Alzheimer’s patients divided into 5 subgroups, potentially enabling ‘personalized medicine,’ study finds

 According to a new study published January 9 in the journal Nature Aging, researchers have identified a total of five subgroups among Alzheimer's patients.

Different groups may require different treatment options, as explained in a press release from the Alzheimer's Center Amsterdam, Amsterdam UMC and Maastricht University.

"Previously, it was thought that Alzheimer's disease was one disease, and that the treatments being developed would work equally for all individuals," lead researcher Betty Tijms, associate professor of neuroscience and brain imaging at Amsterdam UMC, said in an email. told Fox News Digital.

"We found that there is variation in the biological processes involved among patients with Alzheimer's disease – meaning that treatments will likely only work for a subgroup of patients."

In the study, researchers analyzed 1,058 proteins in the cerebrospinal fluid of 419 people with Alzheimer's disease from the study at the Alzheimer's Center Amsterdam.

According to the release describing the findings, they identified five different types.

The first group had increased amyloid production in the brain, resulting in a buildup of plaque that interferes with cognitive function, a hallmark of Alzheimer's.

The second group was found to have disruption in the blood-brain barrier, reduced amyloid production and reduced growth of nerve cells.

The researchers noted that the remaining groups showed differences in protein synthesis, immune system function and cerebrospinal fluid production.

Progression of symptoms was found to be faster in some groups than in others.

In an earlier, smaller study, researchers found three subtypes (abnormal neuroplasticity, innate immune activation and blood-brain barrier dysfunction), Tijms noted.

"In our new, larger dataset, we again found those three subtypes, but also found two new subtypes, with underlying processes that we did not previously expect to find," she said.

One of those new subtypes was rare, comprising only 6% of patients — but it had the worst prognosis, the researchers said.

"This subtype had problems with protein synthesis," he said. "The second subtype had damage to the choroid plexus, which is the organ in the brain that produces cerebrospinal fluid."

The researchers acknowledged that the study had some limitations.

“While we expected that subtypes might have different responses to treatment, we were not yet able to demonstrate this, because we needed access to cerebrospinal fluid samples from existing drug trials,” Tijms said. Said.

"We hope to test this in future studies."

Additionally, the study was conducted among relatively young patients, with an average age of 66 years.

"The subtypes may vary across older ages, as most AD patients are 80 years of age and older," Pieter Jelle Visser, associate professor of neuroscience at Amsterdam UMC, told Fox News Digital.

Based on these findings, researchers involved in treatment development should keep in mind that treatment response and side effects may vary between patients of different subtypes, Visser said.

"For example, they can define subtypes of patients to identify those who respond best to the test," he said. "This can also be done with samples that have already been collected in previous tests."

Tijms said researchers can test new treatments only in the subtype that can respond to treatment, such as testing immune therapies in subtypes with increased immune activation.

Dr. Kirk C. Wilhelmson, professor of neurology and head of cognitive neurology at the West Virginia University Rockefeller Neuroscience Institute, said the research is an "important paper," but he said it is not ready to be implemented in clinical practice. .

Wilhelmsen was not involved in the study.

"This may explain why some patients respond better to certain treatments," he told Fox News Digital. "This could save some drugs that have failed in clinical trials."

Dr. Claire Sexton, senior director of scientific programs and outreach at the Alzheimer's Association in Chicago, said in a statement to Fox News Digital that although there are common changes in the brain that define Alzheimer's, the experience of the disease varies from person to person. Varies in.

"We are now learning more about how some aspects of the biology of Alzheimer's may differ for different patients," said Sexton, who was also not a participant in the Amsterdam research.

"This includes differences in symptoms, speed of progression and response to treatment," he added.

"Research that gives us a better understanding of the biology of Alzheimer's disease ... can inform therapeutic possibilities and drug development, and move the field toward personalized therapy approaches."

If these subtypes are validated and confirmed, Sexton said, they could help explain why some individuals do or do not respond to certain treatments, or experience different types and severity of side effects. Are.

"Each subgroup may need their own treatment, or version of treatment, or combination of treatments to be effective with minimal side effects," he said.

To confirm these findings, Sexton called for additional research with larger study groups that "accurately represent the diversity of at-risk and affected populations."