prions.
        
       | aurizon wrote:
       | New prion diseases are being found in other animals and might
       | evolve to enter humans. There is a deer version being watched -
       | not yet found in people, AFAWK?
       | https://www.cdc.gov/prions/cwd/index.html
       | 
       | There have been many cases of assorted Human Papilloma viruses
       | (HPV) transmitted by kissing as well as assorted variances of
       | oral sex. Recent vaccines are very
       | effective.https://www.cdc.gov/vaccines/vpd/hpv/public/index.html
        
         | CommanderData wrote:
         | Do you mean HSV? I have seen articles implicating that virus
         | but it's the first time I've heard of a HPV association.
        
       | genman wrote:
       | So is this small bit of information any use for figuring out the
       | general case?
        
         | Reubend wrote:
         | Yes, definitely. It hints to the root cause being "very similar
         | in many respects to what happens in the human prion diseases
         | like CJD, with the propagation of these abnormal aggregates of
         | misfolded proteins and misshapen proteins."
         | 
         | So while this might be unrelated to the general cases, it's
         | still a promising area of investigation.
        
       | jollyllama wrote:
       | Why isn't the procedure used anymore, since they stopped using it
       | before this was discovered?
        
         | bemusedthrow75 wrote:
         | Because it was shown to also spread a prion disease (CJD,
         | though not the variant kind as far as I have understood)
        
         | Reubend wrote:
         | As the article says, there is now a synthetic hormone which is
         | given to the patients. We don't need to extract the hormone
         | from dead people anymore.
        
         | skissane wrote:
         | We worked out to produce these hormones (or equivalent
         | compounds) synthetically, so we no longer need to extract them
         | from the brains of deceased humans, a procedure which risks
         | transmitting disease.
         | 
         | Not just human growth hormone, also other hormones used to be
         | derived this way, e.g. those used to induce ovulation in
         | fertility treatment.
         | 
         | I know someone who received cadaver-derived fertility hormones
         | in the 1980s. She has a small risk of developing CJD and dying
         | from it. It hasn't happened yet, and probably never will, but
         | no one can say for sure if she is infected. If you don't
         | develop symptoms (some people are infected but never progress,
         | others suddenly develop symptoms one day after decades of being
         | asymptomatic), the only way to know for sure if you had it is
         | at autopsy, through destructive testing of brain tissues.
        
         | munificent wrote:
         | Second paragraph of the article:
         | 
         |  _> In the interim, scientists had discovered that that type of
         | hormone treatment they got could unwittingly transfer bits of
         | protein into recipients' brains. In some cases, it had induced
         | a fatal brain disease called Creutzfeldt-Jakob disease, or CJD
         | -- a finding that led to the banning of the procedure 40 years
         | ago._
         | 
         | In other words, it gave people mad cow disease.
        
       | jovial_cavalier wrote:
       | I've often wondered if Alzheimer's is actually novel instances of
       | prion disease.
       | 
       | For instance, Kuru was developed within I think a handful of
       | generations in a population of ~20,000 with limited opportunities
       | for transmission (only transmitted when someone dies and their
       | family eats their brain).
       | 
       | If the base incidence rate for a novel prion is that high, can
       | you explain Alzheimer's as just that? It would be sad news for
       | pharmaceutical companies - it would render Alzheimer's as a
       | disease in the same class as cancer. Total systems breakdowns
       | that are low-probability but inevitable on a long enough
       | timescale.
        
       | boringuser2 wrote:
       | I actually don't believe this conclusion based off the fact that
       | it would be slam-dunk evidence for the pathogenesis of
       | Alzheimer's, which we don't have.
        
         | echelon wrote:
         | Multiple pathways could lead to the disease.
         | 
         | It's entirely possible that a metabolic dysfunction or viral
         | origin causes immune dysfunction and the downstream
         | dysregulation, misfolding, amyloid/tau signals, etc.
         | 
         | There might be multiple entry points to causing this disease.
        
           | boringuser2 wrote:
           | That might be true, but I don't think this makes the
           | conclusion any more compelling because it now fails Occam's
           | razor.
           | 
           | Chances are greater the conclusion is simply incorrect.
        
             | echelon wrote:
             | > it now fails Occam's razor.
             | 
             | I mean, mechanistically speaking, so does cancer. I don't
             | think that's quite the lens to apply to biological systems.
             | 
             | Biology is wildly complex and subverts expectations all the
             | time.
        
               | boringuser2 wrote:
               | It is the lens to apply to any system.
               | 
               | You don't defend a tenuous conclusion by doubling down
               | with a tenuous defense.
               | 
               | "Science" is constantly inaccurate. I can pull two papers
               | right now with opposing conclusions.
               | 
               | Assuming a scientific conclusion is simply incorrect is a
               | pretty good bet, even if you have absolutely no context
               | or idea what is happening at all.
        
               | echelon wrote:
               | > It is the lens to apply to any system.
               | 
               | I can point to countless instances where it fails to
               | adequately guide investigation in biology.
               | 
               | Occam's razor leads to premature simplification. When the
               | space is vast, dynamical, and unknown, it's absolutely
               | not a tool.
               | 
               | Do you think V(D)J recombination satisfied Occam's razor
               | when we asked ourselves how adaptive immunity worked?
               | 
               | There is a metric ton of pure serendipity in the study of
               | biology.
        
             | cbsmith wrote:
             | That's a misapplication of the razor here. The simplest
             | explanation for the statistically unusual prevalence of the
             | disease amongst these patients is indeed that there is a
             | causal link.
        
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       (page generated 2024-01-29 23:00 UTC)