“The Alzheimer’s Germ Quest”  is now closed, with no $1M winner. The three year entry period closed Dec 31, 2020.  No one researcher, no one germ “won,”  but eight researchers were awarded lesser prizes.

Of course, the brain is no stranger to infection, sometimes with devastating acute or chronic consequences.  Childhood meningitis and neurosyphilis in adults are two classic examples, and even COVID-19 is associated with “brain fog.”  But no one has been able to pin down an association of a germ with the progressive neurodegenerative process seen in Alzheimer’s and other dementias.

Dr. Leslie Norins created the prize in 2018, offering a $1M prize for research that could provide convincing evidence that Alzheimer’s Disease (AD) was caused by a microbial agent.  An MD PhD / infectious disease specialist / medical publisher, with a career that included work at the CDC, he presents his rationale for the search in a whitepaper on his website.

The results are published online in his summary statement, Feb 23. There were 83 inquiries, but fewer official entries.  Candidate germs included Herpes viruses, the protozoan Toxoplasma, and four bacteria (details in the link)  No presentation was deemed worthy of winning outright, as explained in the statement, but eight individuals were named for prizes.

The other big money prize looking for AD etiology is the Oskar Fischer Prize, $4M total.  It is named after the neurologist who described the classic neuropathology in dementia patients the same year that Alzheimer did.  Fischer died a Holocaust victim during WWII. It’s funded by industrialist Dr. James Truchard, through UT-San Antonio, but the timeline to award the prize is unclear.

There have been no Nobel prizes for AD per se, although one in 1927 was for “dementia paralytica” (neurosyphilis) and 2014 was about neurophysiology in the hippocampus.  There have been Lasker Award and Lundbeck Award (so-called “Nobel of Neuroscience”) winners for AD related work, the latter in 2018 for work in amyloid, tau, secretases and genetics.  The XPrizes had an award in 2017 ($25M?  unsure of progress / outcome) and the NIA had the Eureka Prize, three caregiving awards divided $400K.

This blogger won’t speculate on why these intelligent folks with resources felt compelled to create prize incentives, since AD is not exactly a new condition, and all the aspirational research overviews seem to use the word “innovation.” Maybe readers will have their own ideas. Of course, as of this writing, for patients there are still no FDA approved disease-modifying therapies.

The Chan-Zuckerberg Initiative created a “neurodegeneration challenge,”  but they seemed like one time grants (> $50M total?), a few years ago.  Bill Gates, through his venture process, is said to have invested millions in AD work but by 2019 was slowing that down. The Alzheimer’s Assn evidently grants at least $40M yearly for research; the AD budget at NIH is said to be ~$3 Billion now.  For reference, Operation Warp Speed for COVID-19 vaccine development is variously estimated to be ~$12 to 18 Billion.

Terrific AD science continues, as seen in the growing AAIC meetings, more basic neuroscience than clinical.  Practical interventions for ways that could positively affect patients anytime soon just seems resistant to the body of work, and to jumpstarting prizes. There may be incremental progress.

Inflammation, for example, part of the human defense against germs, has a growing literature in Alzheimer’s studies. Some stalwarts of the Amyloid Hypothesis seem to be modifying their ideas to include inflammation.  One example is Tanzi and Moir’s “Innate Immune Protection Hypothesis.” Whether inflammation implies a germ and infection, or something else, or is even of primary significance in this arena, does not seem to be well worked out. Of course, readers of this blog may remember the posting below, about “Inflammaging and the Fountain of Youth.”  If only….

https://wp.me/pa8bpr-lW

Kassandro WikiMedia CC0 3.0 Der Jungbrunnen, Bad Harzburg, Germany

 

Perhaps families need to wait for serendipity, “happy accidents” in a lab somewhere, so famous in the discovery of penicillin, but also evidently prominent in clinical neurosciences.  A breakthrough would be a prize unto itself, and surely accolades would follow.