LBD Research, Part 3. Starting Early

 A couple of studies have identified possible ways to limit the damage that Lewy bodies can cause. In both cases, the researchers started with a fetus—which is about as early in a person’s life that they can get! The first study is one where researchers identified a fetal protein that reappears to protect healthy older people from age-related stresses. The second may eventually provide a safe way for researchers to test LBD drugs, and to test them much earlier in the disorder’s progress. Treating LBD early is important. For some time, researchers have believed that most neurological diseases will remain incurable until they can be identified and treated closer to their start.

A person goes through more changes before birth than they ever do again. Researchers believe that the protein, REST, helps the fetus adapt to the stress of these changes. After birth, it apparently disappears until the aging process starts. They found that healthy seniors have more of this protective protein than do people with most forms of dementia, including LBD. They also found that REST levels drop as symptoms worsen. Thus, a person with mild cognitive impairment will be better able to handle stress that a person with full-blown LBD. Most of the REST drop-off was in the learning, memory and planning centers of the brain, with little change in other areas of the brain. (reference)

Researchers do not know yet which comes first, the decline of REST or the cognitive losses. Since research must still be done with autopsied brains, this study could not show how a person handled stress—it could only show the results. However, we can postulate that without the REST protein there to provide protection, additional stress may cause an increase in the number or severity of cognitively related symptoms, such as hallucinations and confusion. As caregivers, we are well aware that as dementia increases, our loved one’s tolerance for stress decreases. We know that while stress may not cause the disorder itself, stress sure can make it worse. This study supports caregiver’s observations.

If researchers can find a way to replace lost REST proteins in the brains of people with dementia, the cognitive losses might stop or become less troublesome. Of course, a lot more study and research must happen first. More immediately, this study provides a scientific basis for the reason that our loved ones do poorly when stressed and why their stress tolerance is so low, which emphasizes the importance of stress management.

Stem cell research. Researchers have used stem cells to identify an abnormal form of alpha-synuclein, the protein which turns into Lewy bodies when it “misfolds.”

Stem cells are the building blocks of our body. They can adapt and grow into any organ. It used to be that most stem cells came from aborted fetuses. This is seldom true anymore. In fact, in most states this is illegal. Sometimes, they come from the cord blood of live births, blood that would otherwise have been discarded. More likely they came from “cell lines,” stem cells collected long ago and cloned to grow more.

Researchers have been able to grow mis-folded alpha-synuclein, (Lewy bodies) in stem cells. The goal is to eventually be able to use these cells to test new drugs. The advantages of using these manufactured cells are several. (reference)

• They are human cells and therefore, a better fit than animal cells would be. Actual human trials will still be needed, but this should speed up the research.

• Testing with stem cells first reduces the risk of possible side effects of yet untried drugs. Even when clinical trials with animals have shown drugs to be safe, there is still a chance that they won’t be with humans. This adds another level of safety before clinical trials with humans.

• Researchers can watch the cells spread and change as the disease progresses. While researchers can see such changes by examining autopsies of people in various stages of the disease, this has more continuity.

• Tests can start at various stages of the disease, including very early stages. 

Like the REST study, this study using stem cells has a long way to go before being practical. However, it is exciting to see what might be in the future.

To learn more about Lewy Body Dementia read our books:

A Caregiver’s Guide to Lewy Body Dementia

Managing Cognitive Issues in Parkinson’s and Other Lewy BodyDisorders