Where does current research focuses its resources, and what may the future of such research involve?
Claudia R. Padilla, MD
Claudia R. Padilla, MD, medical director of the Baylor AT&T Memory Center, is leading research into novel biomarkers of Alzheimer's disease—a neurodegenerative condition that raises as nearly many clinical questions as it had at the time of its discovery. In a discussion with MD Magazine® Padilla explained her own personal experiences with the disease, where current research focuses its resources, and what the future of such research may involve.
MD Mag: When did you first become involved with this program?
Padilla: I started the research program here. Before that, I was finishing my fellowship training at UCLA. We were involved in a lot of research there as well. That’s where I’d say I started my research for Alzheimer’s disease and other neurodegenerative diseases, and then started the program at the Baylor Memory Center.
What in particular drove you to this field? Did you have any personal stake to it?
I did have a personal experience. My grandparents were both diagnosed with Alzheimer’s, when I was in college. And that led me to neuroscience and trying to understand the brain a little bit better. That interest continued through medical school, and my neurology residency. I was always interested in researching Alzheimer’s, in understanding the disease better, because of that experience. That continues to drive me today—also working with the number of patients with Alzheimer’s, and trying to bring more patient awareness regarding the disease. I’m trying to help people understand that it’s not only a disease of the old, in their 80s and 90s. It’s also a disease that affects individuals in their early years.
It’s interesting you mention that. It seems that a lot of people going into the field would believe that that there’s a distinct understanding of the disease. But researchers have said there’s still misconceptions and nuances that need to be better understood in order to push the progress of clinical research.
What are some of the things you had to learn along the way to better your own research?
I think we’re still just trying to decide and figure out the central hypothesis of why Alzheimer’s disease affects certain individuals, and how does the process affect them. The theory that has been put in place for many years regarding the 2 abnormal proteins that accumulate in the brain—amyloid and tau—that are part of that central theory. And then there’s other certain things that may happen in the brain, like inflammation, that also play a role.
So we don’t really have one cause. There’s multiple things that occur in the brain, and so research tries to better understand that in Alzheimer’s disease—what’s actually occurring.
There was a recent report about researchers in Dallas that are really taking a look at tau proteins. Theyre trying to understand why the normal protein turns into a toxic protein, like tau, and why it causes the changes in the brain and neurodegeneration.
It’s always changing and we’re always learning.
What’s been found in particular tau protein research?
In the past, there was some discussion about some viral implication with Alzheimer’s disease. But there’s been some research applications about trying to develop a vaccine. From what I know, those early trials did not work out. I think right now, research is targeting that tau protein—how do we stop the production of that, how do we clear that from someone’s brain.
So that’s where research is really heading. Initially, beside some vaccination trials, the central research approach was looking at the amyloid protein, targeting that protein with a base inhibitor or an anti-amyloid monoclonal antibody that would attack the protein and remove it from the brain. There has been numerous clinical research that has shown that approach of targeting the amyloid protein didn’t work. There were no positive endpoints in research studies, so we’re switching our approach now to the tau protein to see how we can stop the protein from forming in the brain.
In 5-10 years down the road, what is the state of Alzheimer’s research and its progression?
I think there’s more awareness about the need for continued research and development in Alzheimer’s disease. I just had received an email from the Alzheimer’s Association (AA). Here at the Dallas chapter I’m the chair of the Accelerating Research Committee, and we get a lot of information about the progress AA is making in Washington, DC, and the conferences they attend. They had just sent us an email today about a lot more money being funded to the NIH (National Institutes for Health) for Alzheimer’s research. I think that we have to continue to talk about the disease and how important it is to continue research, and encourage individuals to get an evaluation and learn more about clinical research trials, because the only way we’ll develop new treatments is if we have patients enroll in this trial.
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