Meet Racing Scientists to Unravel COVID’s Potential Link to Alzheimer’s

As the pandemic rages across the globe, scientists have begun to identify a pattern of chills: An estimated one-third of people infected with COVID-19 develop neurological symptoms including strokes, headaches, and headaches. and disturbances of consciousness. In some brains, COVID causes molecular changes that mirror those seen in the brains of people with Alzheimer’s disease, leading some scientists to believe that persistent COVID may be a disruptive disorder. atypical memory loss. There are also larger concerns that brain damage caused by COVID may increase the risk of developing dementia later in life. The ultimate long-term health effects are still poorly understood, but impressive preliminary evidence suggests a complex link with Alzheimer’s disease.

Amid the overall effort to better understand the long COVID — on April 5, President Joe Biden ordered a new research initiative among federal agencies — there is also a worldwide effort. world to study this implicit link to Alzheimer’s disease, with various groups racing to understand the overlap between COVID and neurological damage. In New Jersey, one project stood out by incorporating another important overlap: people at high risk of developing both severe COVID and Alzheimer’s.

Rutgers University researchers are now enrolling older black people in an observational study that aims to examine the consequences of COVID and how these relate to the risk of Alzheimer’s disease. The neurodegenerative disease disproportionately affects black Americans, with the number of cases predicted by the CDC increasing over the next 40 years. COVID is also causing more deaths for black Americans, a fact stemming from longstanding inequalities in public health.

Mark Gluck, professor of neuroscience and public health at Rutgers University-Newark, told The Daily Beast. Genetics and differences in the immune system may play a role, but specific ideas are still hard to come by.

Gluck leads ongoing COVID-Alzheimer research, along with Patricia Fitzgerald-Bocarsly, an immune system researcher and Rutgers Provider of Biomedical and Health Sciences-Newar, and Maria Laura Gennaro, an educator professor of medicine and epidemiology at Rutgers. By looking at questions surrounding COVID — such as why age is a risk factor and why some develop lingering symptoms — the team hopes to “gain insights.” insight into Alzheimer’s disease that we’ve never had before,” Gluck said.

In some ways, examining what COVID has to do with the brain is actually a proxy for understanding the immune system’s impact on the brain. The immune system is known to play a role in the development of Alzheimer’s disease: People with the disease have faulty microglia (a type of immune cell) and chronic inflammation is often thought to be responsible for the decline. awareness. Gluck explains that it’s possible that “to some extent, Alzheimer’s can resemble an autoimmune disorder,” in which immune cells attack healthy brain cells and damage brain tissue. due to inflammation.

COVID can induce an immune response in the brain, which may explain why some people develop brain fog and dementia. This may reflect what is happening in the brains of people with Alzheimer’s disease. “It also suggests that Alzheimer’s researchers, who primarily talk to scientists who study neurodegenerative diseases, should talk more to immunologists,” says Gluck.

Fitzgerald-Boscarly is one of the immunologists. While scientists have been interested in the intersection of the immune system and neuroscience for decades, she told The Daily Beast what is happening now is the maturation of the field. Driven by advanced research tools. Early in her career, she was in the lab, which saw some of New York’s first HIV patients. HIV also causes inflammation, which can damage the brain.

“In a sense, my career has so far been bound by two pandemics: HIV and COVID,” says Fitzgerald-Boscarly.

In June 2020, Fitzgerald-Boscarly announced the finding that in older adults, there is an accumulation of cytotoxic T cells (that kill cancer or infected cells) that are no longer active due to aging – what biologists call senescent cells. She believes that the accumulation of these faulty cells in older adults may, in part, lead to low-grade chronic inflammation, which contributes to diseases such as dementia. Their presence may also explain why COVID is more dangerous for older adults.

The team was particularly curious about the APOE4 and APOE2 gene variants, which are known to play a role in the risk of Alzheimer’s disease. APOE4 is the strongest risk factor gene for Alzheimer’s disease, and early research suggests it also increases the risk of developing severe COVID. Meanwhile, APOE2 seems to protect against the development of Alzheimer’s disease. The question is whether it can protect asymptomatic patients from the most severe consequences of COVID.

Supported by a grant from the National Institutes of Health awarded in April 2021, the Rutgers study is currently enrolling black people over 60 in the Newark area. The goal is to build a group of 200 to 300 participants, half of whom have some degree of COVID and half do not. They will be asked about their sleep, fitness, cognitive status and overall health while participating in genotyping and brain scans.

Dr. Alexander Salerno is a partner in this recruitment. He runs the Salerno Medical Association, a family-owned practice that serves the communities of Newark and East Orange, New Jersey. His practice serves approximately 20,000 residents at five clinics, including 6,000 older Blacks — at least half of whom have contracted COVID between 2020 and 2021.

When Salerno looks back on when COVID first hit her community, it was with pride and surprise. When other facilities closed, his clinics remained open. In the spring of 2020, the Salerno Medical Association partnered with Rutgers for FDA approval for the saliva test and has since gone live, testing hundreds of patients each day. The rules are constantly changing and resources are almost impossible to obtain.

“It was really tough at first,” Salerno told The Daily Beast. “Technically, our offices are located in federal underserved areas when it comes to primary care. Now add a pandemic to it. Our urban communities are very vulnerable. “

Today, Salerno notices “various degrees of long-distance syndrome.” But it is difficult to know what causes COVID. Many of his patients halted care during the worst of the pandemic, and subsequently many of their diabetes, high blood pressure and cardiovascular conditions worsened. He suspects some patients have had COVID but show no signs of further illness but may remain in the future. “The summary of all that we still don’t really understand,” says Salerno.

When Salerno assessed patients’ interest in participating in the Rutgers study, it was an overall conversation about brain health. His goal is to direct dementia and educate his patients about controllable factors, like diet and exercise, that can modulate risk and severity.

Gluck believes that the community-driven nature of Salerno’s operation, along with its history, drives its clients to engage in research. Salerno’s parents founded the company in the 1950s, and after the Newark riots of 1967 broke out amid racial tensions, they stayed while the other businesses left. The practice also serves patients through three programs designed to expand access to care and advance healthcare knowledge.

“We feel this is important because healthcare is not a universal approach,” says Salerno. “Not everyone can go to a clinic or doctor’s office, and when they do, there’s a lot of advice as opposed to good service.”

In the distant future, that service may include Alzheimer’s care as informed by participation in the Rutgers study.

“From a diagnostic standpoint, understanding the role of the immune system in Alzheimer’s disease can help us understand who is most at risk,” says Gluck.

Furthermore, knowing exactly which aspects of the immune system can lead to therapeutic interventions that target them. This needs more research, explains Fitzgerald-Boscarly. For example, it is known that drugs known as serology clear old cells. But because evolution has allowed aging cells to accumulate, there may be some benefit. The trick will be determining how to deliver quality therapies, without inadvertently causing harm.

For now, the focus of the study is on studying people at high risk for Alzheimer’s and COVID and looking for models, but there are plans to collaborate with other universities and test their immune system responses. elderly people hospitalized with COVID. “They are “squeezing into this area of ​​the neurotechnology industry,” says Fitzgerald-Boscarly. “As a scientist, no two days are alike – as studies evolve and evolve, there is joy in discovery.”