THE HOUSE THAT DAVE BUILT - University of Toronto Magazine

ing of the disease today to where cancer
research was 20 years ago. The first
generation of anti-amyloid drugs are
being tested and, until the results are
in, “all bets are off,” he says. Although
confident that new therapies will slow
the disease and may even induce a
slight improvement in patients, he’s
doubtful that removing the amyloid
plaques is the end of the story.
St. George-Hyslop is particularly
concerned about the tangled fibres that
form inside diseased neurons. Although
it’s possible that treating the amyloid
will be all that’s necessary to bring about
improvements in Alzheimer’s patients,
the amyloid may, in fact, have caused
tangles to form or irreversibly damaged
neurons in other ways. In other words,
simply removing amyloid from the
brain, or preventing it from aggregating,
may not be enough. (Scientists now
believe that amyloid builds up in the
brain for years, or even decades, before
patients start to show symptoms.) St.
George-Hyslop worries that the tangles,
which are deadly to neurons, may cause
the disease to progress until they are
stopped. “That’s a major concern at this
point,” he says.
Research into any disease proceeds in
three phases: first, understanding its
causes and how it works; then, designing
treatments to stop or prevent it; and
finally, repairing the damage it has
caused. So far, most Alzheimer’s research
falls into the first category; work on the
second phase, designing treatments, is
just beginning. However, CRND is now
looking for researchers for the final stage
– studying how neurons are born, move
around the brain and connect with each
other – in the hope of being able to
repair brain damage.
Last spring, St. George-Hyslop won
the $5-million Premier’s Summit
Award, which recognizes world-class
research in Ontario. He will use the
money to recruit researchers interested
in neuronal repair. This type of study is
in its infancy, but could have huge
implications not only for people with
Alzheimer’s disease, but for individuals
who have had a stroke or who have a
brain tumour or mental retardation, says
St. George-Hyslop. “Even in a simple
animal, such as a worm or fly, understanding
these processes is going to be
very difficult. In humans it will take a
decade or two.”
As with all research endeavours,
money is crucial – and not always easy
to come by. For the bulk of its funding,
CRND relies on peer-reviewed research
grants and donations from individuals
and non-profit societies interested in
neurodegenerative diseases. Although a
$5-million grant is considered unusually
large in Canada, St. George-Hyslop says
it would be fairly typical in the U.S.
With its funding limits, CRND must
choose its projects carefully. “Right now
we’re constrained to pursuing a number
of main ideas, but there are many other
projects we could do in six months or a
year if we had the resources,” he says.
In the meantime, the difficult lab
work continues. St. George-Hyslop
doesn’t encounter Alzheimer’s patients
on a day-to-day basis, but the centre has
relationships with many of the families
who have donated DNA for studies.
He’s aware that they’re grateful for the
groundbreaking research at CRND, but
he’s not prepared to accept any plaudits
– not until an effective treatment is
found. “We haven’t accomplished our
goal yet,” he says.
McKinley understands that her
condition will worsen. She
remains hopeful, however,
that the work of St. George-Hyslop
and other researchers around the world
will lead to an effective treatment and,
one day, a cure. In the meantime,
McKinley knows that, despite the
drugs she is taking, she will gradually
lose the ability to do many of the things
she likes, such as baking bread and
cycling with her husband. I ask her if
she fears for the future. She shakes her
head, smiles. “I’m loving life and I have
a very good feeling with God,” she says.
“I have no problem moving on.”
Scott Anderson is the editor of U of T
Magazine
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