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More Evidence Herpes Virus Strongly Tied to Alzheimer’s
Mounting research is helping to cement a proposed link between the herpes virus and Alzheimer’s disease (AD).
Dr Ruth Itzhaki
The researcher who got the ball rolling nearly 30 years ago by first uncovering the herpes-AD relationship believes it’s time to investigate the use of antivirals in mid-life with the view of preventing AD later on.
Ruth F. Itzhaki, PhD, professor emeritus, University of Manchester, United Kingdom, reviews her own research and that of others that examines the viral concept of AD in an article published online October 19 in Frontiers in Aging Neuroscience.
Causal Link?
Over the past few decades, research has shown that individuals who are infected with herpes simplex virus type 1 (HSV1) are at increased risk for dementia and that use of antiviral drugs decreases this risk.
Results of more recent studies suggest the link is more than a mere association.
“Some very important epidemiological work is being done that suggests that it’s not just an association but that it’s causal,” Itzhaki told Medscape Medical News.
Most of the population is infected with HSV1 by age 70. Researchers believe the virus travels to the brain, where it remains in a latent state. Reactivation occurs intermittently, caused by events such as immunosuppression, peripheral infection, and inflammation.
Data suggest that HSV1 may cause amyloid beta plaques, and Itzhaki and others have shown that abnormal tau protein accumulates in HSV1-infected cell cultures.
The types of antiviral used to treat AD should be “carefully chosen,” said Itzhaki. The exact stage at which the drug would be most effective and how long it should be used should also be closely calculated, she added.
Treatments would probably be more effective if combined with an anti-inflammatory, she said. The herpes virus, she noted, causes inflammation as well as direct damage.
Itzhaki and her colleagues hope to secure funding to test a “double treatment” of an antiviral and an anti-inflammatory in patients with mild AD to see whether this prevents further deterioration.
She sugggested that clinicians keep a note in the patient record of cold sores and other signs of herpes infection. This would make it easier to track whether they were more likely to develop dementia later on, should they be treated in mid-life with an antiherpes agent.
Not Enough Direct Evidence…Yet
For Hendrix, it’s still “way too early” to recommend that adults take antivirals for the primary prevention of AD. “We don’t have enough direct evidence to even go there yet,” he said.
Vaccination against HSV1 would be ideal to prevent the disease, but unfortunately, there’s currently no such vaccine. Developing a vaccine would be expensive and would take years to complete, said Itzhaki.
Although there have now been upwards of 150 studies investigating the link between herpes and dementia, Itzhaki said the accumulating data “have been ignored or dismissed.”
She said she and others have been battling for years to draw attention to research linking herpes to AD, to little avail.
This, she said, has been “very unfortunate” for patients who developed the disease. “Surely, now is the time to rectify the situation,” she said.
She has two theories as to why this area of research has been all but dismissed.
One is that “people have very entrenched views,” and the prevailing view and the focus of research is that beta amyloid and tau cause Alzheimer’s.
“We think amyloid is involved; we just don’t think it’s a cause or primary cause,” she said.
Hendrix acknowledged that although the Alzheimer’s Association funds “a whole range” of different topics and “doesn’t pick the winners and losers,” past budget limitations forced it to focus more on “mainstream” areas.
But now that more federal funding has been secured, the association will be able to take a more diverse approach, he said.
And that approach should include the role of viruses. He noted that research on the immune system in AD is “exploding.”
“Whether herpes or other viruses are actually having an impact on the immune system is a very important area and probably one of the hottest areas of AD research today,” he said.
Dr Itzhaki and Dr Hendrix have disclosed no relevant financial relationships.
Front Aging Neurosci. Published online October 19, 2018. Full text
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