CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

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nunchers
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CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

Post by nunchers »

Here's a really interesting article about a guy / clinic that is tracking blood markers for alzheimers and trying to lower risk scores.

https://www.cnn.com/2024/05/18/health/a ... index.html

The test he is using is Preclicity AD2, "a clinically-validated algorithm that combines Aβ42/40 and p-tau217/np-tau217 (%p-tau217) ratios". I have no idea if this test is actually better than just a p-tau test.

I agree with the interventions they list in the article. Most notably, the guy started taking tirzepatide, one of the new GLP-1 drugs. A similar drug, semaglutide (ozempic) is currently being tested in phase 3 for alzheimers. It has already been shown effective for Parkinson's. The brain effects are separate from the weight loss effects, though the weight loss probably helps also.

I got my p-tau tested last week at Quest. I'm going to take that result, whatever it is, and see if I can lower my score using semaglutide (i ordered oral semaglutide from indiamart). Also, I'm already taking rapamycin and have been told that doctors have seen good results lowering p-tau using rapa, so that's promising as well.

I'm 4/4 and interested in finding a group of folks who would like to track their p-tau over time and compare notes on interventions. Maybe we can start a discord or email list or something. Please message me if you are interested!!!
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

Post by nunchers »

Reading a little more right now, it appears that p-tau 217 is a moderately better indicator than p-tau 181 (which is what i got done at quest) but it seems like both are pretty clear correlates and probably both would work ok.
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

Post by NF52 »

nunchers wrote: Sat May 18, 2024 2:30 pm Here's a really interesting article about a guy / clinic that is tracking blood markers for alzheimers and trying to lower risk scores.

https://www.cnn.com/2024/05/18/health/a ... index.html
Hi nunchers,

Thanks for starting this topic and posting the link to the CNN article about a small clinical trial by Dr. Richard Isaacsson in Boca Raton, FL. I agree that the array of strategies, is impressive. Yet this is one case study of a man 55, younger than the typical age for people with ApoE 4/4 to have an elevated amyloid PET scan, which he apparently had in 2019 at the age of 50 and severe coronary artery disease at age 40, with a strong family history of early and/or fatal heart attacks.
My sister had three heart attacks, and when I was 40, I was told that I had atherosclerosis, with a ridiculously massive coronary artery calcium score of like 1,500 and occlusions in about 96% of my arteries.” A normal coronary artery calcium score is zero....Doctors...finally resorted to surgery, opening three of Nicholls’ arteries with stents....Slowly, Nicholls’ heart condition began to improve, but the bad news didn’t end there. A brain scan found telltale signs of vascular damage in Nicholls’ brain, which occurs when the tiniest blood vessels are starved of oxygen.
“The doctors said I had too many white matter lesions.
Someone with vascular disease might not have an elevated amyloid plaque score, but could still have cerebral amyloid angiopathy (CAA) and exacerbation of the white matter lesions or possible micro-hemorrhages in his brain. I'm frankly surprised that Dr. Isaacson doesn't mention repeating an MRI to look at the risk of continuing vascular brain changes.

This individual clearly is motivated by his young children--one of the best reasons to make lifestyle changes! But I agree with Dr. Isaacson's comment:
Despite these amazing outcomes, Isaacson remains cautious. After all, this is one person, and similar findings have not been been replicated in a larger, more controlled sample and published in a peer-reviewed journal.

“I don’t believe in the term ‘reverse’ because I don’t know what will happen if the person stops doing the intervention,” Isaacson said. “I also don’t know if the brain might normalize for a short period of time and then, five years later, catch up. Until I have more data, I don’t think that reverse is the right word."
The link provided in the CNN article to the "recent review published in Nature" was not in fact published in the prestigious journal Nature, which recently carried this peer-reviewed research study: APOE4 homozygozity represents a distinct genetic form of Alzheimer’s disease.

It is in Nature Mental Health and is behind a paywall. Alzheimer’s disease risk reduction in clinical practice: a priority in the emerging field of preventive neurology.

Here's the available content. It's hard to disagree with the focus; but hard to ignore that public health efforts to reduce Alzheimer's risk might bring these benefits to many more people.
Abstract

Alzheimer’s disease is increasing in prevalence disproportionately to longevity, placing enormous burden on individuals, families, healthcare systems and the economy. Pathological brain changes may occur decades before the symptoms of Alzheimer’s disease manifest. With new tools designed to identify at-risk individuals (for example, blood-based biomarkers and polygenic risk assessments), a focus on prevention could begin early and continue throughout life. Targetable risk factors associated mainly with cardiovascular and metabolic health have been established, while mental health factors are increasingly recognized. Given the heterogeneity of the risk and pathogenesis of Alzheimer’s disease, interventions for risk reduction are most effectively determined on an individualized basis. Here we review the evidence for a precision medicine approach to Alzheimer’s disease risk reduction that involves multidisciplinary expertise, with a new emphasis on novel genetic and biomarker advances, and psychological factors. We propose integration of this approach into routine clinical practice and acknowledge obstacles to the widespread practice of preventive neurology.
4/4 and still an optimist!
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

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Thanks NF52! A few replies:

1. My main point is not that these particular strategies are comprehensive or do or don't work, but that p-tau appears to be a well-validated metric for tracking the disease and that it seems that high risk individuals like you and me could be tracking it and seeing if various interventions lower our scores. That doesn't mean we would be covered for all types of dementia, and it's not a guarantee of anything, but it seems better to me than flying blind, since we know that damage is likely accumulating while we all wait for more research studies to come along. Totally agree that this one success story can't be extrapolated from, especially because he has so many risk factors changing at once. Agree repeat MRI would make sense for that guy. Again, I just think the approach of tracking tau makes sense and that if enough of us did so, we would start to see patterns in what is working for people.

2. GLP-1s appear to have overall benefits for vasculature, so I think they may be promising for vascular dementia.

3. 'Nature Mental Health' is published by the same organization as 'Nature' but yes, definitely less prestigious. I don't believe the 'Gold Open Access' option lets you pay to publish, I think it lets you pay to ensure the article is open access and some funders will cover that to ensure the work is widely available. It should be as rigorous in terms of acceptance and review regardless. That being said, I don't know anything about that particular journal and that article seems to be a strategy proposal, not something with any kind of associated trial that would give definitive direction.
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

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Yes, the Good Open Access makes the article accessible to everyone without a subscription. This fee is high compared to other journals. Nature affiliated journals can get away with that. Can’t say the publishing model makes sense - researchers beg journals to accept their work for free, do much if the editorial work themselves, and pay so others can read the article. But that’s how it works these days. BTW that fee could have supported the training of a young undergrad in the lab for a summer.

https://www.nature.com/natmentalhealth/ ... ng-options
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

Post by BrianR »

nunchers wrote: Sat May 18, 2024 2:30 pm Here's a really interesting article about a guy / clinic that is tracking blood markers for alzheimers and trying to lower risk scores.
NF52 wrote: Sat May 18, 2024 3:54 pm
Apparently CNN is releasing a (paywalled streaming) episode of The Whole Story with Anderson Cooper focused on Alzheimer's assessment and treatment: The Last Alzheimer’s Patient. (This episode may also show up as freely available podcast here: https://www.cnn.com/audio/podcasts/the-whole-story-with-anderson-cooper )

Here is an article specifically specifically discussing Dr Gupta's assessment with Dr Richard Isaacson:

I have a family history of Alzheimer’s disease. I wanted to understand my own risk
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

Post by NF52 »

nunchers wrote: Sat May 18, 2024 8:40 pm Thanks NF52! A few replies:

1. My main point is not that these particular strategies are comprehensive or do or don't work, but that p-tau appears to be a well-validated metric for tracking the disease and that it seems that high risk individuals like you and me could be tracking it and seeing if various interventions lower our scores. That doesn't mean we would be covered for all types of dementia, and it's not a guarantee of anything, but it seems better to me than flying blind, since we know that damage is likely accumulating while we all wait for more research studies to come along. Totally agree that this one success story can't be extrapolated from, especially because he has so many risk factors changing at once. Agree repeat MRI would make sense for that guy. Again, I just think the approach of tracking tau makes sense and that if enough of us did so, we would start to see patterns in what is working for people.

2. GLP-1s appear to have overall benefits for vasculature, so I think they may be promising for vascular dementia.

3. 'Nature Mental Health' is published by the same organization as 'Nature' but yes, definitely less prestigious. I don't believe the 'Gold Open Access' option lets you pay to publish, I think it lets you pay to ensure the article is open access and some funders will cover that to ensure the work is widely available. It should be as rigorous in terms of acceptance and review regardless. That being said, I don't know anything about that particular journal and that article seems to be a strategy proposal, not something with any kind of associated trial that would give definitive direction.
Thanks for your helpful replies!

I appreciate the info on Nature Mental Health and edited my post to delete my mis-information.

As a participant in AHEAD-45, my p-tau217 is captured, I think, every 6 months in blood work and once every 2 years on a PET scan. I know I had elevated amyloid at age 65 as an ApoE 4/4 carrier. Whether my p-tau is coming down may depend more right now on whether I am on the placebo or lecanemab, which reduced PET tau in the CLARITY trial by about 10%, I think. I won't be told of results for several more years, which I'm willing to wait for, given the uncertain association of specific actions with a change in plasma -tau and the level of tau in my medial temporal lobe or other brain regions. It is exciting that some anti-tau drugs are coming to Phase 2-3 trials coming out in 2025, which I'm hoping to hear more about soon.

Nancy
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

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Fiver wrote: Sun May 19, 2024 4:53 am Yes, the Good Open Access makes the article accessible to everyone without a subscription. This fee is high compared to other journals. Nature affiliated journals can get away with that. Can’t say the publishing model makes sense - researchers beg journals to accept their work for free, do much if the editorial work themselves, and pay so others can read the article. But that’s how it works these days. BTW that fee could have supported the training of a young undergrad in the lab for a summer.

https://www.nature.com/natmentalhealth/ ... ng-options
. Thanks for the info, Fiver! I deleted my snarky comment!
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

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[/quote]. Thanks for the info, Fiver! I deleted my snarky comment!
[/quote]

Snarky is good. And how I feel most of the time! 🙂

I’m finding all these new studies and news articles great but a bit overwhelming. And new journals - that Nature subjournal is new too. Thank you for helping me keep up with them.
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Re: CNN article about a guy who is tracking and lowering ptau -- anyone want to try?

Post by SusanJ »

If anyone is interested in hearing Dr Sanjay Gupta's process with Dr. Isaacson (whose work we mention on this forum), it will be on shown on “The Whole Story with Anderson Cooper” on CNN on (tonight) Sunday, May 19, at 8 p.m. ET/PT.

I think many of us can relate to the feelings you get going through the battery of tests...
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