Scientists from around the world are trying to find new approaches to Alzheimer’s disease, and two Brazilian laboratories have stood out in this race. Recently, researchers Mychael Lourenço from the Federal University of Rio de Janeiro (UFRJ) and Wagner Brum from the Federal University of Rio Grande do Sul (UFRGS) were awarded by international organizations for their contributions to the topic.
Lourenço received the ALBA-Roche Prize for Excellence in Neuroscience Research, offered by the Alba organization to mid-career scientists who have already achieved exceptional accomplishments. Brum, in turn, was selected as the Next “One to Watch” (“the next one to watch”, in free translation), an award given by the American organization Alzheimer’s Association to promising young scientists.
Alzheimer’s disease is considered one of medicine’s greatest challenges, as few treatments to date have proven effective in slowing its progression, and no cure has been found.
The most recognized symptom is the loss of recent memory, but as the disease advances, the patient develops difficulties with reasoning, communication, and even movement, becoming completely dependent.
Data on the Brazilians
UFRJ professor Mychael Lourenço has been studying Alzheimer’s since his undergraduate degree in Biology, honing this interest during his master’s, doctorate, and post-doctorate, until taking up teaching and founding the Lourenço Lab, a research group dedicated to dementias.
“I’ve always been interested in mysterious things. For example: ‘how does the brain work?’. I still don’t have an answer today, but it remains a major object of interest,” he jokes.
But Lourenço is driven by more than just curiosity.
“We have about 40 million people with Alzheimer’s disease in the world today. Of these, about 2 million must be in Brazil, a number that may be underestimated due to health access and diagnosis issues. And we have a population that is aging more and more, but most studies are done in the Global North. We need data to understand the disease in Brazil.”
The researcher explains that since Alois Alzheimer described the disease in 1906, it was known to cause plaques in the brain, but it was only in the 1980s that scientists discovered these plaques are made of beta-amyloid, protein fragments that accumulate for some reason.
However, effective drugs to remove these plaques have not reversed the disease, revealing a gap between cause and effect that science still needs to fill.
“We’re still trying to understand what makes the brain vulnerable and causes the disease to develop, including looking at what we call Alzheimer’s resilience. There are people like Fernanda Montenegro, for example, 96 years old, completely lucid and active. And there are people who develop beta-amyloid plaques in the brain and show no cognitive symptoms. What differentiates them?”
In parallel, the Lourenço Lab is also testing substances in animals that could prevent the accumulation of beta-amyloid and another protein called tau, which is also involved in plaque formation.
“Possibly, these proteins tend to accumulate, but cells have a natural degradation system called the proteasome. But in Alzheimer’s, it’s as if the garbage collection company had stopped working. So, boosting the activity of that system would be a way to improve that flow.”
Early Diagnosis
Another line of research focuses on early diagnosis of the disease, which could allow it to be controlled before causing irreversible brain damage.
Lourenço coordinates a study seeking to identify whether biological markers found in the blood of people with Alzheimer’s in other countries also apply to Brazilians, and whether our population has any specific marker.
“Alzheimer’s disease doesn’t start when symptoms appear: it begins to develop much earlier. So, we’re trying to capture that window, where the disease is developing, but symptoms haven’t appeared so clearly yet.”
“We may never be able to cure patients who are already in a very advanced stage. But we can prevent the disease before that,” he adds.
Research on biomarkers has also put physician Wagner Brum in the spotlight. Today, he is pursuing a doctorate at UFRGS and is a researcher at the Zimmer Lab, a group studying Alzheimer’s. His scientific drive emerged early.
“I studied at a very traditional public school in Rio Grande do Sul called Fundação Liberato, which organizes the largest science fair in Latin America. I grew up with my mother taking me to that fair, so when I entered high school, I already started working on research. In college, I chose UFRGS because it’s a university with a strong research tradition, where I could develop as a physician-researcher.”
Brum’s most notable work was developing protocols for the clinical implementation of a blood test that diagnoses Alzheimer’s disease based on the presence of the p-tau217 protein, one of the disease’s main biomarkers.
Although the test proved accurate in research, standards for interpreting results were needed for it to be adopted in routine diagnosis. And that’s what Brum did.
“In patients with very high or very low measurements, we could clearly know, just from the blood test, whether the person has the disease or not. But about 20% to 30% fall into an intermediate range, and those need an additional test.”
From the Lab to SUS
According to Brum, the protocol increases the test’s reliability and is already used by labs in Europe and the United States. Unfortunately, in Brazil, only some private labs have incorporated the technology so far. But the Zimmer Lab continues research, aiming to facilitate large-scale diagnosis of the disease.
“To be implemented in SUS, which is our main goal, studies are needed showing that introducing these tests can improve diagnostic confidence and change patient treatment. What is seen in other countries is that these tests achieve that.”
Tests for this purpose are already being conducted in Rio Grande do Sul and will later expand to other Brazilian cities. Brum highlights that, currently, Alzheimer’s diagnosis is mainly based on symptoms, with clinical analysis by the doctor and aid from tests that are not fully accurate.
“The most common are structural imaging exams, like CT or MRI, which show which parts of the brain already have atrophy. But natural aging also causes atrophy, as do other neurodegenerative diseases. There are more typical patterns for Alzheimer’s, but these exams are not specific.”
The two existing precise tests are cerebrospinal fluid examination, which analyzes material withdrawn from the spine, and Positron Emission Tomography (PET-CT), but both are expensive and hardly accessible.
Brum believes adopting the blood test could not only facilitate diagnosis but also increase physicians’ confidence in their practices. In the future, biomarker tests could detect the disease before symptoms appear.
“It’s great to see that the international research community pays attention to what we do and values it. There are many people doing excellent research in Brazil, in various areas, who deserve visibility.”
The two award-winning researchers work with funding from institutions such as the Rio de Janeiro State Research Support Foundation (Faperj), Serrapilheira Foundation, and Idor Institute Pioneer Science.
Source: Agência Brasil