Read the abstract:
Journal of Neuroinflammation 

Histopathogic image of senile plaques seen in the cerebral cortex in a patient with Alzheimer disease of presenile onset.

An extraordinary new scientific study, which for the first time documents marked improvement in Alzheimer’s disease within minutes of administration of a therapeutic molecule, has just been published in the Journal of Neuroinflammation.

This new study highlights the importance of certain soluble proteins, called cytokines, in Alzheimer’s disease. The study focuses on one of these cytokines, tumor necrosis factor-alpha(TNF), a critical component of the brain’s immune system. Normally, TNF finely regulates the transmission of neural impulses in the brain. The authors hypothesized that elevated levels of TNF in Alzheimer’s disease interfere with this regulation. To reduce elevated TNF, the authors gave patients an injection of an anti-TNF therapeutic called etanercept. Excess TNF-alpha has been documented in the cerebrospinal fluid of patients with Alzheimer’s.

The new study documents a dramatic and unprecedented therapeutic effect in an Alzheimer’s patient: improvement within minutes following delivery of perispinal etanercept, which is etanercept given by injection in the spine. Etanercept (trade name Enbrel) binds and inactivates excess TNF. Etanercept is FDA approved to treat a number of immune-mediated disorders and is used off label in the study.

The use of anti-TNF therapeutics as a new treatment choice for many diseases, such as rheumatoid arthritis and potentially even Alzheimer’s, was recently chosen as one of the top 10 health stories of 2007 by the Harvard Health Letter.

Similarly, the Neurotechnology Industry Organization has recently selected new treatment targets revealed by neuroimmunology (such as excess TNF) as one of the top 10 Neuroscience Trends of 2007. And the Dana Alliance for Brain Initiatives has chosen the pilot study using perispinal etanercept for Alzheimer’s for inclusion and discussion in their 2007 Progress Report on Brain Research.

The lead author of the study, Edward Tobinick M.D., is an assistant clinical professor of medicine at the University of California, Los Angeles and director of the Institute for Neurological Research, a private medical group in Los Angeles. Hyman Gross, M.D., clinical professor of neurology at the University of Southern California, was co-author.

The study is accompanied by an extensive commentary by Sue Griffin, Ph.D., director of research at the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences (UAMS) in Little Rock and at the Geriatric Research and Clinical Center at the VA Hospital in Little Rock, who along with Robert Mrak, M.D., chairman of pathology at University of Toledo Medical School, are editors-in-chief of the Journal of Neuroinflammation.

Griffin and Mrak are pioneers in the field of neuroinflammation. Griffin published a landmark study in 1989 describing the association of cytokine overexpression in the brain and Alzheimer’s disease. Her research helped pave the way for the findings of the present study. Griffin has recently been selected for membership in the Dana Alliance for Brain Initiatives, a nonprofit organization of more than 200 leading neuroscientists, including ten Nobel laureates.

“It is unprecedented that we can see cognitive and behavioral improvement in a patient with established dementia within minutes of therapeutic intervention,” said Griffin. “It is imperative that the medical and scientific communities immediately undertake to further investigate and characterize the physiologic mechanisms involved. This gives all of us in Alzheimer’s research a tremendous new clue about new avenues of research, which is so exciting and so needed in the field of Alzheimer’s. Even though this report predominantly discusses a single patient, it is of significant scientific interest because of the potential insight it may give into the processes involved in the brain dysfunction of Alzheimer’s.”

While the article discusses one patient, many other patients with mild to severe Alzheimer’s received the treatment and all have shown sustained and marked improvement.

The new study, entitled “Rapid cognitive improvement in Alzheimer’s disease following perispinal etanercept administration,” and the accompanying commentary, entitled “Perispinal etanercept: Potential as an Alzheimer’s therapeutic,” are available on the Web site of the Journal of Neuroinflammation,

Collaboration Aims to Find High-Tech Solutions for Quicker Diagnosis, Better Treatments

Today, Mayo Clinic and IBM (NYSE: IBM)small-banner-1.jpg announced the creation of a collaborative research facility aimed at advancing medical imaging technologies to improve the quality of patient care. The Medical Imaging Informatics Innovation Center (MI3C) is an extension of a Mayo-IBM research collaboration announced in 2007, the results of which have given physicians the ability to register medical images up to 50 times quicker and provide critical diagnosis, such as the growth or shrinkage of tumors, in seconds instead of hours.

“This facility will allow us to explore projects in medical imaging and radiology that can help to provide faster and better information for our physicians, and in turn, improved treatments for our patients,” said Bradley Erickson, M.D., Ph.D., head of Mayo’s Radiology Informatics Lab. “The collaborative potential of the MI3C gives us the opportunity to develop computationally intensive solutions for diagnostic problems we see every day, but that we at Mayo could not attempt to resolve on our own.”

Driving these patient-centered projects will be a full-time team of Mayo and IBM researchers and development staff. Together, they will tackle a long list of potential projects, including:

— Maximum-resolution organ imaging to provide physical (phenotype)
information that parallels the current level of genetic detail available
for the same tissue. This is designed to give physicians a much more
complete impression of a patient’s condition.
— Image-guided tumor ablation to pinpoint and maximize efficiency of
heat transfer probes used to destroy cancer tumors. By guiding physicians,
this innovation can help to improve accuracy and minimize side effects.
— “Video swallow analysis” to see and compare how stroke patients
swallow in order to better determine the severity of their disability and
help provide proper physical therapy as well as protection against choking.
— Automated Change Detection and Analysis designed to allow physicians
to compare a new image with a previous one, eliminate what has not changed
and to better assess what change has occurred, helping to improve
diagnostic speed and accuracy.

At the heart of the MI3C will be the latest in high-end imaging platforms and computational hardware, including IBM’s breakthrough computing system based on the Cell Broadband Engine(TM) and blade technology. The MI3C will showcase this capability along with Mayo’s leadership in medical imaging research and informatics.

“The MI3C is a physical manifestation of the larger set of skills and resources IBM and Mayo Clinic can collectively apply to the medical imaging space,” said Bill Rapp, IBM distinguished engineer and chief technology officer for IBM’s Healthcare and Life Sciences team. “IBM has world-class research and development teams focused on the fundamental algorithms that drive medical imaging informatics and hardware, while Mayo Clinic provides its expertise for exploiting these algorithms in applications that support a working, real-life radiology environment.”

The MI3C will be housed on the Mayo Clinic campus in Rochester, MN, and will bring together clinicians, researchers and vendors in an environment where they can freely interact. By mutual agreement, third parties also will have future opportunities to collaborate with IBM and Mayo in the facility.

In addition to increasing interest and participation in imaging projects that can help to improve patient care, the MI3C also hopes to attract research grants for future investigations. The work will not only grow assets in imaging informatics at IBM and Mayo, including potential new graphics tools for visualization, but also lead to development of a software library for advanced medical imaging on high-end computer systems.

About Mayo Clinic

Mayo Clinic, a not-for-profit medical center, thoroughly diagnoses and treats complex medical problems in every specialty. It also conducts wide-ranging, interdisciplinary medical research with the sole goal of improving patient care. Mayo Clinic has campuses in Arizona, Florida and Minnesota.

About IBM

For more information on IBM, visit
*Cell Broadband Engine is a trademark of Sony Computer Entertainment, Inc. in the United States, other countries, or both and is used under license therefrom. All other company product or service names may be trademarks or service marks of others.