Important Notice: Opine Online provides an
informal way for the research community to express its views on current topics.
The results are not a scientific poll and do not necessarily reflect the percentages
of all Alzheimer researchers who agree with these positions.
Poll Question: What's the AD drug smith to do about the blood-brain barrier?
Study the BBB
BBB is overrated; any molecule can be engineered to get in
Serious obstacle; make penetrance first ‘kill’ criterion
Remember the Mad Hatter's symptoms? Why is no one looking at mercury fillings in people's heads. Seems simple to me. When we pack mercury in people's teeth, mercury beads surface and are swallowed. How would that get out of their bodies? A small spill on the carpet and everyone panics, but it is okay to put it in your head. What about other countries that have outlawed mercury fillings? What are their stats for Alzheimers?
I believe the answer to Alzheimer disease will be found by looking at evolutionary changes of humans. The blood-brain barrier is one of our natural defense mechanisms, and I feel the proper course is to find a way to work with it, not necessarily around it.
We do Alzheimer disease preclinical trials using animals, yet we know that their blood-brain barriers are incomplete. Drugs used in these trials cross the blood-brain barrier readily, so the results obtained are different from those in humans.
In preclinical trials, we should use subjects that mimic the human blood-brain barrier, if there are any.
BBB Is Overrated; Any Molecule Can Be Engineered to Get In!
Not a single drug on the market has been successfully "engineered" to get inside the brain. The BBB problem represents the number one challenge of CNS drug development. Just look at pharmaceutical companies' pipelines: the vast majority of new molecular entities (NME) including biopharmaceuticals are restricted to peripheral disease. Despite improvements in recent years, we still have the feeling that many scientists and drug companies adopt the strategy of the ostrich regarding the BBB. Worst of all: besides a few biotech companies and less than 10 academic research groups, not much is done to address those BBB-related issues. In the meantime, hundreds of millions of dollars are invested in identifying new drug targets for CNS diseases that could be useless because of the lack of non-invasive brain drug delivery systems.
The BBB is generally underestimated - it is not just scientists who develop drugs for AD who avoid the issue of the BBB.
However, why would anyone in his right mind invest so resources into the development of new molecular entities targeted at the brain and not invest into research whether and how this NME passes the BBB?
Doing BBB research myself I know it is costly and time intensive, but it is feasable and definitely necessary.