Alzheimer’s a collection of diseases to be treated separately

Neurodegenerative diseases are incurable.

Holocaust survivor Betty Stein, 92, (L) and Eli Boyer, 91, play ping pong at a program for people with Alzheimer's and dementia at the Arthur Gilbert table tennis center in Los Angeles (photo credit: REUTERS)
Holocaust survivor Betty Stein, 92, (L) and Eli Boyer, 91, play ping pong at a program for people with Alzheimer's and dementia at the Arthur Gilbert table tennis center in Los Angeles
(photo credit: REUTERS)
Deciphering the mechanism that underlies the development of Alzheimer’s disease in certain families but not in others, researchers at the Hebrew University of Jerusalem’s Faculty of Medicine suggest it is actually a collection of diseases that should be treated with a variety of different approaches.
Neurodegenerative diseases are incurable. Debilitating conditions that result in degeneration or death of nerve cells include prion disorders (such as “mad cow disease,” known to doctors as Creutzfeldt-Jakob disease), Alzheimer’s and Parkinson’s. They have in common the fact that they emerge late in life as a result of aberrant protein folding and aggregation.
These maladies emerge either sporadically or as familial, mutation-linked illnesses (certain prion diseases can be also infectious).
Most sporadic cases are diagnosed during the patient’s seventh decade of life or later, while familial cases typically manifest during the fifth or sixth decade.
Despite their relative rareness, mutation-linked cases are very important, as they provide hints that can help decipher the mechanisms underlying the development of the disease.
This raises key questions: Why do those who carry the disease-linked mutation show no clinical signs until their fifth or sixth decade of life, and why do apparently distinct disorders share a common temporal emergence pattern? One possible explanation is that as people age, the efficiency of the mechanisms that protect younger people from the toxic aggregation of proteins declines, thus exposing them to disease. Indeed, previous studies clearly indicate that the aging process plays key roles in enabling neurodegenerative disorders to onset late in life.
Since neurodegenerative disorders stem from aberrant protein folding, an international research team, led by Prof. Ehud Cohen and Dr. Tziona Ben-Gedalya at the medical faculty’s Institute for Medical Research Israel – Canada (IMRIC) suggested that an aging-associated decline in the activity of proteins that help other proteins to fold properly may be one mechanism that exposes the elderly to neurodegeneration.
To identify such mechanisms, they searched for similar mutational patterns in different proteins that are linked to the development of distinct neurodegenerative disorders. Their research showed that the development of Alzheimer’s disease in certain families, and of a familial prion disorder in other families, originate from very similar mutational patterns.
“Our study proposes that the failure to develop efficient Alzheimer’s therapy emanates from the pooling, in clinical experiments, of patients who suffer from distinct disorders that eventually lead to Alzheimer’s symptoms,” said Cohen. “Therefore it is essential to carefully characterize and classify the mechanisms that underlie Alzheimer’s to allow for the development of novel therapies for the individual patient according to his or her relevant disease subtype.”
More than 1,000 youngsters – 70 percent of them up to the age of five – are scalded every year by boiling liquids and hospitalized for painful treatment of their burns, according to Beterem, the Israel Council for Children’s Safety and Health. The number of victims is rising.
Friday and Saturday are the most common days when this accident occurs – apparently due to the fact that on Shabbat, electric samovars hold hot water in kitchens and metal containers of water are placed on hot plates.
For some reason, such injuries are more common among boys (56.5%) than girls (43.5%). The vast majority of such burns – usually from hot water, coffee or tea, but sometimes hot soup, sauces or oil – occur at home.
In almost two out of five cases, an adult was within a meter or two of the victim, which indicates adult negligence.
Beterem urges parents to ensure that samovars and other hot objects are always kept out of the reach of young children.
Consumers with a sweet tooth who eschew sugar will be happy. Food scientists headed by food engineering Prof. Syed Rizvi at Cornell University in New York have reduced the natural sweetener stevia’s bitter aftertaste by physical – rather than chemical – means, as reported recently in the journal Food Chemistry.
While previous studies have focused on masking taste receptors, the researchers took a different approach, working on one of stevia’s components, rebaudioside A (Reb A), the glycoside molecule that provides its sugary taste but yields a speck of aftertaste that limits the sweetener’s commercial possibilities.
The researchers modified Reb A by applying “hydrophobic effects” to the bovine serum albumin protein, which creates a stable Reb A-protein complex, essentially dissipating the Reb A molecular components without breaking or forming any chemical bonds. This protein solution disengages stevia’s bitter components, making it less likely for the human tongue’s bitter receptors to recognize the modified Reb A-protein complex.
Researchers tested the modified protein’s sturdiness in orange juice and found the sweet binding remained intact. The study’s findings could encourage the beverage industry, packaged dressings, cream sauces, powdered soups and dairy products to use more stevia, a zero-calorie all-natural herbal sweetener derived from a plant, instead of sugar or artificial sweeteners.
A new clinic for treating bedwetting has been opened at Laniado Medical Center in Netanya. One of the voluntary hospital’s 60 outpatient clinics, it offers behavioral and pharmaceutical treatment and is run by a senior nephrologist and a pediatric pelvic-floor physiotherapist.
The problem occurs in more than 100,000 children of various ages, with a fifth of them still affected at age five.
Most of the children suffer from difficulties connected to the emptying of the bladder and the digestive system.
Most bedwetting clinics in the country are run by psychologists, but Laniado said it preferred a multidisciplinary approach suited to each child. Many parents are leery of taking their children for psychotherapy so they won’t be labeled as problematic; when there is an emotional problem, the therapists prefer to use biofeedback.
Daniella Tzarfati, one of the few pediatric pelvic-floor physiotherapists in the country, said that young patients are tested for their urinary habits and taught to eat and drink properly and relax their muscles. A bell wakes them so they go to the bathroom in time rather than urinate in bed. Those whose problem is caused by urinary infections are treated. Families with supplementary health insurance get discounts, Laniado said.