Book: "Conquering Alzheimer Disease" by Susumu Shimoyama

 Sometimes I buy things from Amazon Japan. Find something of interest, leave it in cart, and once they accumulate, I order them.

Exchange rate for USD to JPY was 115 JPY/USD on Jan 2022. Now it is 144 JPY/USD. What I buy from Japan with USD now is like 25% off from Jan 2022. Lucky enough.

I ordered 24 books. One of the books is this nonfiction/documentary on Alzheimer drug development. Written by Susumu Shimoyama, a nonfiction writer, published on 1/8/2021. Language is Japanese.

Until recently, we did not have drug for Alzheimer's disease (AD). We have seen over 200 failed clinical trials. Huge amount of money and efforts for nothing. Some pharmas went bankrupt or merged because of failed trials.

As in this documentary, Eisai, a Japanese pharma, found Aricept, a drug that helps neuronal functions and thus helps cognitive functions for a while. My mother was taking the drug for her AD if I remember correctly.

Then, amyloid-targeting drug (antibody drug against amyloid-beta protein, a major pathology component of AD) came to the market.

This documentary covers the stories of AD drugs and their developers. 

Each chapter describes different players. Eisai drug development team, international familial AD consortium, AD transgenic mouse generators, AD vaccine and amyloid antibody drug developers, leading scientists on amyloid cascade hypothesis, scientists chasing non-"mainstream" target, and so on.

I really enjoyed reading those. Went through this 330 page book in 2 days. 

 

The stories actually are dramatic. AD is a lethal disease and people die. Before they die, they go through dreaded processes of loss. 

Some of "inside company power struggle" episodes reminded me of "Kousaku Shima", a Japanese manga series. The manga series were about career of a corporate "salaryman" worker and were very popular. As corporate culture and common sense for work environment have changed quite a bit in this past 20 years, I am not sure if the series are still popular, though.

The book ends with the FDA approval of Aducanumab, an antibody drug for AD, on 2021, under somewhat controversial circumstances. 

Controversial as it was, it was undeniable that the FDA approval gave some momentum and hope to AD drug developers. Now, second anti-amyloid drug is about to launch, and other drugs are being tested. 

New drugs that work represent humankinds' progress and answers to people's hope.

Also, new drug is where the money is.

As a researcher/scientist, I have a few ideas as well as questions on the AD drug field. Yet the progress in 35 years portrayed in this book was undeniably important.

[book cover]

Many American AD researchers and scientists were interviewed and appeared in the book. This book ought to be translated to English.

Life: Slow-moving American medical system

 I am a lucky guy. I've hardly had any major sickness or injury in my life. 

Knee injury in skiing and ACL reconstruction was the biggest injury. But it was oh-so-many years ago. Although I quit skiing and was cautious in taking on martial arts exercise afterwards, I've been walking, jogging, hiking, dancing and doing everything else just fine.

As such, I've stayed away from hospitals and doctors, other than annual flu shot and covid vaccinations. 

However, in the past a few years, I started feeling funny sensation in my upper right abdomen and back. I had some pulsing pain around my liver a few weeks ago. I am fine, but the sensation/pain is a nuisance.

I am a cancer biologist. I've seen many tumors in mice in person and photos of human cancers. This kind of long-lasting abdominal pain/sensation makes me nervous. Just get to see a doctor and ask a diagnosis should be a much better way than speculating by myself.

Speaking of speculation, most likely it is gallstone or related inflammation. Imaging analysis should pick up gallstone, kidney stone or tumor (I'm not gonna like it. I attended a lecture on Hepatocellular Carcinoma last Friday. They presented survival curves from recent clinical trials for liver cancer, and they did not look too promising. Treatment benefits were there, but small. Liver cancers are still "difficult" cancers for sure...I digress). Blood work should detect liver damage or inflammation (hepatitis) if any, which can be followed up with other diagnostics to determine the cause and therapy strategy.

What should be done is there as routines for hospital staff.  They can answer what this is. And we can determine what to do next.

I am from Japan. I don't know recent situations in Japan, but I was used to get to see a doctor quickly, in a matter of hours and days at most, when sick.

American medical system moves like glacier for me.

After the pain episode, by the book, I asked my primary care physician to refer me to internal medicine.

2.5 weeks later, I got a call (yesterday) that the referral got through. They made an appointment with a doctor on December (now is Sept 22),......2.5 months later.

I'd get to see a doctor if it is an emergency, like stroke, heart attack, serious injury or acute infections (...would I? I hope I would). But for non-emergency, the system seems to be moving so slow. And I doubt covid patients are still clogging up the hospital system.

Seriously, some aspects of American life are like those in third world countries. 

Well, maybe because I am not very familiar with the medical system and there may be a fast lane (I did ask around, though). Or maybe the hospital system seriously needs work. Or maybe it is just such a time and we have not recovered from the covid impact on medical system (I saw some doctors and nurses quit).

I know the doctors, nurses and hospital staff are working hard for what they are supposed to do and for what they can. I am not trying to be a Karen. But from the standpoint of a patient, there are improvements to be made.

What can I do to make improvements?

Science: Translational Advances in Cancer Prevention Agent Development (TACPAD) 2022 (9/7-9/2022)

Translational Advances in Cancer Prevention Agent Development (TACPAD) is a scientific meeting sponsored by the Division of Cancer Prevention, NCI (National Cancer Institute) and the Office of Disease Prevention, NIH (National Institutes of Health).

The three day virtual meeting presented talks from the researchers in the NCI cancer prevention group.



In recent years, the NCI cancer prevention program went through significant changes in its portfolio (i.e., what kind of research topic they fund and support). Notably, increase in immuno-oncological approaches to prevent cancers (with target-specific drug, vaccines [peptide, DNA], etc).

Reflecting the shift, many talks were about cancer vaccines targeting cancers in different organs (lung, colon, ovary, oral, pancreas, etc).

Yet, there also were more familiar topics; inflammation, target-specific drugs, and so on.



Many talks were about clinical trials, meaning that the cancer prevention approaches are moving from lab animals to the clinic. Some did not show good efficacy, others looked promising. We will see if they go up the ladder further.



Recent advancements in technology are also showing in the presentations. Data science approach is combined with model-based laboratory studies.



A thing about cancer prevention research is that we are dealing with generally healthy population even with a higher risk of developing cancer, instead of cancer patients with existing cancer.

Risk-return in clinic is assessed conservatively. Some approaches used in cancer therapy (an emergency situation) are (unfortunately?) not an option in prevention research with the fear of side effects, although they are proven effective on the specific cancer. An example is immune checkpoint inhibitor. There are many things to consider in translational science application to the public.



I saw cancer prevention research results steadily advancing toward clinical application. It is good.

 [TACPAD meeting webpage]

Science/Life: Professor M.H. retirement party; see your career from an end

Professor M.H is Professor in Cell biology department. She had been working on an enzyme related to liver cancer. 

She is wife of my postdoc-era boss. They are the reason somehow I came to OKC, and the first people I met in OKC. I was staying in their home for a few days before I found and settled in my apartment in this strange city.

Her retirement party was today. 

They came to this institute in 1999-2000. Her active tenure as professor encompasses 22-23 years.

There were speeches from her colleagues and herself. How one defines success in his/her life is his/her prerogative. But a Professor's main work are research, teaching, and administration. The speeches portrayed her accomplishments in each of these three categories. And the portrayal sounded good.

Sometimes it is good to think from the end (or an end). At the end of her tenure, her accomplishments in the 22-23 years were counted as tangible events. We should actively design our own events as well. Well, things do not go as planned in many occasions, but we should have vision for the future as a part of our own pursuit of happiness.

While seeing her retirement, in these days I am working on my career also. This is such a time to look back the past, and to work on the future with vision.