[HN Gopher] Do viruses trigger Alzheimer's?
___________________________________________________________________
Do viruses trigger Alzheimer's?
Author : helsinkiandrew
Score : 174 points
Date : 2025-03-23 07:29 UTC (15 hours ago)
(HTM) web link (www.economist.com)
(TXT) w3m dump (www.economist.com)
| helsinkiandrew wrote:
| https://archive.ph/bxpk0
| ekianjo wrote:
| > Two other studies, one by GSK, a pharmaceutical company, and
| another by a group of academics in Britain, also reported that a
| newer "recombinant" vaccine, which is more effective at
| preventing shingles than the live version, appeared to confer
| even greater protection against dementia.
|
| "confer" is something you use for a proven link with an
| interventional study, not for some random link you found within
| the thousands of variables you went fishing for in your
| observation study dataset.
| Mordisquitos wrote:
| Hence why the article does not say that the vaccine _conferred_
| protection against dementia, but rather that it _appeared_ to
| confer protection.
| ekianjo wrote:
| appear to confer is a pretty biased wording. Rather, the only
| correct way to write about it is "there was a correlation
| that needs further investigation, we have no idea if there is
| a causal link about it".
| throwawaymaths wrote:
| thr vaccine study is a pretty clear (partial) causal link.
| there is a jump discontinuity in all causes dementia cases
| based on week of birth, where the jump occurs at the NHS
| policy cutoff week (if you are older than this week you are
| ineligible fof the vaccine).
|
| It's likely partial because vaccines only confer resistance
| against one subset of virii and there may be nonviral
| Alzheimer's too. in any case causality is not really in
| question in that study
| Mordisquitos wrote:
| I do not see the bias, all the more so given that the whole
| article after that first paragraph very clearly explains
| that further investigation is taking place to determine
| whether there is such a causal link. I have no idea whether
| _conferring_ is a strictly defined term in the context of
| clinical research, but even if it is this is not a
| scientific journal article but aimed at the general public.
|
| Going in detail to the claim that 'appear to confer' is
| biased, even if we take such a strict understanding of
| _confer_ , compare the semantic effect of affirming and
| negating the sentence with and without 'appear to'
|
| 1. _' the vaccines conferred protection'_
|
| 2. _' the vaccines did not confer protection'_
|
| 3. _' the vaccines appeared to confer protection'_
|
| 4. _' the vaccines did not appear to confer protection'_
|
| Which of the sentence above is closest to the truth, and
| which is most inaccurate?
| gus_massa wrote:
| I agree.
|
| Double blind randomized controled trial or it didn't happen.
|
| Perhaps people with early symptoms are not given the vacine
| because it's too expensive and not mandatory?
|
| Perhaps people with the vaccine are younger becase it's a
| recent vaccine?
|
| Perhaps people that has no money for the vaccina had no money
| for therapies to slow the sympthoms?
| energy123 wrote:
| Double blind randomized controlled trial with endpoints and
| statistical methods disclosed in advance from a lab with a
| reputation for publishing null results, or it didn't happen.
| Mordisquitos wrote:
| Penultimate paragraph of TFA:
|
| _' The first double-blinded randomised clinical trial to
| test the effectiveness of antivirals against dementia is now
| under way. A group of researchers mostly based at Columbia
| University are testing whether valacyclovir, an antiviral
| used against HSV1, can slow down cognitive decline in people
| with early stage Alzheimer's. Between 2018 and 2024, the
| researchers recruited 120 patients and treated half with the
| antiviral. They expect to publish their findings later this
| year. John Hardy, whose research forms the basis of the
| dominant amyloid theory of Alzheimer's, and who has been a
| critic of the virus theory, says that a positive result in
| this trial would begin to convince him otherwise. If Dr
| Geldsetzer and his team can secure the funding, a similar
| trial of the shingles vaccine may soon follow.'_
| apinstein wrote:
| Oh wow, a bunch of Alzheimer's grants at Columbia were
| canceled, including the Alzheimer's Disease Research
| Center. Unclear if this study was affected...
|
| https://taggs.hhs.gov/Content/Data/HHS_Grants_Terminated.pd
| f
| gus_massa wrote:
| So... and unfinished RCT of an unrelated drug an a project
| to start in the future a RCT of this new use of the
| vaccine.
|
| The problem is mixing the real protection of the vaccine
| against shingles that has been tested in RTC and new
| aplications that have not been tested enough.
|
| If there are too many false provisional anouncements,
| people will not thrust medicine.
| Mordisquitos wrote:
| The article opens describing how people vaccinated
| against the HSV1 virus are statistically less likely to
| develop dementia, and that a newer virus appears to
| confer an even bigger effect.
|
| The article then proceeds on the history of the
| scientific debate on whether the HSV1 virus has a causal
| link to Alzheimer's and the level of acceptance of the
| hypothesis.
|
| Finally, the article concludes describing how an RCT is
| taking place to find whether an antiviral which is used
| to treat HSV1 has an effect on the development of
| dementia.
|
| It all ties together with the theme of the article, which
| is about the possibility that viruses may trigger
| Alzheimer's and the reason why research is being carried
| out in that direction. That open question is literally
| expressed in the headline.
|
| I honestly cannot understand the problem you are seeing
| in the article. How else would you express the same
| information?
| throwawaymaths wrote:
| > Double blind randomized controled trial or it didn't
| happen.
|
| This is just cargo culting. Read the original source paper
| and you'll understand why the causal relationship makes sense
| without an RCT.
| gus_massa wrote:
| Do you have the DOIs?
|
| I found https://www.nature.com/articles/s41591-024-03201-5
|
| They compare people that got the old vaccines in 2014-2017
| with people that got the new vaccine in 2018-2020. Some
| strange parts:
|
| They say they are analyzing 6 years, but for the second
| group the 6 years period has not ended. This makes the
| comparison difficult.
|
| These periods includes the covid-19 epidemic in 2020, with
| lock downs, changes in death rates and new vaccines. This
| makes any comparison difficult.
|
| The comparison in figure "1 e" have very different initial
| slopes. I'd expect dementia to be a slow accumulation of
| small problems in the brain, so I'd expect an initial equal
| slope and after some time a difference. They start the
| comparison after 3 month, but I expect a slower effect.
|
| Figure "1 f" has the same initial slope difference, but
| there is also a strange slope change in d=1750 and the red
| line is more noisy probably due to the unfinished 6 years
| period).
| kps wrote:
| Preprint of the main paper on pubmed:
| https://pmc.ncbi.nlm.nih.gov/articles/PMC10246135/
|
| They rule out the objections in your top post -- as well
| as whether people chose to get the vaccine, which would
| be a huge confounder for a disease that affects
| cognition.
| roenxi wrote:
| The part of these sort of conversations that makes me wary is
| this understanding that "Alzheimer's" is a disease with a single
| cause. I think it is beyond question that _some_ viruses trigger
| Alzheimer 's, because viruses can do pretty much anything. The
| real question that they're studying is _to what extent_ do
| viruses cause Alzheimer 's. If it turns out that most Alzheimer's
| cases are a Herpes symptom then that sounds big.
| FollowingTheDao wrote:
| I agree, it is very frustrating. I will say that the reason
| they have not found a cause and/or cure for Alzheimer's is that
| it is a polygenic and polyenvironmental disease. The only way
| to cure Alzheimer's is to look at each person individually
| (personalized medicine) but that is expensive and not as
| profitable.
| h0l0cube wrote:
| So then "curing Alzheimer's" is akin to "curing cancer". If
| this is true, I wish this truth was better disseminated.
|
| Is the theory now that Alzheimer's just actual brain rot, of
| which their are multiple causes, and that beta amyloid
| plaques are just detritus of a losing battle?
| chneu wrote:
| Some researchers think Alzheimer's is a man made disease.
|
| The last time I read up on this it was basically that we
| all have some predetermined risk of developing an
| Alzheimer's type disease, but that modern environmental
| variables raise that risk to such a high likelihood that
| it's become something it never used to be.
|
| Interesting to think about.
| peterfirefly wrote:
| > , but that modern environmental variables raise that
| risk to such a high likelihood that it's become something
| it never used to be.
|
| Well, yeah, because _more people get old enough to get
| it_.
| jononor wrote:
| We have built a rather large toolset for detecting and
| treating a range of cancer variants over the last decades.
| With meaningful changes in expected outcomes. Considerable
| drop in mortality, for example. Far from cured though.
| Alzheimer's might be much trickier. ..
| h0l0cube wrote:
| I'm guessing it's trickier because it's harder to get
| biopsies of the brain mid treatment. It doesn't help that
| it's been treated as one disease and assuming a single
| cause for so long
| EasyMark wrote:
| Do you have know of any individualized Alzheimers treatments
| resulted in the cure, slowing down, or "stopped further
| damage"? That would seem like big news, even if it was only
| in a person or two.
| tim333 wrote:
| I wouldn't say the question should be "to what extent do
| viruses cause Alzheimer's". I mean you could run a regression
| analysis to find that and then what?
|
| The real question is what is going on and how do we fix it?
| pedalpete wrote:
| The way I've looked at it (and I work in the adjacent space of
| neurotech/sleeptech) is that it is likely we are assigning
| multiple diseases with the label of Alzheimer's because we
| don't understand the disease well enough.
| elif wrote:
| Do we really need questions as headlines?
|
| It's bad enough that people fail to contextualize or deeply
| consider the reality behind sensational headlines, but when you
| open the door to vague questions as headlines, you are somehow
| journalistically allowed to memetically plant a known lie into
| the zeitgeist of the majority of internet users who read the
| headline but dont click to read the article.
| Mordisquitos wrote:
| I would agree if the article was an example of Betteridge's law
| of headlines [0], but in this case it is legitimately
| reflecting the overall message of the article, which is that it
| is becoming an open research question in science whether
| viruses trigger Alzheimer's having previously been a fringe
| hypothesis.
|
| The very fact that the last sentence of the article is
| expressed as a conditional is also consistent with the use of a
| question for the headline:
|
| > _' If antiviral treatments can indeed slow, delay or prevent
| even a small subset of these cases, the impact could be
| tremendous.'_
|
| [0] https://en.wikipedia.org/wiki/Betteridge's_law_of_headlines
| tim333 wrote:
| We don't need them but I don't see a problem either if they are
| appropriate to the article as in this case.
| A_D_E_P_T wrote:
| Very interesting.
|
| Memantine is an antiviral/nootropic (NMDA agonist) that's
| considered one of the best conventional therapies for
| Alzheimer's. For e.g., https://pubmed.ncbi.nlm.nih.gov/32914577/
|
| Amantadine is a related compound that's seemingly more potent as
| an antiviral, and less potent at the NMDA receptor.
|
| Medical hypothesis: This makes me wonder if amantadine might be
| an effective drug in Alzheimer's treatment. It would come as a
| total shock to the med chem community if memantine's activity had
| to do with its suppression of viral replication, and much less to
| do with its activity at the NMDA receptor.
|
| As an aside, the Russians have a similar drug called bromantane
| which is sold OTC as a sort of mental energy booster. It's not
| really a stimulant, and its effects are mild enough for daily
| use. It might also be very interesting in this context.
| https://en.wikipedia.org/wiki/Bromantane
| johnisgood wrote:
| I believe most nootropics work for Alzheimer's, probably
| Huperzine A, too. Perhaps even Noopept.
|
| NMDA agonists and acetylcholinesterase (they inhibit the
| breakdown of the neurotransmitter acetylcholine) in general.
|
| Benadryl (DPH) and first-generation antihistamines are the
| opposite of that, they can cause delirium (and it messes up
| your memory and cognition in general) and whatnot, they are
| anticholinergic, some more than others. I had anticholinergic
| toxicity from DPH before.
|
| I take Alpha-GPC (a very soluble form of choline) and Huperzine
| A for cognition / memory, others couple it with racetams (e.g.
| piracetam, pramiracetam, aniracetam, etc.).
| TechDebtDevin wrote:
| My primary care doctor is telling all of her patients not to
| take Zyrtec for an anti-histamine because it is causing
| dementia side effects in her older patients. Antecdotal but
| interesting.
| johnisgood wrote:
| For the reasons I mentioned, yes. :)
|
| But Zyrtec is second-generation. It shows 20,000-fold or
| greater selectivity for the H1 receptor over the five
| muscarinic acetylcholine receptors, and hence does not
| exhibit anticholinergic effects, so it should be OK. May
| still cause drowsiness, however.
| jadbox wrote:
| I've had some experience here and will add a couple notes.
|
| Memantine has been useful for slowing down Alzheimer's and
| temporarily improving responsiveness. However, Memantine has
| not shown any effectiveness in reversing Alzheimer's or fully
| stopping its progression (sadly). Memantine does seem to
| increase self-awareness clarity but, counterintuitively, seems
| to also disrupt memory recall. Word of caution, in one rat
| study, I had read that Memantine could have long term side-
| effects of hindering memory recall.
|
| Amantadine has a fascinating structure, but it seems like it's
| not super useful by itself from studies. It seems more like a
| very promising 'base structure' to build future compounds upon
| (like Memantine and bromantane).
|
| Anyways, this family is rather interesting for a number of its
| properties and are still not very well known or understood.
| Please do share any more insights.
| A_D_E_P_T wrote:
| Random notes:
|
| - Unlike amantadine, chemically-related tromantadine is
| potently effective against HSV.
| https://pmc.ncbi.nlm.nih.gov/articles/PMC185716/
|
| - There's another paper which may shed some light on the
| herpes-Alzheimer's connection, and it notes that treatment
| with tromantadine (among others) is starkly beneficial:
| https://pmc.ncbi.nlm.nih.gov/articles/PMC5935641/
|
| - If the connection is established, it could be that a
| tromantadine-like molecule with activity against herpes
| simplex -- _plus_ mild activity at the NMDA receptor reducing
| excitotoxicity and protecting neurons -- could potentially be
| a good prophylactic against Alzheimer 's.
|
| - It would be interesting to test amide-linked amantadine-
| phenylalanine and memantine-phenylalanine conjugates. Such
| things would probably penetrate the BBB very well, as they
| could take advantage of amino acid transporters. (The LAT1
| transporter in particular.) And they resemble tromantadine --
| where it is said that the amide itself is a necessary moiety
| in countering HSV. Structure:
| https://i.ibb.co/7tS4MGGL/Amantadine-Phe.png
| DrAwdeOccarim wrote:
| Are you a drug developer by trade? You certainly think like
| someone who's seen some SARs...
| chriscappuccio wrote:
| Memantine is an NMDA antagonist like ketamine and other
| dissociatives.
| TechDebtDevin wrote:
| My doc put my on amantadine for post covid symptoms and I felt
| like it gave me mild dementia and had to stop :/
|
| edit: Fun fact, the side effects were so bad I made a very big
| mishap that destroyed a (very very expensive) f-class flight
| simulator.
| nraynaud wrote:
| It's really surprising that with all the statistical tools we
| have, the signal for the link between a common virus and a
| disease is unclear. Even if the road to a proven intervention is
| long, you'd think at least the link would be clear.
| tim333 wrote:
| I think the link has shown up in the statistics for a long
| time. The article mentions Ruth Itzhaki being on it for 40
| years. But things seem delayed by something along the lines of
| politics/corruption, or by the complexity of the situation with
| HSV1 not being the only cause. It can become a mess
| https://www.nytimes.com/2025/01/24/opinion/alzheimers-fraud-...
|
| I'm hoping that AI helps sort this stuff out. It can read the
| papers and say hypothesis A is most likely even if professor Y
| had built an empire on it being hypothesis B.
| giantg2 wrote:
| HSV1 is estimated to affect more than 80% of the population,
| but less than 80% have dementia. This seems to imply there
| are other factors at play. Maybe it requires other factors
| like genetics or immune issues for it to progress.
| amanaplanacanal wrote:
| I can't point to a citation but I'm sure I've seen it
| hypothesized that it requires both the infection, then some
| sort of injury to allow the virus to cross the blood brain
| barrier.
| bognition wrote:
| The issue is that we don't have the primary data. This stuff is
| messy and the systems at play are extremely complicated. Often
| one of the most challenging parts of bio sciences is figuring
| out a test that will cleanly show a result that is true.
|
| Without directly testing for a connection it's extremely rare
| to get unexpected data that confirms an alternate hypothesis.
|
| Even if the statistical tools are there, they can't make up
| numbers that we haven't collected yet.
| readthenotes1 wrote:
| With Alzheimer's, it's possible that it's fraud hiding the
| linkage.
|
| E.g., https://www.science.org/content/article/potential-
| fabricatio...
|
| https://www.science.org/content/article/research-misconduct-...
|
| https://arstechnica.com/science/2024/07/alzheimers-scientist...
|
| https://stanforddaily.com/2023/02/17/internal-review-found-f...
| lttlrck wrote:
| > Authors sometimes share those with researchers conducting
| similar work, although they usually ignore such requests,
| according to recent studies of datasharing practices.
|
| If the research was in anyway paid for with federal dollars
| all this data should be public. Not only that, if true it is
| a waste of federal dollars.
|
| It's probable that the widening mistrust in science is due to
| this a sort of behavior and the resulting administration.
|
| Waste due to inefficiencies is one thing, waste due to fraud,
| data hiding, misdirection is something else.
| giantg2 wrote:
| The part that might not be clear could be due to other factors,
| such as a genetic or lifestyle component that cause this to
| only progress to disease in some individuals.
| crazygringo wrote:
| The article clearly explains that the link isn't clear at all.
|
| It's that certain damaging proteins are a line of defense
| against the HSV1 virus, that something _sometimes_ sends those
| proteins into overdrive, that this is influenced by genetics
| broadly, further influenced by a particular gene, and that it
| 's a _second_ infection with shingles that can reactivate the
| proteins, worsening it.
|
| Given that this is the interplay of something like at least 5
| factors, and there may be more, it's not surprising it's taken
| this long to put together, even with all our statistical tools.
| epidemiology wrote:
| It's not that we haven't thought up the statistical tools. The
| core theoretical tools you need are there. It's that gathering
| the data that you need is extremely difficult and time
| consuming.
|
| If you gather EHR or medical claims record data for vaccines
| for example, you have to take very seriously the biases and
| impact of missingness inherent in the data. Is that person you
| have no evidence of disease for truly not diseased or do they
| just have missing data? IS it missing because they just didnt
| go to the doctor because they're healthy enough to kick the
| disease on their own or because they're so financially unstable
| that they can't afford to consistently see their primary care
| doctor. Is the data missingness itself actually what's more
| correlated with the disease than the vacciation you are looking
| at?
|
| Example: If your outcome is dementia then may be using
| cognitive tests that have a high level of variability due more
| to social class, education, test taking ability. Is receiving a
| fancy vaccine is more likely in an affluent area? Could be that
| correlation itself might completely explain away the positive
| effect that vaccine has on cognitive test scores.
|
| In Alzheimer's you're often trying to correlate things that
| happen in early life with long term damage that only surfaces
| many many years later. Retrospective studies where you go back
| and ask sick or healthy people have recall bias where the sick
| ones remember more issues with themselves early on than healthy
| ones do even with the same early life issues.
|
| Not trying to say epi is perfect or that there isn't room for
| improvement in tools (there absolutely is). But just like often
| happens when crossing over into the biological sciences there's
| a lot stickier problems than people outside the field realize.
| nradov wrote:
| Right, the data quality is usually crap. Beyond the issues
| you mentioned, patients often switch providers or health
| plans and their data doesn't get migrated. In the USA at
| least there is no centralized national repository for that
| data so the further back you try to go the more likely the
| data will just be missing (or incorrectly coded). In theory
| there are interoperability APIs and national networks to
| solve this problem but in practice a lot of systems still
| aren't properly connected.
|
| For vaccinations specifically the CDC Immunization Gateway
| can be a good place to start. Most states also maintain their
| own immunization registries that can be queried through
| standard HL7 V2 Messaging and/or FHIR APIs if you have the
| appropriate permissions.
|
| https://www.cdc.gov/iis/iz-gateway/index.html
| bkfunk wrote:
| Once I started learning more about biology, I realized that
| everything is just so complex. The body repurposes chemicals a
| lot, so you have things like serotonin being a key
| neurotransmitter in the brain, but also in the gut. And you
| have enzymes that are coded in genes, but then there are also
| networks of genes that are up- or down- regulated by hundreds
| of other genes, and sometimes only in certain types of cells or
| certain physiological environments. And then of course there
| are epigenetic and immune-modulated effects at the genome, gene
| network, and individual gene levels. Not to even mention all
| the feedback mechanisms and meta-feedback mechanisms (the drive
| toward homeostasis is POWERFUL), and effects of countless
| chemicals in our environment.
|
| There are certainly clear-cut cause-effect relationships in
| biological systems, but even they will have edge cases and
| random chance to muddle the picture.
|
| I would posit that the human body is far more complex than even
| the largest codebase, not least because it was jury-rigged
| together with no architect or style guide.
|
| Also, in general, the more common the exposure, the harder it
| is to find a link; try finding a control group of people who
| have never been exposed to PTFEs, or HSV, and who also aren't
| like hunter gatherers.
| inciampati wrote:
| The problem is simply observational. We don't even have
| reliable DNA and RNA sequencing of our own bodies. And we
| cannot reliably observe things in a host without knowing, to
| some extent, what we're looking for first. Even that space is
| so large, it's very hard to ascertain accurately. Biology is
| always suffering for lack of clear observations.
|
| Also, adding complexity is the difficulty or even literal
| impossibility of observing the direct interactions of
| elements of the system, which operate at a quantum scale,
| that you would disturb and do disturb when attempting to
| observe.
| senkora wrote:
| My favorite way of describing biology comes from another HN
| comment:
|
| > It's more like a _vibrating causal cloud_ than a chain of
| causality.
|
| https://news.ycombinator.com/item?id=38898335
| acallaha wrote:
| > A group of researchers mostly based at Columbia University are
| testing whether valacyclovir, an antiviral used against HSV1, can
| slow down cognitive decline in people with early stage
| Alzheimer's. Between 2018 and 2024, the researchers recruited 120
| patients and treated half with the antiviral.
|
| Outsider view: while I'm excited we're making progress, I can't
| shake a feeling of sadness that the best we could manage was a
| study this small, started 7 years ago. If it's as pivotal as the
| article suggests, one would hope we could get more than 60 people
| in the experimental arm (IIUC this antiviral is widely
| prescribed, well-tolerated, and off-patent). Nonetheless, excited
| to see the outcome
| epidemiology wrote:
| >If it's as pivotal as the article suggests
|
| Let's be honest, this is a longshot.
| tim333 wrote:
| Quite an interesting attempt to advance the general process is
| DeepMind's project to make a cell simulation so you can try
| chucking in drugs into the simulation and see what they would
| do quicker than in the lab/patients. They are talking about
| having a simple cell up in five years. Hassabis talking about
| it: https://youtu.be/CEOOMYxMvY4
| bkfunk wrote:
| > off-patent
|
| Well there's your problem: no one can make money off of it,
| unless they develop a new delivery mechanism, etc.
|
| Patents encourage developing new medicines, but not developing
| new knowledge about (never mind use of) old medicine.
|
| The solution (in the US) is obvious: federal funding of
| research that stands to help lots of people but not make lots
| of money. Since most of these patients (in the US) are going to
| be on Medicare, there could be huge potential cost savings to
| the taxpayer: memory care is EXPENSIVE, so even the paltry
| amount covered by Medicare racks up (and the opportunity costs
| of people paying for private memory care is enormous).
|
| But instead of increasing funding for this kind of life- AND
| MONEY-saving research, this administration is freezing and
| slashing research funding, and specifically targeting Columbia
| for political/Trump's-petty-grudge reasons.
| absolutelastone wrote:
| I suspect the lucrative patent system has helped create
| rather exorbitant costs and restrictions for performing
| trials, which hinders non-patentable research, ironically.
|
| But both the federal and state govts do fund tons of such
| research. Some states have specific Alzheimer's trials and
| funds. I would think they could handle dirt-cheap therapies
| like this without getting into sweeping political changes.
| Though I suspect the solution is much harder than just run a
| trial with the drugs we have, or else we would already be
| hearing about mountains of evidence from doctors using the
| medications off-label.
| alzamos wrote:
| Worth mentioning that the evidence says that patents don't
| have an effect on new drug creation/inventions. Evidence is
| collected here http://www.dklevine.com/general/intellectual/a
| gainstfinal.ht..., pretty neat to know that Italy/Switzerland
| had a patentless pharma industry until quite recently.
|
| Having said that, I think you're right that under this
| system, research/capital definitely gets directed in a
| different way.
| cyberax wrote:
| This is bullshit. Drug research costs money, A LOT OF
| MONEY. A new drug right now costs somewhere around $5
| billion, mostly because 90% of drugs fail in trials.
|
| mRNA vaccines, semaglutide, mAB therapies, none of these
| would have happened without patents as an incentive.
| bookofjoe wrote:
| >Well there's your problem: no one can make money off of it,
| unless they develop a new delivery mechanism, etc.
|
| You hit the nail on the head. Ketamine is a generic drug that
| costs next to nothing; Spravoto (ketamine-derived nasal
| spray) is already a billion dollar/year drug for Johnson &
| Johnson, with prospects of $5 billion/year.
|
| Source: https://archive.ph/rzqxt [Wall Street Journal]
| cyberax wrote:
| > Well there's your problem: no one can make money off of it
|
| You can patent new applications of an existing drug. This has
| been somewhat of a problem, as companies can just look at how
| drugs are being used off-label, and patent some of these
| uses.
| absolutelastone wrote:
| This article is all the supporting evidence without any of the
| setbacks and failures at reproducing the correlations. There
| have been attempts at showing benefits with antivirals before.
| Just not a full-on double-blind study apparently. I recall
| reading about a study with high doses that showed no benefit
| for people in early stages.
|
| The 7 years time duration probably comes from the size of the
| study and also how long it is believed to take to get benefit
| if there is one. I would think if it really worked they would
| have stopped early for ethics reasons because they should also
| give the treatment to the placebo arm rather than watch them
| decline while knowing how to prevent it.
| vjk800 wrote:
| I don't know what it looks like from the perspective of someone
| in the field, but just as someone who is interested in this sort
| of stuff, it seems more and more plausible that quite many of
| diseases that have grown more prevalent in the last century,
| especially autoimmune diseases, are cause by viruses.
|
| It makes sense: the viral pressure has increase by a lot due to
| both increase in population density and increased travel across
| the world. At the same time there has been an increase in many
| autoimmune diseases, many types of cancer, Alzheimer's disease,
| etc. Also, from some proven cases, we know that viruses can
| trigger serious diseases (MS disease, type 1 diabetes).
| bloqs wrote:
| Immunocompromisation due to chronic inflammation from dietary
| issues and stress in addition to the above as well
| anovikov wrote:
| The frequently cited "stress" thing of modern lives is just
| eyebrows-raising. Do anyone actually believe that lives of
| people 100 or 200 years ago have been less stressful?
| giantg2 wrote:
| It's possible they had better support systems due to larger
| families, church being more prominent, etc.
| MrMcCall wrote:
| Any form of positive community is helpful, religous or
| not. Just having caring neighbors is a boon to well-
| being.
| theoreticalmal wrote:
| I think the idea is that the cells are stressed due to
| inflammation due to diet, rather than psychological
| feelings of stress
| anovikov wrote:
| Average "healthy" body temperature is down more than half
| degree exactly because of reduction in inflammation.
| People used to have very unsanitary lives and were
| fighting infections nonstop. 37.0C was the "normal" body
| temperature when the "norm" was first discovered in the
| early XIX century, now it's considered to be a sickness
| already.
| xeromal wrote:
| I'm not an expert but maybe keeping the immuno-army busy
| with constant infections keeps it from going bored and
| attacking itself
| serf wrote:
| also not-an-expert opinion, but an average higher body
| temperature would reduce immune system workload by virtue
| of killing a lot of stuff dead via inhospitable
| environment before an immune reaction could ever muster..
| phkahler wrote:
| Work is not the same as stress. People today (especially
| near the bottom of the ladder) are not in control of their
| own destiny like they used to be. It's a different kind of
| stress.
| victorbjorklund wrote:
| Slaves were more on control of their own destinys than
| someone working an entry job today?
| anovikov wrote:
| And they used to be more in control? Epidemics wiping out
| whole families? Gulags, concentration camps? Religious
| violence? Persistent threat of starvation death that was
| just the norm of life? One year of crop failures, and
| your kids are dead. Two years, and you are dead yourself.
| And it doesn't depend on you at all, just bad luck (if
| there was too much luck - like a generation without crop
| failures - population doubled, then just one year of crop
| failures meant you were dead). And yeah, the Church that
| keeps telling people that they were all sinners and will
| burn in hell, very comforting. Tell me about "control of
| one's own destiny".
| cosmic_cheese wrote:
| I think there's something to this. Life in those times
| was difficult and stressful, yes, but most hardships then
| were entirely beyond any individual's control. To a large
| extent, good times and bad times would come and go
| regardless of what you did.
|
| Contrast this to the modern day where more often than
| not, hardships are attributed to personal failings ("You
| should've worked harder if you didn't want to be stuck
| working abusive under-compensated jobs!") and people
| perpetually teeter on the edge of a knife suspended over
| a bottomless pit. If anything goes wrong, it's treated as
| nobody's fault but your own, regardless of the reality of
| the situation. It's almost a type of psychological
| torture.
| vjk800 wrote:
| Physical activity gives an outlet to stress, and people
| used to get way more of it. Stress and physical effort are
| supposed to go hand-in-hand; you feel stressed, which gives
| you a boost of adrenaline, which you need to physically
| fight back whatever caused the stress. When the physical
| component is missing, the stress just lingers and wreaks
| havoc on your body.
| ta12653421 wrote:
| well, you may read & discuss this one? :)
|
| https://en.wikipedia.org/wiki/List_of_common_misconceptions
| _...
| theoreticalmal wrote:
| Have you read Dr. Casey Means' book on this?
| idiotsecant wrote:
| Literally every time in the history of the universe when
| someone has structured a sentence like this, in this
| context, whoever they're talking about ends up being a
| giant crackpot. I'm not saying this person is a crackpot,
| just that the pattern recognition systems are throwing off
| some alarms.
| rubyfan wrote:
| First sentence from wikipedia says:
|
| _Casey Means is an American functional medicine
| /holistic medicine physician, entrepreneur and author._
|
| https://en.m.wikipedia.org/wiki/Casey_Means
| gcanyon wrote:
| I'm more influenced by this passage:
|
| _Means withdrew from her medical residency at age 30.
| She has attributed this decision to the lack of training
| she received about nutrition and the underlying causes of
| chronic disease. Means dedicated her practice to
| functional medicine, which focuses on the root causes of
| disease._
| kwertyoowiyop wrote:
| As one comedian said: "Do you know what they call
| alternative medicine that works? Medicine!"
| serf wrote:
| that's cute but how much alternative medicine eventually
| finds a way into real medicine?
|
| in other words : someone telling someone to practice yoga
| to relax and reduce their heart rate 200 years ago was a
| quack right up until the point that modern doctors
| decided to include it in their repertoire?
|
| it's a cute joke but it skips over the fact that there
| seems to be an 'alternative medicine -> real medicine'
| pipeline, even if a lot of it turns out badly.
| gcanyon wrote:
| The actual quote (from memory, but I just listened to the
| monologue a minute ago): "Do you know what they call
| alternative medicine that's been scientifically proven to
| work? Medicine!"
|
| In other words, the quote is exactly referring to your
| "pipeline."
|
| Tim Minchin's "Storm" monologue:
| https://www.youtube.com/watch?v=KtYkyB35zkk
| cyberax wrote:
| Medicine as a science didn't exist 200 years ago.
|
| Breath exercises, and physical therapy for relaxation
| were mainstream in 1960-s.
|
| > it's a cute joke but it skips over the fact that there
| seems to be an 'alternative medicine -> real medicine'
| pipeline
|
| Not really. Most of the non-medicine (I refuse to call it
| "alternative") stays non-medicine: acupuncture,
| homeopathy, all the "energy meridians" nonsense,
| ayurveda, alkaline foods, etc.
|
| And even with activities like yoga, it's not more
| effective than other types of similar physical activity.
| There is some very weak evidence that yoga _with_
| physiotherapy might be more effective than just increased
| levels of physiotherapy.
| gcanyon wrote:
| Tim Minchin! (about 4 minutes in):
| https://www.youtube.com/watch?v=KtYkyB35zkk
| absolutelastone wrote:
| Well that red flag versus the immediately-preceding
| passage listing a Doctor of Medicine degree at Stanford
| Medical School.
|
| I looked into one of the links and apparently she pushes
| fairly mainstream preventive medicine stuff, diet,
| exercise, and screening tests. The only questionable
| thing I saw was the continuous glucose monitoring thing
| which the jury may still be out on when it comes to non-
| diabetics.
| nradov wrote:
| I haven't tried a continuous glucose monitor myself but
| those non-diabetics who have generally claim that it gave
| them interesting insights into how their blood glucose
| level reacted to different foodstuffs and timing of
| meals. There is a lot of individual variation there due
| to genetics, lifestyle, gut microbiome, etc. We'll
| probably never see a large-scale, long-term randomized
| controlled trial to show that CGM use improves health
| outcomes for non-diabetics. But for healthy people who
| already have the basics dialed in, a CGM can probably
| help them eke out some additional marginal gains.
| basisword wrote:
| If you end up dealing with a chronic disease that medical
| doctors completely fail in dealing with, you naturally
| get driven to look at "alternatives". There's a lot of
| nonsense out there - but some of it works. As a former
| skeptic I'm now much less dismissive of these things due
| to my own circumstances. Particularly when I can see that
| poor medical treatment over the years actually
| exacerbated my condition and being less skeptical could
| have improved my quality of life significantly sooner.
| giantg2 wrote:
| Has viral pressure really increased? It seems stuff spread
| globally a few generations ago with things like the flu in the
| early 1900s. Even in the middle ages you had stuff like the
| plague.
|
| What has changed is the sterility of our environment. Better
| bathing, more hand washing, food safety rules, etc. There have
| been theories that autoimmune diseases might be increasing
| because we aren't exposed to enough "normal" pathogens.
|
| I'm highly suspicious that higher viral pressures are the cause
| of increasing dementia rates, as it seems we're exposed to less
| today.
| Nux wrote:
| Agreed. We've had this immune system battling stuff non-stop
| throughout evolution and now we're living in these clinical
| environments and it's going haywire.
|
| Not to mention we're poisoning ourselves with all sorts of
| novel stuff, especially poor hi-carb nutrition, ultra
| processed food and pollution from various sources that act as
| endocrine disruptors and God knows what else.
| vjk800 wrote:
| Bacterial, fungal and parasitic load has lessened, for sure,
| due to sterility of the environment, because many of those
| come from exposure to animals and plants. But viral load from
| viruses that spread from human-to-human and live exclusively
| in humans has increased because there are more humans and
| they spread the diseases around the world more effectively
| than before.
|
| Yes, we probably get way less pathogens overall than we used
| to, but at the same time we get more pathogens that live
| exclusively on humans (such as respiratory viruses).
| hn_throwaway_99 wrote:
| > But viral load from viruses that spread from human-to-
| human and live exclusively in humans has increased because
| there are more humans and they spread the diseases around
| the world more effectively than before.
|
| This seems like pure conjecture to me, and without any
| actual evidence to support it, I'm disinclined to believe
| it. My guess is that the number of people any one
| individual interacts with has gone down considerably since
| the beginning of the century, and earlier. Before the
| advent of the car, shared forms of travel were much more
| common. People do much less forms of basic shopping than
| they used to given the rise of the Internet. Air travel,
| while much faster, is much less crowded that the ship
| travel of earlier generations.
| inetknght wrote:
| There are significantly more humans in which a human-
| borne virus could live and/or mutate.
| nradov wrote:
| There are significantly fewer humans living in close
| contact with livestock in which a zoonotic virus could be
| transmitted. I'm skeptical that there has been a net
| increase. It's possible but I haven't seen any reliable
| evidence one way or the other.
| inetknght wrote:
| But there are significantly more amounts of livestock in
| contact with those fewer humans.
|
| Think of it this way: more total numbers = more
| opportunities for viruses to grow or mutate = more
| chances for runaway or novel infections. Runaway
| infections are dealt with fairly well by government
| entities. Novel infections... might be harder to discover
| because they're, well, novel.
| Al-Khwarizmi wrote:
| > Before the advent of the car, shared forms of travel
| were much more common. Air travel, while much faster, is
| much less crowded that the ship travel of earlier
| generations.
|
| Maybe in the US. Definitely not in most of the world. For
| my grandparent 70 years or so ago, the way to travel long
| distances was riding a donkey. Now travel by bus, train,
| subway, etc. is really common and something that most
| people experience often. 100 years ago of course there
| were trains, stagecoaches, boats, etc. but they were for
| a tiny minority of society or for special occasions (like
| to migrate a different continent to not return in
| decades, etc.). I'm also pretty sure air travel has a
| much higher penetration than ship travel would have 100
| years ago.
|
| As further anec-data points, there are much more massive
| gatherings now (concerts, sports, etc. - church used to
| be the major gathering, but churches tend to be ample and
| ventilated). And every parent knows that daycare and
| kindergarten are a major vector for pathogens. I used to
| get like a cold a year with 2 days mild congestion, and
| since my kid started kindergarten (he didn't go to
| daycare) we all started getting sick like monthly or so,
| for a couple of years. Putting dozens of kids in a closed
| space for hours is something that just wasn't a thing in
| previous generations either.
|
| So personally, yes, I would bet that chances for pathogen
| spread have increased greatly.
| crowselect wrote:
| Time scale. Viral load has increased dramatically over what
| it was like 1000 years ago. The change over the past 100
| years is all lifespan due to antibiotics and the sterility
| another comment is pointing the finger at. It's possible that
| viral load + lifespan = cancer, dementia, autoimmune stuff,
| etc.
| strawpoll-foe wrote:
| I have both T1D and MS. For MS, one leading idea is that
| getting exposed to Mono later in life can trigger the disease.
| There's solid evidence for this.
|
| For T1D, it's similar - there's a notion that you're
| genetically predisposed to it and certain types of infections
| during adolescence can cause it to manifest.
|
| I've had discussions with researchers in the space and
| apparently certain autoimmune diseases happen less often in
| "grubbier" parts of the world (their words, not mine) even when
| the population density is high, and an inference here is that
| >early exposure< to certain infections might not trigger some
| of these problematic autoimmune reactions.
|
| Side note: these diseases aren't fun, especially when working
| in tech. I'm appreciative of those dedicating their lives to
| researching autoimmune disease.
| delusional wrote:
| > I've had discussions with researchers in the space and
| apparently certain autoimmune diseases happen less often in
| "grubbier" parts of the world
|
| Is that corrected for mortality? It seems like an analysis
| like that would be quite prone to survivor bias.
| sigmoid10 wrote:
| For MS in particular there's several EBV mRNA vaccines in
| clinical trials - not just to prevent mono itself, but also
| to prevent long term complications (theoretically including
| MS) for people who already had it.
| pretzellogician wrote:
| And obesity.. there are several adenoviruses associated with
| it. Example: https://www.nature.com/articles/s41366-021-00805-6
|
| (Although the article takes pains to say that obesity is
| multifactorial, conflicting evidence in humans, etc.)
| kwertyoowiyop wrote:
| Can we take it as proven that the rate of these diseases has
| increased? I wonder if in the past some conditions we now
| classify as particular diseases were considered a normal part
| of aging, perhaps at most getting a blanket classification of
| "senility".
| Melatonic wrote:
| Bacterial infections can also trigger autoimmune diseases -
| it's not just viruses.
|
| Realistically immune systems are extremely complex and I
| suspect there are probably lots of environmental triggers
| beyond viruses and bacteria as well
| Mo3 wrote:
| My girlfriend has Crohn's disease that can be directly
| correlated to food poisoning while on vacation. Now years later
| I can't even count the times I've read and heard exactly the
| same story from other people with Crohn's disease. A simple
| search for "Crohn's food poisoning" turns up hundreds of
| results. I can't believe this is not being investigated with
| higher priority
| tim333 wrote:
| Along similar lines there was a good article in the Guardian: The
| brain microbiome: could understanding it help prevent dementia?
| https://www.theguardian.com/lifeandstyle/2024/dec/01/the-bra...
|
| Apparently viruses and also bacteria and fungi getting in the
| brain and causing problems are quite common.
| paul_h wrote:
| "Alzheimers-like" is a thing too:
| https://www.research.uky.edu/news/uk-researchers-find-alzhei...
| (after covid). I am sure there were other studies, but I'm darned
| if I can find them after searching just now.
| zhivota wrote:
| I think there is something to viruses being a big agent of aging.
| I'm 40 and recently came down with a bad case of norovirus,
| followed by some kind of flu-like thing. 3 weeks of illness.
| Afterwards, I felt as if I had aged 10 years, and looking into
| the mirror it was like looking at what I will probably look like
| at 50.
|
| It made me wonder how much of aging is mediated by damage from
| infection, which we fight off, but come out of weaker for it.
|
| It certainly makes me want to double check all my vaccines, and
| once my kids are older, practice a little better hygiene
| including things like masking up in tight spaces (pretty much
| impossible with a 6 and 9 year old in the house, they are the
| vector right now).
| chneu wrote:
| Getting sick is a very stressful period, physically and
| mentally. It absolutely ages you.
|
| We're sick far less often nowadays. Common illnesses were more
| common in previous generations. Back in the day "everyone got
| measles".
|
| While people fear being "too clean" there is also a downside to
| being "too exposed".
| AnotherGoodName wrote:
| One that i recently experienced is 'reactive athritis' which is
| a form of athritis commonly experienced after a stomach virus.
|
| If you start looking into it it's due to an immune response
| that occurs in people with the
| https://en.wikipedia.org/wiki/HLA-B27 gene and that gene is
| associated with a large number of athritis risk factors (but
| also resistance to a lot of things including HIV).
| gambiting wrote:
| I've had the same. It took over 5 years for me to go back to
| normal. Apparently somewhat common, but rarely talked about.
| And any virus can cause it.
| smeeger wrote:
| the debunked theory that certain diseases like alzheimer's and
| autism are caused by viruses cannot be true because that would
| mean that they are caused by inflammatory insult and that would
| mean that vaccines contribute to or cause certain diseases. this
| is dangerous thinking and should not have a platform anywhere
| Mordisquitos wrote:
| > _the debunked theory that certain diseases like alzheimer 's
| and autism are caused by viruses_
|
| No. Not only is it not "debunked", it is not even "a theory".
|
| > _cannot be true because that would mean that they are caused
| by inflammatory insult_
|
| No. Something being caused by a virus does not imply that the
| mechanism is "inflammatory insult".
|
| > _and that would mean that vaccines contribute to or cause
| certain diseases_
|
| No. That certain viral infections may cause ill effects by
| means of inflammatory processes does not imply that "vaccines
| contribute to or cause certain diseases".
| SubiculumCode wrote:
| and 20ish percent of autism. See maternal immune over-activation.
| torcete wrote:
| Wouldn't this theory be easy to prove by sequencing brain tissue
| samples from deceased patients?
|
| Probably more than 90% of the reads would be human, but still.
| MPSFounder wrote:
| Can someone explain to me how it can be so hard to track down the
| exact cause for this disease? My grandma passed from it. It seems
| to be relatively common. What makes this so difficult to treat
| relative to other diseases? Freshman year of college I was told
| it was amyloid proteins. Then make a drug to eliminate them. I am
| having difficulty seeing how 20 years since my grandmother
| passed, the cause still shows as unknown on reputable sources.
| pedalpete wrote:
| We still don't have a correct model for what Alzheimer's is,
| and therefore how to treat it.
|
| Compare this to something like HIV, where we were able to
| quickly understand that the virus attacks CD4 cells, and limits
| the body's ability to defend from disease.
|
| With Alzheimer's, we're still in the - is it amyloid and tau?
| is it inflammation? is it viral?
|
| This is compounded by our limited understanding of the brain.
|
| Another hypothesis which I ascribe to is that we are lumping
| multiple diseases under the label of Alzheimer's because we
| don't understand it enough.
| narrator wrote:
| This is why methylene blue has been so successful in Alzheimer's
| research. It's antimicrobial and gets into the brain easily.
| ProjectArcturis wrote:
| By "so successful", do you mean "failed all pivotal clinical
| trials"?
| pedalpete wrote:
| We cannot ignore that we know so little about how Alzheimer's
| works, we are potentially lumping multiple diseases under the
| same label.
|
| The amyloid hypothesis doesn't have to be wrong for the T3D to be
| true, and the viral potential to also be true if we are looking
| at 3-5 different diseases that have similar presentations. This
| also somewhat suggests why it may be the most common form of
| dementia.
|
| I work in the neurotech/sleeptech space
| (https://affectablesleep.com) and there is a strong link between
| sleep quality and Alzheimer's. It is theorized that AD is more
| common in women due to the lack of sleep through child-rearing
| and menopause, which decreases the brain's ability to remove
| amyliod/tau. Of course, this is only relevant to the amyliod
| hypothesis.
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