Alzheimer’s is almost impossible to treat. Now there are treatments drawing on brain waves and protein tangles in the pipeline beyond the focus on sticky amyloid plaques

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Immune cells, toxic protein tangles and brain waves are among the targets of future Alzheimer’s treatments, scientists say.

These approaches are noteworthy because they do not directly attack the sticky amyloid plaques in the brain that are a hallmark of Alzheimer’s.

The plaques have been the focus of most Alzheimer’s drug development in the past 20 years. And the drug Aduhelm was given conditional approval by the Food and Drug Administration in June based primarily on the medication’s ability to remove amyloid from the brain.

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Another target for future treatments could be a protein called tau, which is responsible for the toxic tangles that appear inside brain cells as Alzheimer’s develops.

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Experimental drugs might be able to halt this process by removing toxic forms of tau, but it has been difficult to get these drugs past the blood-brain barrier.

So researchers at Denali [Therapeutics] began studying a system that helps iron cross from the bloodstream into the brain. The system involves proteins called transferrin that carry iron throughout the body. The linings of tiny blood vessels in the brain are equipped with special transferrin receptors that allow iron to reach brain tissue.

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