Conquering Alzheimer’s: a look at the therapies of the future

Researchers are looking to drug combinations, vaccines and gene therapy as they forge the next generation of treatments for the condition.

Alison Abbott

Nature | April 04, 2023

A brain scan reveals the extent of damage caused by Alzheimer’s disease. Credit: Zephyr/Science Photo Library

When neurologist Reisa Sperling stepped up to receive her lifetime achievement award at an international Alzheimer’s conference last December, she was more excited about the future than about celebrating the past.

What thrilled Sperling, who won the award for her work on clinical trials of Alzheimer’s treatments, was a sense of hope, which has been conspicuously missing from research into the disease for many years. Most other attendees felt the same.

Just a few months before the meeting, researchers had announced that an antibody drug called lecanemab clearly lowered the amount of amyloid protein plaques — a tell-tale sign of the disease — in the brains of participants in a clinical trial, and slowed their cognitive decline.

Industries can harm health in many ways: Here are 3 that aren’t so obvious

Some products and practices are directly linked to avoidable ill health, planetary damage and social and health inequity, especially by large transnational corporations

Sameera Mahomedy

Down To Earth | March 30, 2023

 Research confirms the adverse effects of social media on mental health. Photo: Shutterstock

A recent ground-breaking series of reports in the science journal The Lancet unpacks what commercial determinants of health are, and how they affect public health. It uses a new, broader definition of the determinants:

the systems, practices and pathways through which commercial actors drive health and equity.

Some commercial entities contribute positively to health and society. However, research shows that some commercial products and practices are directly linked to avoidable ill health, planetary damage, and social and health inequity. Large transnational corporations are especially to blame.

Habit-linked brain circuits light up in people with eating disorders

Parts of the brain associated with habit formation seem unusually active in people with eating disorders.

Bianca Nogrady

Nature | April 04, 2023

The putamen (highlighted green) has been associated with habit formation, following brain scans of women with binge-eating disorder or bulimia.Credit: Kateryna Kon/SPL

Brain scans of people with binge-eating disorder or bulimia show altered activity in areas linked to habit formation and hint at new possibilities for eating-disorder treatments1.

A habitual behaviour is automatically triggered by external cues — for example, reaching for the seat belt as soon as you get into the car. Scientists have identified two areas in a part of the brain called the striatum that are active in laboratory rats when they perform habitual behaviours. Although the human brain is somewhat similar to the rat brain, neuroscientists weren’t sure what the analogous structures in the human brain were — or whether such structures even existed.

The effects of racism, social exclusion, and discrimination on achieving universal safe water and sanitation in high-income countries

Joe Brown, PhD 

Charisma S Acey, PhD

Carmen Anthonj, PhD

Dani J Barrington, PhD

Cara D Beal, PhD

Drew Capone, PhD

Oliver Cumming, MSc

Kristi Pullen Fedinick, PhD

Jacqueline MacDonald Gibson, PhD

Brittany Hicks, BS

Michal Kozubik, PhD

Nikoleta Lakatosova, MA

Karl G Linden, PhD

Nancy G Love, PhD

Kaitlin J Mattos, PhD

Heather M Murphy, PhD

Inga T Winkler, PhD

The Lancet | Open Access | Published: April, 2023 | DOI:https://doi.org/10.1016/S2214-109X(23)00006-2

Summary

Drinking water and sanitation services in high-income countries typically bring widespread health and other benefits to their populations. Yet gaps in this essential public health infrastructure persist, driven by structural inequalities, racism, poverty, housing instability, migration, climate change, insufficient continued investment, and poor planning. Although the burden of disease attributable to these gaps is mostly uncharacterised in high-income settings, case studies from marginalised communities and data from targeted studies of microbial and chemical contaminants underscore the need for continued investment to realise the human rights to water and sanitation. Delivering on these rights requires: applying a systems approach to the problems; accessible, disaggregated data; new approaches to service provision that centre communities and groups without consistent access; and actionable policies that recognise safe water and sanitation provision as an obligation of government, regardless of factors such as race, ethnicity, gender, ability to pay, citizenship status, disability, land tenure, or property rights.

At World Health Organization, the future of health care is being decided, and contested

Peoples Dispatch | February 27, 2023

Jyotsna Singh of the People’s Health Movement talks about the recent Executive Board meeting of the World Health Organization. She talks about what happens during such meetings and the major issues on the table at the WHO. This is a key moment for the future of global health care as amendments to the International Health Regulations and the Pandemic Treaty are being discussed. Jyotsna describes the concerns raised by countries of the Global South and the ways in which the pandemic has influenced these discussions.

Impact of malnutrition on early outcomes after cancer surgery: an international, multicentre, prospective cohort study

GlobalSurg Collaborative and NIHR Global Health Unit on Global Surgery | Open Access | Published: March, 2023 | DOI:https://doi.org/10.1016/S2214-109X(22)00550-2

Summary

Background

Malnutrition represents a key priority for global health policy, yet the impact of nutritional state on cancer surgery worldwide remains poorly described. We aimed to analyse the effect of malnutrition on early postoperative outcomes following elective surgery for colorectal or gastric cancer.

Methods

We did an international, multicentre, prospective cohort study of patients undergoing elective surgery for colorectal or gastric cancer between April 1, 2018, and Jan 31, 2019. Patients were excluded if the primary pathology was benign, they presented with cancer recurrence, or if they underwent emergency surgery (within 72 h of hospital admission). Malnutrition was defined with the Global Leadership Initiative on Malnutrition criteria. The primary outcome was death or a major complication within 30 days of surgery. Multilevel logistic regression and a three-way mediation analysis were done to establish the relationship between country income group, nutritional status, and 30-day postoperative outcomes.

How quickly does COVID immunity fade? What scientists know

Cassandra Willyard

Nature | February 02, 2023

A kiosk in Shanghai, China, offers free SARS-CoV-2 testing.Credit: CFOTO/Future Publishing via Getty

Three years into the pandemic, the immune systems of the vast majority of humans have learnt to recognize SARS-CoV-2 through vaccination, infection or, in many cases, both. But just how quickly do these types of immunity fade?

New evidence suggests that ‘hybrid’ immunity, the result of both vaccination and a bout of COVID-19, can provide partial protection against reinfection for at least eight months¹. It also offers greater than 95% protection against severe disease or hospitalization for between six months and a year after an infection or vaccination, according to estimates from a meta-analysis². Immunity acquired by booster vaccination alone seems to fade somewhat faster.

How the World Bank weakens health systems

Health researchers Natalie Rhodes and Remco van de Pas discuss about the nature and limitations of the World Bank Pandemic Prevention, Preparedness and Response fund.

Peoples Dispatch | October 31, 2022

Natalie Rhodes, PhD candidate at University of Leeds, and People’s Health Movement, along with Remco van de Pas, researcher at the Centre for Planetary Health Policy, and People’s Health Movement discuss in detail about the implications of the newly established World Bank fund for Pandemic Prevention, Preparedness and Response and the Bank’s other policies pertaining to public health.

The health status of Indonesia’s provinces: the double burden of diseases and inequality gap

Vicka Oktaria and Yodi Mahendradhata

The Lancet | Open Access | Published: November, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00405-3

In The Lancet Global Health, the Global Burden of Disease Study (GBD) 2019 Indonesia Collaborators report on 30 years of disease burden and risk factors in Indonesia, expanding their analysis to a more granular subnational level.

¹

 Given the ongoing challenges of obtaining comparable subnational data, the GBD data provides enlightening evidence for decision makers at the subnational level for future programmatic planning and policy strategies specific to their local health issues. These findings will ultimately help narrow down the inequality gaps at regional levels. This paper is perfectly timed to captured and illustrate the health status in Indonesia before and after the launch of the universal health coverage (UHC) programme Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) in 2014. The BPJS has now covered more than 75% of the Indonesian population.

²

Although excellent programmatic interventions and policies have significantly reduced the disease burden in the past three decades, communicable diseases remain the main source of disability-adjusted life-years (DALYs) in Indonesia, along with the rising burden of non-communicable diseases (NCDs) such as diabetes. Diabetes has become one of the main priorities of the national government as programmatic research and efforts towards prevention, early detection, and treatment of diabetes are increasing. Apart from poor quality of life, health-care costs related to diabetes complications are high, with diabetic retinopathy accounting for nearly 2% of the total national state budget, and are estimated to triple by 2025.

³

Inside the US Supreme Court’s war on science

A new ultraconservative supermajority on the United States’ top court is undermining science’s role in informing public policy. Scholars fear the results could be disastrous for public health, justice and democracy itself.

Jeff Tollefson

Nature | September 14, 2022

Illustration by Sébastien Thibault

In late June, the US Supreme Court issued a trio of landmark decisions that repealed the right to abortion, loosened gun restrictions and curtailed climate regulations. Although the decisions differed in rationale, they share a distinct trait: all three dismissed substantial evidence about how the court’s rulings would affect public health and safety. It is a troubling trend that many scientists fear could undermine the role of scientific evidence in shaping public policy. Now, as the court prepares to consider a landmark case on electoral policies, many worry about the future of American democracy itself.