Shot in the dark

HEALTH

season, news of an arthritis medicine that fights Alzheimer's disease.

It's novel to see Bollywood dealing with disorders in the body rather than the body politic. Black offered a heartwarming take on blind-deaf-and-dumbness, Taare Zameen Par on dyslexia, and now Ajay Devgan's U Me Aur Hum marries love drama with love's low points, such as one of the partners being confronted by a calamitous disease "" Alzheimer's "" in, of course, an ultimately heartwarming way.

Alzheimer's disease (AD) normally affects people above 65. It starts with short-term memory loss and progresses to a debilitating loss of long-term memory, confusion and inability to function.

Scientists don't know what causes it or how it develops, although more than 20 million people worldwide suffer from it. What they do know is that "plaques and tangles" in the brain break the links between cells that allow the brain to go about its business.

There is no cure for AD. Doctors recommend mitigating measures like mental and physical exercise and a good diet, but these only delay the progression, not halt or reverse it. Eventually a patient may not be able to speak or think, nor even recognise his family.

However, doctors at the private Institute for Neurological Research in California are now claiming startling success with etanercept (brand name Enbral), ordinarily a medicine for sufferers of rheumatoid arthritis. Doctors have known for years that some anti-inflammatory arthritis drugs ease or delay AD "" but this is a new step.

To deliver etanercept to the brain cells, it is injected into the spine at the neck. Once in the brain, it works to inactivate tumour necrosis factor-alpha (TNF), the chemical which causes swollen, painful joints in arthritis patients. Since TNF is thought to block communication between brain cells, it brings a rapid improvement in function "" or so the few cases under study indicate.

A video on the Institute's website shows a man mumbling incoherently before being given the injection. A few minutes later he recognises and embraces his shocked wife, for the first time in years.

Four weeks into the treatment, his wife says he makes sense 90 per cent of the time (it was 10 per cent before). But the effect plateaus after three months.

This is a still-untested and experimental treatment, so AD experts across the world are sounding a note of caution; however, it's a ray of hope in the otherwise dark landscape of Alzheimer's disease.