The medical director of the Baylor AT&T Memory Center explains how in-house biomarker testing could improve opportunities for clinical drug research.
Claudia R. Padilla, MD
The development of care for Alzheimer's disease is at something of a standstill. A few elements—such as limited funding and available patients for clinical trials—makes it difficult for researchers to progress the state of therapy options for the neurodegenerative disease.
That's why Claudia R. Padilla, MD, is looking into biomarkers. The medical director of the Baylor AT&T Memory Center talked to MD Magazine® about in-house clinical trials involving patient urine and blood sample analysis, and what needs to be focused on to progress the state of research.
MD Mag: Can you talk about some of the work being done at Baylor to address Alzheimer’s disease treatment needs?
Padilla: By better diagnosing an individual—whether they have a cognitive change, whether they have Alzheimer’s disease, or any type of neurodegenerative disease—really helps us with the treatment. And it helps us target research so that we could find a disease-modifying treatment for Alzheimer’s disease and neurodegenerative diseases.
A lot of times, I find the patient has been diagnosed with dementia, which is not really so much of a diagnosis as it is an umbrella term that we use to tell us the person is having trouble with memory or cognition and it has changed their functional life.
So one of the studies we’re trying to do is try to identify new or novel biomarkers, and the category of biomarkers is in the category of metabolomics. We’re partnered with the director of metabolomics at Baylor, and he is approaching the patients’ biomarkers. We’re using blood and urine biomarkers, and he’s running a targeted metabolomic analysis in these samples of individuals that have been diagnosed with Alzheimer’s disease and are in different severities of the disease—mild, moderate, or severe. We’re trying to see what are the specific metabolomics that are involved in these individuals that have been diagnosed, versus a normal individual.
That’s one of the studies we’re recruiting patients for here at Baylor. The way we do that is by a clinic visit, using some diagnostic approaches with imaging. Once they have their diagnoses, we collect the samples and send them off to the metabolomics laboratory so they could do these analyses. We’re still enrolling patients, so we don’t have any results yet, but hopefully we will have preliminary results in the next 6 months to a year—hopefully 6 months, so we can see any patterns in those who have been diagnosed.
Do you have any plans for follow-up?
Most of the patients recruited in the study are patients in our clinic, so we do have a pretty good follow-up in terms of seeing the patient. For the research study, what we try to do over a course of year to a year-and-a-half is follow them up every 6 months and get 3 different samples over time.
With our other research study, which is targeted at early onset Alzheimer’s disease patients, and those patients who do not have any family history of the disease, we only are collecting one sample and running an analysis in our blood sample to take a look at their genetic makeup to see if there’s any abnormalities.
Is there anything of note in Alzheimer’s disease comorbidities that need to be addressed?
It’s really important that you bring up comorbidities, because we have to think about the effects of cardiovascular risk factors and how that association is hand-in-hand with changes in the brain. It’s really important when you’re evaluating an individual with cognitive changes, doing a cardiovascular changes risk assessment, assessing things like high blood pressure, hypertension, hyperlipidemia, diabetes risk factors. Those all can contribute to changes in cognition and also create changes in the brain. Discussing that with the individual, looking over those types of things are critical evaluations.
For more extensive coverage from the Alzheimer’s disease space, check out MD Magazine's sister site, NeurologyLive. The Clinical Focus page serves as a resource for clinical news, articles, videos, and newly released data pertaining to dementia, too.