"When we think about those proteins that aggregate in the brains of Alzheimer's patients and other types of degenerative diseases, they actually form structures that look like this pasta. They are twisting, and not only twisting, twisting in one way specifically. Those twisted structures are what creates a lot of the toxicity," explained Dr. Ronit Freeman, an associate professor of applied physical sciences at UNC.
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Freeman explained right now, there isn't a true understanding of what drives which amyloid plaque structure and which structure is more toxic.
"By our ability to understand for each patient what type of structure that they would have, what type of amyloid plaques that we have in the brain, we can tailor therapy that will be more suitable for them," said Freeman.
UNC researchers teamed up with a team from Emory University on the study, which also investigated potential treatments.
"If we can make them untwist like that, are we able to use the fact that they can curl like that and even hide certain drugs within them," said Freeman.
One potential therapy included the use of heat.
"Some of the structures melted in between 37 and 40 degrees (Celsius), which is very doable temperature for us to get to. If we can even locally heat about 40 all the way to 45 degrees Celsius, it would not be damaging anything else in our bodies," Freeman explained.
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While the research is still regarded as preliminary, it's welcome for Jay Reinstein.
"There's no question it gives me hope. It gives millions of people hope," said Reinstein, who was diagnosed with Alzheimer's in 2018 at 57 years old.
While he struggles with short-term memory loss and is unable to drive, Reinstein has remained active, including in advocating on behalf of other patients. Last summer, the FDA approved Leqembi, a drug which has shown to slow cognitive decline in early Alzheimer's patients.
"I think that the more approved drugs through the FDA, it's going to get more companies throughout the world saying, 'Hey, we're making some headway here. We're going to keep developing,'" Reinstein said.
He supports continued efforts to address different types of dementia.
"Right now there is no cure, yet there are thousands of researchers out there. It's not going to be a one-size-fits-all. I think the approach has to be different perspectives. As our brains are so different, they might find a treatment that helps," Reinstein explained.
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Reinstein worked in local government for 25 years, and retired as assistant city manager from Fayetteville at the time of his diagnosis. Now, he travels the country, attending conferences and meeting with other patients to discuss ways to push forward treatments.
"It's exciting because we weren't hearing about this just three or four years ago, and for 20 years we didn't hear anything. To find out, (this research) is in my own backyard--and I love UNC--It makes it even more exciting," Reinstein explained.
According to the Alzheimer's Association, it's estimated that 6.5 million Americans 65 years and older live with Alzheimer's dementia, including 180,0900 North Carolinians.
"If we understand how (amyloid plaque) forms, can we understand how to deform them, how to so-called melt them in order to get rid of them, and maybe in this way discover a path towards a cure," said Freeman.
In response to the study, a spokesperson for the Alzheimer's Association wrote:
"The Alzheimer's Association applauds research that considers the complex needs of people with neurodegenerative disorders, including Alzheimer's, and their caregivers regarding effectively delivering treatments, especially now that there are treatments available for Alzheimer's, with more on the way soon. But it is important to remember that this particular study is very early preliminary research. Continued work in this study will need to take place including preclinical research before any testing in humans is done."