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Could Painkillers Prevent Alzheimer's?

Mouse study suggests so, but human trials are needed

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FRIDAY, Aug. 1, 2003 (HealthDayNews) -- Research in mice suggests that eight painkillers may be able to play a role in preventing Alzheimer's disease.

Mice who took the drugs, including the common painkiller ibuprofen, had lower levels of a brain protein that has been connected to the illness. While experts are far from recommending that anyone take the drug to prevent the disease, the findings will provide guidance to researchers working with humans, says Dr. Todd Golde, co-author of the newly released study and associate professor of neuroscience at the Mayo Clinic in Jacksonville, Fla.

"There's reason for cautious optimism," Golde says.

Alzheimer's is both destructive and mysterious. It affects an estimated one in 10 people over the age of 65, and nearly half of those older than 85, but doctors and researchers still don't fully understand what causes it.

One theory is the disease kicks in as the brains of victims become clogged by bits of protein called "plaque" that are normally processed and harmlessly removed.

Studies in humans have shown that people who take the painkillers known as nonsteroidal anti-inflammatory drugs (or NSAIDs) are less likely to develop Alzheimer's. However, aspirin -- a wonder drug in so many other areas -- doesn't seem to have much of an effect as its sister drugs in that category.

To make matters more complicated, the studies only suggest a possible link between use of NSAIDs and lower risk of Alzheimer's. Since other factors could be at play, the research doesn't prove that the painkillers actually prevent the disease.

In the new study, Golde and colleagues examined 20 types of NSAIDS. The findings appear in the Aug. 1 issue of the Journal of Clinical Investigation.

Eight kinds of painkillers -- diclofenac, diflunisal, ibuprofen (such as Motrin), sulindac, fenoprofen, indomethacin, flurbiprofen, and meclofenamic acid -- reduced the mice brain levels of a protein called Abeta42 that has been linked to Alzheimer's. "Compelling" evidence suggests the protein is a "bad guy" in the development of the illness, Golde explains.

The painkiller known as flurbiprofen did the best job in reducing levels of the protein. Flurbiprofen is currently being tested as treatment for prostate and colon cancer.

Other painkillers -- including naproxen, aspirin, nabumetone and ketoprofen -- had little effect on the protein.

It's not clear why the eight painkillers did such a good job of combating the troublesome protein, Golde says, but it may have something to do with their abilities to reduce inflammation.

"What this really shows is that NSAIDs are probably associated with a decrease in the risk for developing Alzheimer's disease," Golde says. "But they don't show that giving an NSAID to a person with Alzheimer's disease is going to do any good."

The next step is for researchers to launch studies in which they compare people who take NSAIDs with those who unknowingly take a placebo, says Dr. Irene Litvan, director of the Movement Disorder Program at the University of Louisville. Only then will researchers "be able to find out if some of these NSAIDs are in fact beneficial in preventing the disease in subjects at risk [unaffected individuals with known mutations] or stopping it or slowing it in those who have early symptoms of Alzheimer's disease."

For now, Golde says patients worried about Alzheimer's shouldn't run out to take NSAIDs without talking to their doctors. Litvan agrees.

"These agents are not without side effects and may have unexpected effects in patients with Alzheimer's disease," she says. "We should wait."

More information

Try the Alzheimer's Association or the National Institute on Aging for more on Alzheimer's disease.

SOURCES: Todd Golde, M.D., Ph.D., associate professor, neuroscience, Mayo Clinic, Jacksonville, Fla.; Irene Litvan, M.D., director, Movement Disorder Program, University of Louisville School of Medicine, Louisville, Ky.; Aug. 1, 2003, Journal of Clinical Investigation
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