Credit: Nick Romanenko

Karl Herrup, whose lab focuses on the causes of neuron death, believes that a cure for Alzheimer's and other neurogenerative diseases is not likely to come in his lifetime but may be a generation away.

The subject of Karl Herrup’s Henry Rutgers Scholars Lecture, delivered to a full house at the Rutgers Student Center last month, was grim: Alzheimer’s disease. Herrup, professor and chair of the Department of Biology and Neuroscience in the School of Arts and Sciences, told his audience that good news about the disease is sparse, but real.

First, Alzheimer’s is a disease of aging, and most people who have it have lived long enough to miss or survive many other diseases that tried – and failed – to kill them. “This is part of the triumph of modern medicine,” he said. “If we weren’t living longer, many of us wouldn’t live long enough to have Alzheimer’s. Also, diagnosis is much better. New methods allow us to see the disease better than even 10 years ago. And, finally, research is proceeding at a fairly dramatic pace.”

Alzheimer’s disease – first identified by German neuropatholgist Alois Alzheimer more than a century ago – is the most common form of dementia in older people, said Herrup, who has made Alzheimer’s disease his research focus. In particular, his laboratory studies cell cycle regulation – how cells divide, reproduce, and die – in the adult neuron. Alzheimer’s disease destroys the brain’s neurons.

About 4.5 million Americans suffer from some stage of Alzheimer’s. The disease causes a great deal of collateral damage. The relatives and caregivers of those afflicted (often the same people) find their lives dramatically altered by the disease, and frequently their own physical and psychological health suffers. In New Jersey alone, about 350,000 people either suffer from Alzheimer’s disease or are directly affected by it; the cost associated with the disease is about $100 billion per year nationwide.

Alzheimer’s starts with what Herrup called “mild cognitive impairment,” or MCI, which is clinically detectible but doesn’t disable its victim. About 30 percent of the time, MCI doesn’t turn into Alzheimer’s, but into some other form of dementia. Sometimes, it even “resolves” – that is, goes away for one reason or another. For the 70 percent of patients whose dementia becomes Alzheimer’s, the progress of the disease is inexorable.

Short-term memory misfires, fades, and then fails altogether. Emotional control disappears, so that cheerful people become depressed and mild people aggressive. In advanced stages of the disease, the hippocampus, the fold of brain tissue which is the gateway to memory, is nearly gone.

One clue to how Alzheimer’s destroys the brain’s neurons was discovered by Alzheimer himself: abnormally high numbers of odd deposits in the brain – waxy plaques and fibrous tangles. Modern research assigns great significance to the small protein fragment that is the basis of the plaque. A fair amount of evidence suggests that some part of the process that creates the plaque may lie right at the root of the disease. Based on his laboratory research, Herrup thinks the disease is related to the nerve cells’ ability to control their ‘urge’ to replicated themselves – similar in some ways to the problem in cancer.

At the close of the December 12 lecture, an audience member asked what advice Herrup would give someone whose loved one had just been diagnosed with Alzheimer’s disease.

“Let me be very direct,” Herrup said. “I would put my loved one in the hands of a good neurologist. I would seek out the local chapter of the Alzheimer’s Association. I would put the individual’s worldly affairs in order. And I would spend as much time with that person as possible. I’m sorry to be so brutal, but I honestly don’t believe in sugar-coating this disease. It’s just too nasty.”

Herrup is positive about future research. “I’m extraordinarily optimistic,” he said. “Not for myself; I’m not sure a cure will be there by the time I would need it. But I have hope that, for my children, Alzheimer’s will be just a distant memory.”

The Henry Rutgers Scholars Lecture Series runs every semester to highlight the research of Rutgers faculty to alumni and the general public.