Genetically altered astrocytes that express chimeric antigen receptors offer a promising immunotherapy system capable of clearing accumulations of amyloid-β in the brains of mice – a hallmark pathological feature of Alzheimer’s disease, according to a new study. Alzheimer’s disease (AD), the leading cause of dementia in aging populations worldwide, is marked by a distinctive pathological cascade: amyloid-β (Aβ) plaques accumulate in the brain, triggering harmful changes in tau proteins, which may ultimately drive widespread neurodegeneration. Although the amyloid cascade hypothesis remains debated, recently approved anti-Aβ antibody therapies have shown moderate success in slowing AD progression. However, these treatments require large doses and are associated with potentially fatal side effects. To address these shortcomings, researchers are exploring the use of engineered chimeric antigen receptors (CARs) that could program brain cells to recognize and clear Aβ with far more efficiency and precision. Although CAR immunotherapies have been transformative in cancer treatment and shown promise in early in vitro laboratory studies, significant hurdles remain towards their use in treating AD, including safe delivery of CAR cells to the brain. As a result, their effectiveness in mitigating AD in vivo has yet to be demonstrated. Here, Yun Chen and colleagues explored whether engineered CAR-expressing astrocytes – CAR-As – could be leveraged to overcome these challenges. According to Chen et al., these modified astrocytes enhanced Aβ clearance in laboratory experiments and, when delivered noninvasively into the brains of mice, substantially reduced Aβ buildup in living animals. Moreover, the authors found that a single early treatment in a mouse model of AD prevented the development of Aβ pathology. The findings establish a proof-of-concept that CAR-A designs may offer a powerful and potentially durable strategy for clearing Aβ accumulation and mitigating disease progression in AD. “The study of Chen et al. helps establish a foundation for increasingly innovative CAR strategies in AD,” write Jake Boles and David Gate in a related Perspective. “As CAR technologies mature and the ability to selectively neutralize toxic proteins improves, these approaches hold substantial promise for AD and other neurodegenerative disorders.”

Genetically altered astrocytes that express chimeric antigen receptors offer a promising immunotherapy system capable of clearing accumulations of amyloid-β in the brains of mice – a hallmark pathological feature of Alzheimer’s disease, according to a new study. Alzheimer’s disease (AD), the leading cause of dementia in aging populations worldwide, is marked by a distinctive pathological cascade: amyloid-β (Aβ) plaques accumulate in the brain, triggering harmful changes in tau proteins, which may ultimately drive widespread neurodegeneration. Although the amyloid cascade hypothesis remains debated, recently approved anti-Aβ antibody therapies have shown moderate success in slowing AD progression. However, these treatments require large doses and are associated with potentially fatal side effects. To address these shortcomings, researchers are exploring the use of engineered chimeric antigen receptors (CARs) that could program brain cells to recognize and clear Aβ with far more efficiency and precision. Although CAR immunotherapies have been transformative in cancer treatment and shown promise in early in vitro laboratory studies, significant hurdles remain towards their use in treating AD, including safe delivery of CAR cells to the brain. As a result, their effectiveness in mitigating AD in vivo has yet to be demonstrated. Here, Yun Chen and colleagues explored whether engineered CAR-expressing astrocytes – CAR-As – could be leveraged to overcome these challenges. According to Chen et al., these modified astrocytes enhanced Aβ clearance in laboratory experiments and, when delivered noninvasively into the brains of mice, substantially reduced Aβ buildup in living animals. Moreover, the authors found that a single early treatment in a mouse model of AD prevented the development of Aβ pathology. The findings establish a proof-of-concept that CAR-A designs may offer a powerful and potentially durable strategy for clearing Aβ accumulation and mitigating disease progression in AD. “The study of Chen et al. helps establish a foundation for increasingly innovative CAR strategies in AD,” write Jake Boles and David Gate in a related Perspective. “As CAR technologies mature and the ability to selectively neutralize toxic proteins improves, these approaches hold substantial promise for AD and other neurodegenerative disorders.”

Alzheimer's-related brain changes progressed up to 20 times faster in women who also had abnormal levels of a Parkinson's-related protein, according to a Mayo Clinic study published in JAMA Network Open. The same pattern was not observed in men.