[HN Gopher] New nanotherapy clears amyloid-b, reversing symptoms...
       ___________________________________________________________________
        
       New nanotherapy clears amyloid-b, reversing symptoms of Alzheimer's
       in mice
        
       Author : self_awareness
       Score  : 194 points
       Date   : 2025-10-09 14:36 UTC (8 hours ago)
        
 (HTM) web link (www.drugtargetreview.com)
 (TXT) w3m dump (www.drugtargetreview.com)
        
       | 317070 wrote:
       | The paper: `Rapid amyloid-b clearance and cognitive recovery
       | through multivalent modulation of blood-brain barrier transport`
       | https://www.nature.com/articles/s41392-025-02426-1
       | 
       | "Cognitive assessments revealed that treated AD mice exhibited
       | significant improvements in spatial learning and memory, with
       | performance levels comparable to those of wild-type mice. These
       | cognitive benefits persisted for up to 6 months post-treatment."
       | 
       | I'm curious if Derek Lowe will comment on this on his blog. I'll
       | await his opinion on how much we ought to celebrate here. He's
       | not a big fan of the amyloid hypothesis and has worked many years
       | in this exact field, so I reckon he will point out why skepsis is
       | warranted.
        
         | underdeserver wrote:
         | Yup. I hope he says something about what "nanotherapy" means.
        
           | anon84873628 wrote:
           | My biggest criticism of the article is emphasizing
           | "nanotechnology" when it is really just an extra large
           | synthetic molecule.
           | 
           | I mean, it is nanotech! But just not the type most readers
           | would imagine. They could have elaborated on an justified
           | this better by explaining novel synthesis method or
           | something.
        
       | mattkrause wrote:
       | (N+1)th time's the charm!
       | 
       | I do sincerely hope that we find something for Azheimer's, but
       | there's just a mountain of data suggesting that mouse models of
       | Alzheimer's and/or ABeta simply not that useful.
        
       | rob_c wrote:
       | If it's the removal of the proteins not the plaque I wonder if
       | that's the cause of people chasing the plaque for years? Classic
       | correlation causation problem if so... Time to go read
        
         | CrazyStat wrote:
         | Amyloid plaques are protein.
        
       | chc4 wrote:
       | Wasn't it revealed that the research supporting amyloid-beta
       | plaque as the cause of Alzheimer's was fraudulent?
       | https://www.science.org/content/article/potential-fabricatio...
       | https://www.science.org/content/article/alzheimer-s-scientis...
        
         | epgui wrote:
         | Yes, in a sense... but that doesn't mean amyloid-beta is an
         | irrelevant therapeutic target. It's a bit more complicated.
        
         | jvanderbot wrote:
         | IIRC, it was revealed that treating this as a cause is wrong,
         | it complicates or causes dementia, but is a symptom of
         | something else, not a root cause of the disease.
         | 
         | But treating symptoms, esp restoring cognitive function, is a
         | good thing.
        
         | p_j_w wrote:
         | I'm not a neuroscientist, but it seems that hypothesis existed
         | before that paper and has more supporting evidence than what's
         | been retracted:
         | https://en.wikipedia.org/wiki/Biochemistry_of_Alzheimer%27s_...
        
         | mjamesaustin wrote:
         | This therapy doesn't target the amyloid-beta plaques. It
         | repairs the blood brain barrier, and then the body is able to
         | clear away the plaques. Their buildup is a symptom of
         | Alzheimers, not the cause.
         | 
         | The problem with the amyloid-beta hypothesis was the assumption
         | that these plaques were causing the Alzheimers and that
         | removing them by itself could lead to a cure.
        
           | lukeinator42 wrote:
           | Exactly this. Amyloid-beta plaques and their association with
           | dementia were discovered early on (late 1800s/early 1900s
           | https://en.wikipedia.org/wiki/Amyloid_plaques#History), but
           | the theory that they cause dementia hasn't panned out.
        
           | matthewdgreen wrote:
           | Whoa there. Is that what's happening? Cause an alternative
           | theory is cause -> plaques -> cognitive disease. You seem to
           | be arguing cause -> cognitive disease -> plaques, and I'm not
           | sure this research demonstrates that. Does it?
        
             | celrod wrote:
             | I think they're arguing
             | 
             | Cause -> cognitive disease Cause -> plaques
             | 
             | That is, that the same cause is behind both.
             | 
             | There may be some arrows from plaque to disease as well
             | (i.e., that plaques also increase disease).
             | 
             | I dont know the truth, but just trying to understand/follow
             | Alzheimers news and reading comments.
        
             | pessimizer wrote:
             | Why does it seem like they're arguing that? I think that
             | it's supposed to really be: cause -> (plaques = cognitive
             | disease), and the fraud was (cause = plaques) -> cognitive
             | disease.
             | 
             | As I took it, understanding that there was a fraud doesn't
             | mean that continually clearing the plaques wouldn't have a
             | good chance of holding off cognitive disease indefinitely.
        
               | matthewdgreen wrote:
               | I'm simply arguing that the plaques could be the
               | proximate cause and the problem addressed by this
               | treatment could be the remote cause. The OP is being
               | vague in the way they stated it, but it feels like
               | they're saying the plaques are irrelevant. That doesn't
               | seem to fit what we know: the evidence that cognitive
               | symptoms are downstream of plaques is pretty compelling.
               | 
               | I also don't think "fraud" should be used in this
               | discussion at all.
               | 
               | With all that said, if this One Weird Trick can
               | clear/prevent the buildup of plaques (and thus the
               | cognitive symptoms downstream of them), that's just a
               | best possible outcome.
        
           | JamesBarney wrote:
           | I think amyloid being the proximate cause of neural
           | degeneration in moderate and severe Alzheimers is basically
           | disproven at this point.
           | 
           | I still think it's more likely than not (70%) that it is a
           | cause though farther upstream. There is a good amount of
           | evidence tau is more likely the proximate cause due it more
           | closely tracking disability in moderate to late stage
           | Alzheimer's.
        
           | anon84873628 wrote:
           | While the article emphasizes the BBB repair aspect, it seems
           | the treatment does ultimately target plaques directly at a
           | mechanical level:
           | 
           | >Normally, the protein LRP1 acts as a molecular gatekeeper,
           | binding to Ab and transporting it across the BBB for
           | elimination. In Alzheimer's, this system becomes fragile,
           | leading to Ab accumulation. The supramolecular drugs mimic
           | LRP1 ligands, binding to Ab and initiating its clearance,
           | effectively resetting the system and restoring vascular
           | function.
           | 
           | My sense of the narrative is that "unclogging" the amyloid
           | protein with this treatment allows innate repair functions to
           | resume.
        
         | shawnz wrote:
         | Here's a good article which explains the remaining arguments in
         | favour of the amyloid hypothesis:
         | https://www.astralcodexten.com/p/in-defense-of-the-amyloid-h...
        
         | amalcon wrote:
         | It's most likely highly correlated, but not causative. That
         | correlation still makes it diagnostically useful, which is how
         | it's used here.
        
           | tremon wrote:
           | I thought amyloid-b buildup is usually determined at autopsy?
           | That's not really the kind of diagnostic medicine I'm looking
           | forward to. Can it also be determined via brain biopsy?
        
             | mattkrause wrote:
             | You can do PET imaging for it--there are a bunch of
             | 18F-based tracers that work reasonably well. It also
             | _inversely_ correlates with Abeta levels in the CSF. Ne
             | 
             | Neither of those are particularly easy procedures, but
             | certainly better than a biopsy (and autopsy!)
             | 
             | https://pmc.ncbi.nlm.nih.gov/articles/PMC3264790/
        
           | JamesBarney wrote:
           | It's very likely causative. There is just too much evidence
           | for it not to be. All the genes related to amyloid processing
           | are correlated with Alzheimer rates.
           | 
           | The most likely theory I've seen is amyloid causes tau
           | buildup which leads to the majority of the damage. And by the
           | time they give anti-amyloid drugs it's too late and the tau
           | is doing the majority of the damage.
           | 
           | An analogy would be if you have a hole in your house which
           | leads to getting a rat infestation. Once you notice the rat
           | infestation patching the hole isn't going to solve your
           | problem. The hole caused you to get rat shit on your counter,
           | but by the time you fix the hole it's too late to stop the
           | rats from shitting on your counter.
        
         | bitshiftfaced wrote:
         | This article: https://www.astralcodexten.com/p/in-defense-of-
         | the-amyloid-h... makes a pretty compelling argument for
         | continued research on the link between amyloid-beta and
         | Alzheimer's.
        
           | matthewdgreen wrote:
           | This article is incredibly informative and I wish the folks
           | in this thread would read it. Doesn't make the current result
           | any less exciting.
        
         | JamesBarney wrote:
         | There were some important papers that turned out to be
         | fraudulent, but there is a large and broad body of knowledge
         | supporting this link.
        
         | JoshTriplett wrote:
         | It's correlated, much as body temperature is correlated with
         | infection. But much like lowering body temperature won't cure
         | the infection, directly addressing the amyloid-beta plaques
         | doesn't seem likely to directly address Alzhimer's. Addressing
         | the actual root cause may _also_ make the plaques go away.
        
           | anon84873628 wrote:
           | FWIW the article says this:
           | 
           | >"The long-term effect comes from restoring the brain's
           | vasculature. We think it works like a cascade: when toxic
           | species such as amyloid-beta (Ab) accumulate, disease
           | progresses. But once the vasculature is able to function
           | again, it starts clearing Ab and other harmful molecules,
           | allowing the whole system to recover its balance. What's
           | remarkable is that our nanoparticles act as a drug and seem
           | to activate a feedback mechanism that brings this clearance
           | pathway back to normal levels,"
           | 
           | >...
           | 
           | >Normally, the protein LRP1 acts as a molecular gatekeeper,
           | binding to Ab and transporting it across the BBB for
           | elimination. In Alzheimer's, this system becomes fragile,
           | leading to Ab accumulation. The supramolecular drugs mimic
           | LRP1 ligands, binding to Ab and initiating its clearance,
           | effectively resetting the system and restoring vascular
           | function.
           | 
           | So we may be lucky in that addressing the plaques as a
           | symptom does indeed (allow for) repair of the underlying
           | cause. I guess the question is how long the benefit lasts.
           | What triggers the negative feedback loop in the first place?
           | The article claims long term improvement for the mice, which
           | were genetically programmed for amyloid production. (So maybe
           | not an accurate simulation of the root cause, but perhaps
           | actually more of a steel man test.)
        
         | perdomon wrote:
         | This scandal comes to mind any time I see amyloid plaque
         | research. Not sure if I misunderstood the scandal or if
         | Alzheimer's research has too much momentum to pivot. My dad was
         | diagnosed a few years back and seeing stuff like this is always
         | encouraging and infuriating because of this science article.
        
         | bpodgursky wrote:
         | Fraudulent research should be treated as no-info, not a
         | negative signal on the target. You can have fraudulent research
         | supporting a correct theory. In fact this is more common,
         | people will generally fake evidence to support a theory they
         | think is probably true.
        
       | btilly wrote:
       | Yes, we have a mouse model of Alzheimer's that can be cured by
       | preventing amyloid beta buildups. And billions of dollars in
       | failed drug trials demonstrate that what works for those mice,
       | doesn't work for humans.
       | 
       | This has been demonstrated for many years. And yet we waste
       | literally billions per year researching treatments that will only
       | work in mice. And yet we regularly publish articles proclaiming
       | that we can cure mice, humans are next!
       | 
       | This research is BS and a waste of taxpayer money.
        
         | jmount wrote:
         | Isn't it often even worse in that many of the "models" are
         | intentionally inflicting a condition superficially similar to a
         | symptom, and then showing some treatment blocks or reverses
         | that? So sometimes nothing to do with the underlying disease.
        
           | btilly wrote:
           | Yes, this is exactly the problem with animal models. We can
           | tell that the animal has the same symptoms. We don't know
           | that it has it through the same pathway as humans.
           | 
           | The models have worked often enough that it is reasonable to
           | hope that what works in animals, will work in humans. And it
           | is easier to experiment on animals. This is why they are used
           | in research.
           | 
           | But when what works in animals doesn't work in humans,
           | repeatedly, we should stop using that animal model in
           | research.
           | 
           | Here are examples of treatments for Alzheimer's that worked
           | in animals, reached human trials, then failed to help humans:
           | AN1792 (active Ab vaccine, Elan), Tarenflurbil
           | (R-flurbiprofen), Semagacestat (g-secretase inhibitor),
           | Bapineuzumab (anti-Ab mAb), Solanezumab (anti-Ab mAb),
           | Crenezumab, ponezumab, gantenerumab, and BACE inhibitors
           | (e.g. verubecestat, atabecestat).
           | 
           | All of these were considered promising enough in mice to be
           | worth expensive human trials. Where they failed. Those
           | weren't cheap failures, either.
        
           | nradov wrote:
           | The NIH recently changed their grant funding policy to focus
           | more on human experiments instead of animal models. It will
           | take some years to see whether this change has any positive
           | or negative effects.
           | 
           | https://grants.nih.gov/news-events/nih-extramural-nexus-
           | news...
        
         | pbasista wrote:
         | In general I do not think that a research which does not lead
         | to a full resolution of the primary issue can be dismissed just
         | because it does not actually resolve the issue.
         | 
         | Every step of the way towards the resolution of the issue is
         | important. Even ruling out what does not work is important.
         | 
         | Without those incremental advancements, we may never reach the
         | end goal.
        
           | btilly wrote:
           | Of course we should try to learn from past research.
           | 
           | But sometimes the lesson to be learned is that what we were
           | is a bad approach, and we need to rethink things. We can't
           | simply run experiments and get results. We also need to study
           | whether our experiments are telling us what we think that
           | they are telling us. Because if we don't know what our
           | experiments are actually telling us, we're going to
           | misunderstand the results.
           | 
           | https://people.cs.uchicago.edu/~ravenben/cargocult.html is
           | worth a read on this. Among other examples, it includes an
           | explanation of what actually has to be done in order for a
           | rat running a maze to actually test the rat's memory. And how
           | it is that we know that this is what has to be done.
           | 
           | The fact that psychologists ignored that experimental
           | procedure marked psychology as a cargo cult science. (Some 40
           | years later, the replication crisis forced psychologists to
           | at least talk about the issues that Feynman raised...)
           | 
           | The fact that we continue testing animal models of
           | Alzheimer's that we have proven to be a bad model of humans,
           | likewise shows that Alzheimer's research has become a cargo
           | cult science.
        
         | BriggyDwiggs42 wrote:
         | Okay but how exactly should researchers come up with drugs to
         | try on humans then?
        
           | btilly wrote:
           | This argument is like the infamous drunk who was arguing that
           | he should continue looking for his keys under the street
           | light, because the place where he actually dropped them had
           | no light so he couldn't see.
           | 
           | At this point it is a waste of time and money to produce more
           | drugs that are guaranteed to fail in humans. Making it harder
           | to waste time and money in this way is a feature, not a bug.
           | 
           | After we have better basic science about what likely causes
           | Alzheimer's, we can go back to the question of how to find
           | drugs that might help. Trying to do it in the other order is
           | putting the cart before the horse.
        
             | maybelsyrup wrote:
             | The litany of posts you've made in this thread indicate
             | that you're passionate about this topic.
             | 
             | Sincere question: wouldn't the great energy and intensity
             | you're putting into web forum replies be better channeled
             | into Alzheimer's advocacy?
        
           | mattkrause wrote:
           | There are other animal models, some of which even seem to
           | develop dementia-like symptoms spontaneously.
           | 
           | Mice have absolutely dominated research because they're
           | relatively cheap, lots of powerful genetic tools are
           | available, and the PR is more tractable. However, that
           | doesn't mean they're the right choice for every experiment.
        
         | stickfigure wrote:
         | Perhaps you would like to volunteer as a test subject instead?
        
           | pinkmuffinere wrote:
           | That wouldn't work, the test subject needs a brain.
           | 
           | (Sorry, this is a rude joke. Truthfully my disagreement with
           | patent is only medium-strength. I just can't resist jokes.)
        
             | psygn89 wrote:
             | Are you a dad by any chance?
        
               | pinkmuffinere wrote:
               | No, but I have nothing against them. Hell, I'm half dad
               | on my father's side! :D
        
           | btilly wrote:
           | This is a nonsequitur and an ad hominem.
           | 
           | Did you have a substantive response? Or are you just here to
           | deliver meaningless snark?
        
             | stickfigure wrote:
             | It is neither non sequitur nor ad hominem. Look those up
             | (or ask chatgpt to do it for you).
             | 
             | But in case it isn't clear: All models are inherently
             | imperfect. That doesn't mean they aren't useful. The ideal
             | test subject tends to complain when you propose dissecting
             | their brain for analysis.
        
               | btilly wrote:
               | I will not bother to respond to you again.
               | 
               | Instead I will trust that those in the audience that I
               | might care about, can judge your lies and insults
               | correctly.
        
         | biophysboy wrote:
         | Billions of dollars leading to failure during clinical trials
         | is the overwhelmingly likely outcome for all therapeutic areas,
         | particularly so for CNS.
         | 
         | Somebody else asked "what is your alternative?" and you
         | responded with "drunk under a streetlamp". The issue with this
         | is that all of science is drunks under streetlamps. Scientists
         | rely on a set of methods; for preclinical work, this is animal
         | models, organoids/tissue chips (still in development), and in-
         | silico AI stuff. Slim pickings! To use your lamp analogy, all
         | of these options will give off a pretty dim amount of light.
        
           | btilly wrote:
           | What evidence would it take for you to reconsider how we are
           | approaching Alzheimer's?
           | 
           | Our working theory is that amyloid beta plaques cause
           | Alzheimer's, and so preventing them will prevent the disease.
           | We have absolutely demonstrated our ability to prevent those
           | plaques in both mouse models and humans. Doing this cures
           | symptoms in mouse models. It does not cure symptoms in
           | humans. I already gave a list of 9 different approaches that
           | generated this exact result. How many more billions do we
           | need to spend on new approaches to do the same thing, before
           | the field reconsiders the theory?
           | 
           | And the failure here is not just with failed drug trials. In
           | this century, it is easier to find fraudulent data advancing
           | the hypothesis, than real data. With the result that several
           | fraudsters have managed to create very good careers for
           | themselves before being caught. This is a sign that there is
           | something very deeply wrong with the field, if such fraud is
           | rewarded rather than being caught more promptly.
           | 
           | Furthermore you are absolutely wrong about what I said about
           | the alternative. My drunk under a streetlamp comment was
           | about continuing to use these animal models to create more
           | drugs. My suggested alternative was basic science. If amyloid
           | beta plaques are a symptom, not a cause, of Alzheimer's, then
           | what is the cause? We need to figure that out, before trying
           | to create new drugs for it.
           | 
           | And it isn't like basic research has nothing to try.
           | Alternate hypotheses with some suggestive data for them
           | include Tau folding, inflammation (possibly caused by
           | viruses), problems with the blood-brain barrier, problems
           | with the mitochondria of neurons, dysregulation of metal
           | ions, and so on. Maybe the real answer is not even on this
           | list. But finding and demonstrating the real cause should be
           | a high priority.
           | 
           | My father-in-law has Alzheimer's. If research continues for
           | the next 30 years like it has in the last 30 years, there
           | will still be no treatment when my wife gets old enough to
           | worry about getting it. This is not a potential future that
           | I'm particularly looking forward to. (But maybe I'll get
           | lucky and get it before her...)
        
             | biophysboy wrote:
             | All of those alternative hypotheses have been investigated
             | with mice
        
             | didibus wrote:
             | > then what is the cause? We need to figure that out,
             | before trying to create new drugs for it.
             | 
             | Isn't that what the animal experiments are for? Trying to
             | find causation?
        
         | yxhuvud wrote:
         | Research into medicine that make the blood/brain barrier
         | function like on healthy people will certainly find
         | applications though, regardless of if it is useful against
         | Alzheimers though.
        
       | alphazard wrote:
       | > Instead of targeting neurons directly, this method focuses on
       | repairing the blood-brain barrier (BBB), the brain's defence
       | against harmful substances. By restoring proper BBB function, the
       | researchers achieved a reversal of Alzheimer's pathology in
       | animal models.
       | 
       | Alzheimer's patients often respond positively to exogenous ketone
       | esthers, and a ketogenic diet. The proposed mechanism for this is
       | that ketones are transported across the BBB differently than
       | glucose. Even if glucose is unable to be transported into the
       | brain, ketones often still are. Now that there is a drug to
       | repair the BBB, and likely glucose transport as well, I expect
       | the funding will mysteriously show up to properly investigate the
       | "brain diabetes" theory of Alzheimers.
        
         | GenerWork wrote:
         | >I expect the funding will mysteriously show up to properly
         | investigate the "brain diabetes" theory of Alzheimers.
         | 
         | There was the SNIFF [0] study that delivered insulin via nasal
         | spray, so there's already some funding and studies happening.
         | 
         | [0] https://www.clinicaltrials.gov/study/NCT01767909
        
         | JumpCrisscross wrote:
         | > _Now that there is a drug to repair the BBB (and likely
         | glucose transport as well), I expect the funding will
         | mysteriously show up to properly investigate the "brain
         | diabetes" theory of Alzheimers_
         | 
         | Why is this cast as conspiracy versus a natural consequence of
         | risk and incentives? ('Brain diabetes' is in no way a neglected
         | avenue of Alzheimer's research.)
        
           | matthewdgreen wrote:
           | There's been a long-running Internet movement to cast the
           | beta-amyloid and beta-amyloid/tau hypotheses as an evil plot
           | by scientists to siphon money away from research that works.
           | It's a whole thing. I anssume it's because Alzheimer's
           | legitimately sucks (my mom has it) and that means there has
           | to be someone we can blame.
        
             | smt88 wrote:
             | Wait, but isn't that "conspiracy" literally true? People
             | faked data and everything...
             | 
             | https://hn.algolia.com/?dateRange=all&page=0&prefix=true&qu
             | e...
        
             | alphazard wrote:
             | > There's been a long-running Internet movement to cast the
             | beta-amyloid and beta-amyloid/tau hypotheses as an evil
             | plot by scientist
             | 
             | No one was twirling their mustache trying to make people
             | suffer. Someone had a lab, and prestige and control over
             | funding and the best way to keep it all was by being
             | dishonest. That negatively affected progress in the field.
             | You can call it "evil" if you want, but more objectively it
             | was unaligned incentives. The corruption was covered in
             | mainstream news, it's not a conspiracy theory. Since the
             | scandal got out, the speed of progress has improved
             | significantly.
        
               | KPGv2 wrote:
               | > No one was twirling their mustache trying to make
               | people suffer. Someone had a lab, and prestige and
               | control over funding and the best way to keep it all was
               | by being dishonest.
               | 
               | The second sentence and the first sentence are merely
               | literal and figurative descriptions of the same activity.
               | 
               | Also, for this to be true, it has to mean lab workers
               | knew about progress but fucked over their own family with
               | Alzheimers. And it has to mean _every single one of them_
               | did this.
               | 
               | *Edit* Actually there's another way to interpret what you
               | wrote. My mistake. I imagined a scenario where someone
               | knew of progress and was dishonest by hiding it, but you
               | might've been alluding to someone knowing an avenue _wasn
               | 't_ fruitful but was dishonest by making it seem more
               | fruitful.
               | 
               | I think the latter is easier to hide than the former
               | since it doesn't require directly fucking over your
               | family, merely very indirectly by siphoning off a
               | fraction of total funds to be flushed down the toilet.
        
               | feoren wrote:
               | The latter is what happened, for upwards of ten years.
               | And it wasn't a small fraction of the funding -- almost
               | no funding was allocated to any research not looking at
               | amyloid plaques, because the intellectual giants'
               | (falsified) research was showing that that was by far the
               | most promising avenue to explore.
        
               | matthewdgreen wrote:
               | Again, there were a couple of instances of fraud in one
               | sub-branch of a sub-branch of a field ages ago, and The
               | Internet has decided to turn it into a conspiracy theory.
               | 
               | On the off chance that you're actually a decent, honest
               | person, I urge you to actually go learn about this theory
               | that you're promoting. Go out and actually figure out the
               | truth, because if it turns out that you're wrong about
               | the impact and intentions, you're helping to harm a lot
               | of people.
        
               | feoren wrote:
               | > You can call it "evil" if you want
               | 
               | It was a concerted and intentional effort to fake data
               | and falsify research into a pervasive deadly disease,
               | specifically in order to hoard funds going to research
               | they knew was, if not a dead end, at least not nearly as
               | promising as they were claiming, preventing those funds
               | from going to other research groups that might actually
               | make progress, essentially _stealing donations from a
               | charity_ , and using their power and clout to attack the
               | reputations of anyone who challenged them. They directly
               | and knowingly added some X years to how long it will take
               | to cure this disease, with X being at least 2 and
               | possibly as much as 10. When Alzheimer's is finally
               | cured, add up all the people who suffered and died from
               | it in the X years before that point, and this research
               | team is _directly and knowingly responsible_ for all of
               | that suffering. Yes, I think I will call it absolutely
               | fucking evil.
        
               | matthewdgreen wrote:
               | Again, I urge you to read this article and stop promoting
               | conspiracy nonsense. I take this very personally because
               | my mom has this disease, and people who _clearly don 't
               | understand what they're talking about_ fuming about
               | conspiracies really doesn't help anyone, and probably
               | hurts them immeasurably.
               | https://www.astralcodexten.com/p/in-defense-of-the-
               | amyloid-h...
        
               | andrewmcwatters wrote:
               | If that's not evil to you, everything wrong in your world
               | must just be misaligned incentives.
        
               | matthewdgreen wrote:
               | I really urge you to read this article. It was posted
               | elsewhere in the thread as well:
               | https://www.astralcodexten.com/p/in-defense-of-the-
               | amyloid-h...
        
               | alphazard wrote:
               | I can't guess what point you're trying to make with a
               | long article that acknowledges the fraud in the
               | beginning, and then rehashes the initial reasons for
               | looking into the amyloid hypothesis. No one is claiming
               | it was stupid to look into the amyloid hypothesis. They
               | are complaining that it hasn't been the most promising
               | theory in quite a long time, and it was fraudulently held
               | as the most promising. Other theories, arguably more
               | promising, are listed throughout your article.
               | 
               | There is a testable prediction in your article.
               | Unfortunately, I don't think the mechanism is quite
               | restricted enough. TFA says that repairing the BBB helps
               | amyloid plaque clearance. Would the author of your blog
               | post claim that as a win, or admit that the plaques are
               | downstream of the problem, and that BBB integrity is
               | closer to the root cause of the disease process?
        
             | mrguyorama wrote:
             | It's a whole thing because there's been over a century of
             | concerted effort in the US to cast _all of science_ as an
             | evil plot.
             | 
             | The Discovery institute, and all their donors and
             | connections (including literal politicians) tell millions
             | of children that science is a plot of satan to make you
             | doubt god.
             | 
             | The people who created the Scopes "monkey trial" never went
             | away, are fabulously well funded and organized and
             | connected, and _have succeeded beyond their wildest dreams_
             | 
             | Now they are trying to expand that belief to all of
             | academia, so that people who never set foot in an academic
             | institution and have never tried any higher education
             | beyond high school and have _never even attempted to read a
             | scientific paper_ are convinced that all Academics are in a
             | concerted plot.
             | 
             | 30 million Americans claim to believe God created humans
             | exactly as they are now within the past 10k years.
             | 
             | That's the _low estimate_ of christian fundamentalism and
             | science hostile cohort in the US.
        
               | ashtakeaway wrote:
               | The science hostile cohort is flourishing wherever
               | christian fundamentalism is rampant, in some places most
               | people are exactly this. A lot of the depressing things
               | Carl Sagan mentioned in Demon Haunted World turns out to
               | be true. I had thought that 20 years ago we were on our
               | way to being a rational society but it turned out this
               | notion was on its way out.
        
               | regnull wrote:
               | When you say "science", you need to distinguish between
               | science as philosophy vs. science as an institution.
               | Science as philosophy is a way of thinking - an attempt
               | to understand knowledge and reality. The science as an
               | institution on the other hand has all the imperfections
               | as any other institution, since the people in charge are
               | driven by self interest and not just the search for the
               | truth. So, when you say the people distrust science, it
               | seems bizarre that they doubt science as philosophy,
               | while in fact they doubt the institution. It's perfectly
               | fine to mistrust the institution. If you want to consider
               | a few failures, just in the recent years, I have some for
               | you:
               | 
               | - Hungarian-born biochemist Katalin Kariko, who developed
               | the key mRNA modification that enabled effective COVID-19
               | vaccines, was repeatedly denied grants and demoted during
               | her career. She and her collaborator, Drew Weissman,
               | struggled for years to gain recognition and funding for
               | their work [1]
               | 
               | - On the other hand, the Wuhan Institute of Virology had
               | no trouble getting grants from NIH [2]
               | 
               | - Surgeon General Jerome Adams was saying that masks are
               | not effective against Covid [3]
               | 
               | - Social distancing was of supreme importance, until it
               | turned out that it's fine not to distance if it's for a
               | good cause [4]
               | 
               | [1] https://www.statnews.com/2022/02/01/kariko-problem-
               | lessons-f...
               | 
               | [2] https://www.bmj.com/content/382/bmj.p1701
               | 
               | [3] https://www.npr.org/sections/health-
               | shots/2020/07/01/8862991...
               | 
               | [4]
               | https://www.politico.com/news/magazine/2020/06/04/public-
               | hea...
        
               | ToucanLoucan wrote:
               | > So, when you say the people distrust science, it seems
               | bizarre that they doubt science as philosophy, while in
               | fact they doubt the institution.
               | 
               | The vast, vast, vast majority of the Christian
               | fundamentalists whom are the backbone of this movement
               | and the subject of this discussion do not distinguish
               | between these things. They do not distrust "big science,"
               | they distrust science, full stop. The fact that science
               | as an institution is subject to the same corruptive
               | forces as every other institution is a convenient post-
               | hoc rationalization for the belief they already had and
               | wanted to justify, just like a lot of other post-hoc
               | rationalizations they have for other beliefs they have.
               | They dislike science _now_ because they are told to by
               | their ministers, no more reason than that, and we know
               | this because science and their religion coexisted
               | peacefully and uneventfully for centuries until it become
               | inconvenient for a segment of the church 's politics.
               | Excluding of course Gallileo, and for the same reasons.
               | 
               | Science (both as philosophy and institution) gets it
               | wrong, but has built-in mechanisms that correct those
               | issues. Eugenics was discredited by science. Andrew
               | Wakefield's bullshit autism study was discredited by
               | science. Religion gets it wrong and then calls it
               | mystery.
               | 
               | It's especially ironic to hear institutional corruption
               | invoked as a critique of science, when many of the
               | loudest voices in this conversation come from religious
               | institutions that have spent decades shielding their own
               | leadership from accountability for far more egregious
               | abuses.
        
               | greenchair wrote:
               | effective covid vaccines?
        
               | stinkbeetle wrote:
               | The bigger problem and the one that is more damaging to
               | public trust in science is actually politicians (and
               | bureaucrats and other government and non-government
               | institutions) who spread disinformation that policy is
               | science. Their policy is "based on the science" they will
               | claim, and therefore to disagree with their policy is to
               | be a "science denier" they assert, without evidence.
               | These dishonest interests essentially hijack the good
               | name of science by fooling low information voters.
               | 
               | There is a lot of science around epidemiology, virology,
               | vaccines, and medicine. There is no evidence based
               | scientific consensus that it was the "correct" policy to
               | shut down large parts of the economy, subsidize
               | mothballed businesses, admit COVID positive patients to
               | nursing homes, impose emergency policies impinging on
               | human rights like restricting travel and association and
               | medical autonomy, or fast-track vaccines for COVID.
               | 
               | You could argue for those policies, but it should have
               | been completely reasonable to argue against them. That
               | does not make you "anti-science". People can and should
               | question the efficacy of the vaccines, and the lies that
               | were repeated by certain "news" corporations and
               | politicians who had interests in and donations from
               | pharmaceutical companies, with fantastical claims about
               | them that turned out to be false. That does not make you
               | "anti-science" either.
               | 
               | Similar thing with the science of greenhouse gasses and
               | global warming. There is a lot of science around the
               | fundamentals of those mechanisms, there is a lot of
               | science showing that warming can gravely damage
               | ecosystems and human societies and therefore limiting
               | human CO2 emissions would be a benefit. That's great,
               | that is science. What is not science is any particular
               | government policy purported to help this. Proposing to
               | reduce or tax GHG emissions in one country and thereby
               | incentivize production in another country (with far
               | higher emissions intensity of production) is not
               | "science". It's not "anti-science" or "climate denier" to
               | question or disagree with a policy like that, for
               | example.
        
         | overgard wrote:
         | I've heard the colloquial phrase "type 3 diabetes" appear a lot
         | in talk about Alzheimers, so I'd be shocked if there isn't a
         | lot of research going into that. I just read a book about how
         | metabolism is related to a lot of mental disorders (depression,
         | schizophrenia, etc.) so I think it's something that's
         | definitely being looked at (the book is called Brain Energy, I
         | think).
        
           | Mabusto wrote:
           | Hey what was the book out of curiosity?
        
         | ajross wrote:
         | > Alzheimer's patients often respond positively to exogenous
         | ketone esthers, and a ketogenic diet.
         | 
         | I went looking for a cite here and came up almost empty
         | (wikipedia has one link to an 11 year old paper that doesn't
         | really say much authoritative in the abstract).
         | 
         | I wish people would be more rigorous about this stuff.
         | Atkins/paleo/keto is the gluten-free/hemp/cbd/hippy magic of
         | the hacker set, not least because it's nearly perfect wish
         | fulfillment[1]. And it appears in a lot of mystical contexts
         | too, showing up as a cure for whatever is being discussed.
         | 
         | The actual science, every time I look, is a _lot_ less
         | convincing.
         | 
         | [1] Meat! It's all meat! We love meat!
        
           | motoboi wrote:
           | Maybe you can see this as more compelling evidence:
           | https://consensus.app/search/does-ketonic-diet-improve-
           | alzhe...
           | 
           | >Cognitive Effects and Clinical Outcomes > >Multiple
           | systematic reviews and clinical trials report that ketogenic
           | diets (KD) or ketone supplementation can lead to improvements
           | in cognitive function, daily living activities, and quality
           | of life in people with mild-to-moderate Alzheimer's disease
           | 413141819. Chronic KD interventions (3-4 months) have been
           | associated with increased cognitive test scores and improved
           | memory performance 1418. Some studies also show positive
           | changes in Alzheimer's biomarkers, such as reduced tau and
           | increased amyloid-beta 42 in cerebrospinal fluid 7."
        
             | ajross wrote:
             | Well, thanks. That's certainly better than what made it
             | into wikipedia. But honestly: no? Only 41% of papers
             | answering "yes" to an engaging and evocative hypothesis, in
             | the era of the replication crisis, and _especially_ after a
             | decade and a half of the hypothesis sitting around in
             | general lore, generally means  "no, duh" in my experience.
             | 
             | As the site itself says, "evidence is still limited and
             | more research is needed", which is definitely not
             | "compelling". My money still sits on "nerd wish
             | fulfillment". But we'll see.
        
               | motoboi wrote:
               | Yeah, there are studies suggesting neurons, far more so
               | than many peripheral cells, are especially vulnerable to
               | insulin resistance. So by the time you see systemic
               | insulin resistance by standard measures, the brain may
               | already be slipping. I suppose this is why ketonic diet
               | has any role in restoring cognitive function.
        
           | m0llusk wrote:
           | The idea that paleo/keto is all buttered meat is strange and
           | fairly recent, with wish fulfillment probably being strongly
           | involved. Meat would have been a luxury not available for all
           | meals so other tissues like tendon, tripe, and skin would
           | have been common ingredients. That plus other changes like
           | boiling most meals and serving them with the boil water make
           | a huge difference in the nutritional profile.
        
             | ajross wrote:
             | > The idea that paleo/keto is all buttered meat is strange
             | and fairly recent
             | 
             | To be clear: the dietary theories here (such as they are)
             | are surely rigorously defined and subsume all sorts of
             | choices for how to get fats and avoid carbs.
             | 
             | But to a person, every solitary practitioner I've ever met
             | has implemented their Atkins/paleo/keto diet with almost
             | exclusively meat.
             | 
             | It's a MEAT! diet because nerds love MEAT!.
        
               | timschmidt wrote:
               | I read "Prolonged Meat Diets with a Study of Kidney
               | Function and Ketosis" by Walter S. McClellan and Eugene
               | F. Du Bois, Journal of Biological Chemistry (1930). The
               | original paper that kicked off all the Atkins diet ideas.
               | It made quite a point of the fact that the two men
               | participating started off thinking that they'd like
               | eating all meat, and quickly realizing that they began
               | craving fat and organ meat to an extent that it ended up
               | making up the majority of their diet.
        
         | epicureanideal wrote:
         | Would it be possible to artificially increase the glucose in
         | the brain to get a nootropic effect?
        
       | 1970-01-01 wrote:
       | Why isn't "in mice" an automatic flag for posting? This is not a
       | breakthrough in Alzheimer's nor is it headline news in
       | Alzheimer's research.
        
         | bookofjoe wrote:
         | I asked this question in Ask HN about six months ago but
         | received little support and much criticism.
        
       | DaveZale wrote:
       | from the bbb wiki:
       | 
       | There is also increasing evidence that a healthy gut microbiome
       | is necessary to maintain BBB integrity, both in development and
       | aging.[38][39][40][41]
       | 
       | I'll drink to that (kefir)!
        
       | sys32768 wrote:
       | I think the main progression is lymphatic dysfunction > chemical
       | build-up > BBB damage > neurodegenerative plaques and tangles.
       | 
       | My mother died from Alzheimer's at 77 but was the picture of
       | health and happiness for many years prior, but never slept well
       | to the point she had to have her own room away from Dad for many
       | years.
       | 
       | Maybe the trick is going to be repairing the BBB and stimulating
       | lymphatic function rather than chasing down every factor that
       | explains why the BBB and/or lymphatic function is compromised in
       | the first place.
        
         | JamesBarney wrote:
         | I think the cure is going to be something that dissolves tau
         | tangles, or something safe enough we can give as a preventative
         | to people 10-20 years before they develop symptoms that helps
         | with amyloid.
        
         | anon84873628 wrote:
         | The authors of this work believe the treatment enables BBB
         | repair and restoration of healthy vasculature.
        
       | BenFranklin100 wrote:
       | People are criticizing mouse models of AD. There is
       | understandable given the confusion of the roles of animals models
       | in disease. Let me explain:
       | 
       | First, the very name, 'animal model of disease" is misnomer, and
       | the cause of most of the confusion. Animal models are more
       | accurately described as 'models of mechanism'.
       | 
       | Second, while mouse are different from humans and how a disease
       | manifests is different as well, many of underlying mechanisms
       | that drive a disease share strong similarities across species.
       | Mice, rats, dogs, pigs, humans etc... all share the same
       | fundamental building blocks and cellular/tissue/organ mechanisms.
       | Studying how a disease or even partial aspects of a disease
       | manifests in, say, a mouse, can offer extraordinary insights in
       | how the disease may manifest in humans. This can provide a strong
       | experimental basis for potential therapies in humans. (A rough
       | analogy is the field of software is that different programs can
       | use the same functions. Understanding how a function is
       | misbehaving in a simple program can provide insights in how it is
       | misbehaving in a more complex program.)
       | 
       | Third, many diseases are difficult or impossible to study in
       | humans. Alzheimer's is a good example as the progression occurs
       | on a timescale of decades. Further, we obviously can't go around
       | cutting out brain tissue from live humans.
       | 
       | It's a big topic, but hopefully my brief outline provides some
       | context for the use of animals models. We scientists also use
       | cell and organoid models, which, while lacking key details of
       | animal models in unknown ways, can provide insights as well.
        
       | dsign wrote:
       | If the causal mechanism in Alzheimer's is not clear, what's to
       | say it isn't about 20 or 20000 different things going wrong in
       | ways and proportions which are very specific to each individual?
       | 
       | I'm not criticizing basic research, which I consider immensely
       | useful. Rather, the way we expect for it to become magical drugs.
       | The peak of contradiction is posing that humans are inscrutable
       | creations of God who wills us to age and die miserably, and in
       | the same breath also wanting to have a neat repair handbook
       | indicating fixed doses of the same drugs for each symptom--as if
       | we were some cheap car model that comes without spares nor OBD
       | port, and that it's only serviced at the end. I think we need to
       | solve that.
        
         | w10-1 wrote:
         | > what's to say it isn't about 20 or 20000 different things
         | going wrong
         | 
         | In this case, the therapy resulted in old mice performing like
         | young mice (in addition to the amyloid-beta level reducing).
        
         | anon84873628 wrote:
         | Well they synthesized a magic molecule that mimics an
         | endogenous compound that stops functioning in the diseased
         | systems.
         | 
         | Everyone agrees with you. The whole era is "precision
         | medicine".
        
       | Rikudou wrote:
       | For one hundredth goddamn time: Mice don't have Alzheimer's. They
       | can't ever get it and almost none of the successes scientists
       | achieve with the mice illness _that has nothing to do with
       | Alzheimer 's except similar symptoms_ are reproducible in humans
       | at all.
       | 
       | I really wish the news sites would get it correctly from time to
       | time, this is misleading as hell.
        
         | gcanyon wrote:
         | > The researchers tested their approach in mice genetically
         | programmed to overproduce Ab and develop cognitive decline
         | similar to Alzheimer's pathology.
         | 
         | Thoughts on that FTFA?
        
       | rippeltippel wrote:
       | Original article was posted on HN:
       | https://news.ycombinator.com/item?id=45508672
        
       | chermi wrote:
       | The headline really, really annoys me. It makes it sound causal,
       | amyloid-B removal causes reversing symptoms of alzheimer's. Thus
       | supporting and even making seem certain the still somehow
       | overwhelmingly popular (not to sound like conspiracy anti-pharma
       | guy(1)) amyloid theory of alzheimers.
       | 
       | All this shows is that _one_ of the effects of the treatment is
       | clearing aggregates, _IN MICE_. That 's it, nothing more.
       | 
       | We don't know for sure the causal mechanism. There was/is a
       | fanatical well-funded machine behind the amyloid hypothesis; that
       | doesn't make it correct. There is much reason to doubt it or at
       | least downgrade it to a contributing but not sole causal
       | mechanism.
       | 
       | (1) it is absolutely mind-boggling to me that the amyloid
       | clearing drugs like Aduhelm got FDA approval while so many much
       | more proven treatments for other diseases sit waiting.
        
       | wewewedxfgdf wrote:
       | Mice get all the big health discoveries.
       | 
       | We're going to be ruled be a race of super healthy, immortal,
       | super intelligent lab mice.
        
         | jasonvorhe wrote:
         | Nah, we just love torturing and killing animals for science.
        
       | DaveZale wrote:
       | From 2023: It has been suggested that the BBB breakdown may
       | precede cognitive decline and neurodegeneration, highlighting the
       | critical need for further exploration of the BBB's role in AD and
       | its potential as a therapeutic target [22]. The BBB endothelium
       | is a specialized system of brain microvascular endothelial cells
       | that separate circulating blood from the brain's extracellular
       | fluid, maintaining the brain's homeostatic environment [23]. The
       | BBB endothelium plays a crucial role in the protection and
       | functioning of the brain, allowing the selective passage of
       | nutrients and molecules essential for brain function while
       | simultaneously preventing the entry of potentially neurotoxic
       | substances [22].
       | 
       | Also interesting: the two-hit vascular hypothesis of AD suggests
       | cerebrovascular damage (hit 1) as an initial insult that is self-
       | sufficient to initiate neuronal injury and neurodegeneration.
       | Additionally, it promotes the buildup of Alzheimer's Ab toxin in
       | the brain (hit 2)
       | 
       | https://pmc.ncbi.nlm.nih.gov/articles/PMC10671257/
        
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