The acronym NADINE stands for “The NAnosystems for the early DIagnosis of NEurodegenerative diseases”.
The NADINE project aims not to find a cure for Alzheimer’s but to ensure early diagnosis; if a person has visible symptoms, it is usually too late to do anything about Alzheimer’s and other dementia diseases.
In the NADINE Project, we look for molecules (biomarkers) that are specifically linked to the diseases. Typically, there are not one but a range of molecules/biomarkers and they have to be found at very low concentrations. These biomarkers are not very accessible because they occur in cerebral spinal fluid.
Here is an example: If a country wants to screen the population over 55 years of age every other year for Alzheimer’s, we must develop a screening method that is almost pain-free, easy to do, inexpensive to use and without danger to the patient. Taking samples of spinal fluids is the opposite of these things. It is painful, dangerous and expensive.
The technological challenges behind NADINE
NADINE tries to exploit nanotechnological approaches to find and catch these molecules, enrich them and then detect their numbers very sensitively within blood samples. However, the concentrations of these indicators are very low in blood. Also, if we can differentiate between what sort of dementia a person suffers from, it will also be very valuable for both the patients and their families.
The NADINE Project addressed the challenges of a critical need for new reliable tools for the early, differential, potentially predictive, and minimally invasive diagnosis of neurodegenerative disorders.
To be widely usable, the system should be fully integrated and highly automated. It should also identify and quantify accurately a multiplicity of molecular biomarkers.
Number of people with Alzheimer’s
In Europe alone, more than 5.7 million people suffer from dementia, 50-60% of which from Alzheimer´s. Its occurrence is continuously increasing due the aging of the population. As dementia lead to dramatic and long term suffering for the patients and their families, it is a major societal problem. It is also a growing cost burden to the European economy and social security systems. Early detection would mean a reduction in suffering for both patients and their families.
Every fifth death is caused by dementia and we do not know why, nor do we know how to stop the disease. Getting medicine can be difficult because people cannot get the right diagnosis. Today the diagnosis is determined through a complex set of tests, brain imaging, cognitive tests, neurological and psychological tests. Specialists in neurology, geriatric psychiatry and geriatrics are all involved in this and it may take months to unravel and arrive at a “verdict”.
Costs of the disease
As of 2010, the costs in Europe related to Alzheimer’s are estimated to 55 billion Euros per year. These diseases most often have a slow evolution, without clinically clear symptoms for often more than 10 years. No cure for the disease’s damage exists, but intense and promising efforts towards neuroprotective drugs able to retard its evolution are currently under development. Therefore, the earlier the disease is detected and diagnosed, the better the chances for better treatment.
Lack of diagnosis and recognition is a problem but there is also a lack of funding. For every one £ spent on Alzheimer and other dementia diseases in the UK, 10 £ is spent on cancer research. However, if you compare the costs to society for these diseases, Alzheimer’s account for 50 % of the costs whereas cancer accounts for 20 %.
Why the need for a diagnostic tool?
So far, Alzheimer’s can only be diagnosed by the occurrence of a typical combination of clinical symptoms, while molecular or imaging techniques are mainly used to exclude other diseases. Neurochemical markers in cerebrospinal fluid (CSF) seem to monitor disease evolution earlier than what is possible with imaging. Unfortunately, lumbar puncture is an invasive and delicate method, which cannot be used for screening, and is restricted to patients with significant symptoms. In summary, no technique exists so far for large scale population screening in a preventive approach.