Speaker 1: Bloomberg Audio Studios, Podcasts, radio news. You're listening to Bloomberg
Speaker 1: Business Week with Carol Masser and Tim Steneveek on Bloomberg Radio.
Speaker 2: Earlier this month, Bloomberg reported out on how researchers have
Speaker 2: uncovered how the body's own immune system may be driving
Speaker 2: the progression of ALS, a breakthrough that could reshape treatment
Speaker 2: of the fatal disease. But what's key in a big
Speaker 2: broader way, the findings could lead to therapies that target
Speaker 2: the immune system and may have implications for the treatment
Speaker 2: of other neurodegenerative diseases, and that includes things like Alzheimer's
Speaker 2: and Parkinson's. So let's get to our weekly BusinessWeek Women's
Speaker 2: Health segment. We focus on key issues and developing technologies
Speaker 2: impacting the present and future of women's health around the world.
Speaker 2: Our focus today is on Alzheimer's, which affects over seven
Speaker 2: million Americans today. By twenty fifty, that number is projected
Speaker 2: to rise to nearly thirteen million, according to the Alzheimer's
Speaker 2: Association with US is doctor Fanny Allah. She's Associate Professor
Speaker 2: of Neurology and Neuroscience at the Icon School of Medicine
Speaker 2: at Mount Sinai, and she joins us right here in
Speaker 2: New York City. Doctor Lahie, thank you so much for
Speaker 2: being with us. I am curious when it comes to
Speaker 2: neurological problems, what are the difference in what affects women
Speaker 2: versus men.
Speaker 3: It's a pleasure to join you. The short answer to
Speaker 3: that is that we know the statistics of what are
Speaker 3: the diseases that afflict women at a higher prevalence than men,
Speaker 3: and one of them is Alzheimer's disease. But to say
Speaker 3: that we would not be correct to say that we
Speaker 3: understand the why. And I think this is exactly why
Speaker 3: we need to be doing research, because getting the answer
Speaker 3: to why are women's brains more vulnerable to Alzheimer's disease
Speaker 3: and other kinds of neurodegenerative disorders may hold the key
Speaker 3: to understanding how these diseases strike the vulnerable brain, and
Speaker 3: so that knowledge will definitely help women. But I think
Speaker 3: beyond that would help us understand what are the key
Speaker 3: factors that make the aging brains vulnerable to Alzheimer's disease.
Speaker 1: At this point, do we know what? Do we know?
Speaker 1: What are the clues or what are the hypotheses that
Speaker 1: medical professionals have established.
Speaker 3: A central hypothesis that we and others are following is
Speaker 3: that in women's lives there is a huge physiological transition
Speaker 3: in midlife due to menopause. That shift in hormones that
Speaker 3: the brain and other organs see is unique to women.
Speaker 3: It happens in men, but at a much later stage
Speaker 3: in their life. And so what we are doing at
Speaker 3: Mount Sinai is to specifically query the impact that lower
Speaker 3: levels of sugen may have on the cells that form
Speaker 3: the vasculature of the brain, the protective barriers of the brain,
Speaker 3: and other cells within the brain.
Speaker 2: So is a fix and easy fix just keeping the
Speaker 2: hormone levels higher, and I know that there are consequences
Speaker 2: to doing that potentially, how do we think about it?
Speaker 2: How do you guys think about R and D and
Speaker 2: what can be done to help women since they are
Speaker 2: certainly it sounds like more vulnerable as a result when
Speaker 2: it comes to Alzheimer's.
Speaker 3: Absolutely, we certainly hope that for those who can get
Speaker 3: hormone replacement therapy that may diminish their risk to a
Speaker 3: certain extent. But the question is when do those hormones
Speaker 3: need to be started? And we think it needs to
Speaker 3: be perimenopause, you cannot wait too long before starting them.
Speaker 3: The second question is how long do you keep those
Speaker 3: hormones as you may As you alluded to it, those
Speaker 3: hormones also increase the risk of other things such as cancers,
Speaker 3: and those risks increase as women age. So how long
Speaker 3: do you keep someone on hormones in order to decrease
Speaker 3: their risk for Alzheimer's disease, which is a late life phenomenon.
Speaker 3: And then the third question is for the many women
Speaker 3: who actually cannot be on those hormones, what can we
Speaker 3: discover about what those hormones do and just go ahead
Speaker 3: and develop drugs and interventions that activate or deactivate those pathways.
Speaker 1: What about genetic components if somebody else in the family
Speaker 1: has had Alzheimer's, that trade being passed down, does that happen?
Speaker 3: That's an excellent question, and in fact, one of the
Speaker 3: most prevalent genetic risk factors for Alzheimer's disease, the APO
Speaker 3: E four illele, we think interacts with hormones in exerting
Speaker 3: its effect on Alzheimer's disease. Now, the question of heritability
Speaker 3: of Alzheimer's goes beyond just a point four and that
Speaker 3: in of itself is a really big area of research.
Speaker 3: There are other components of the disease, such as metabolism
Speaker 3: and mitochondria that we inherit from the maternal side, for instance,
Speaker 3: that could be contributing to this heritability. But even beyond that,
Speaker 3: there are aspects of our ancestry that continue within us
Speaker 3: informs that we currently don't fully grasp and I hope
Speaker 3: we will understand in the future to again contribute to
Speaker 3: better therapeutic developments.
Speaker 2: So talk to us little bit about You've done a
Speaker 2: lot of work when it comes to blood biomarkers. Why
Speaker 2: might this be important here?
Speaker 3: Blood biomarkers are very exciting because, similar to other disorders
Speaker 3: such as cardiovascular disease, cancer, kidney liver disease, you really
Speaker 3: to detect disease before individuals have prominent symptoms that bring
Speaker 3: them to the medical attention. And in the case of
Speaker 3: Alzheimer's and other kinds of neurodegenative disorders, those are cognitive
Speaker 3: impairment and ultimately dementia. At the point that someone has
Speaker 3: very significant cognitive changes, we think we could potentially slow
Speaker 3: down disease progression. But to say that we can stall
Speaker 3: it or have game changing treatments completely change someone's brain
Speaker 3: trajectory would be not realistic. So these blood biomarkers can
Speaker 3: detect risk of future symptoms with increasingly better predictive ability.
Speaker 3: One thing that I should mention is that we don't
Speaker 3: think that the pathologies that eventually lead to dementia start
Speaker 3: at the time that symptoms present. They really start decades before.
Speaker 3: And these blood BUYO markers for Alzheimer's disease are detecting that.
Speaker 3: My lab works on expanding that panel because right now
Speaker 3: we are detecting only a few aspects of the disease.
Speaker 3: We think a key component of Alzheimer's and other neurodegenerative
Speaker 3: diseases are the changes that happen to the blood vessels
Speaker 3: of the brain, and at the moment, we have no
Speaker 3: biomarkers that detect vascular pathologies with great precision.
Speaker 1: Doctor Lolly, we just have about thirty seconds left. Are
Speaker 1: you optimistic that during your career we will see a
Speaker 1: major breakthrough and either treatment or prevention of Alzheimer's.
Speaker 3: Absolutely, I'm going to go further and seeing that, I
Speaker 3: hope that it's not at the end of my career.
Speaker 3: I have great hope for the decade that is to come.
Speaker 3: We already have two FD approved treatments that slow down
Speaker 3: disease progression, and many other game changing treatments are in
Speaker 3: the pipeline.
Speaker 2: Well, we so appreciate getting a chance to talk to you,
Speaker 2: and you really like laying it out so clearly and specifically,
Speaker 2: Doctor Fannie Alaki. She's Associate Professor of Neurology and Neuroscience
Speaker 2: at the Icon School of Medicine at Mount Sinai.