Koen Dewaele (CEO) started ADx about three and a half years ago, when Fujirebio (the former Innogenetics), cut back its research activities drastically. Four employees who already worked on Alzheimer’s biomarkers decided to continue the research and founded their own company. The company develops diagnostic tests to screen for Alzheimer’s.
Alzheimer's is a dementia in which a person gets memory loss, has mood swings, becomes disoriented and loses the ability to make plans. About 100 years ago, the German psychiatrist and neuropathologist Alois Alzheimer described the disease for which he was later credited. The brain of a person with Alzheimer's exhibits abnormal structures such as "tangles" and "plaques". These structures are aggregations of proteins, in the case of plaques these are β – amyloids, and Tau in the case of tangles. Aberrant values of these proteins can be measured 5-10 years before a patient manifests the symptoms of Alzheimer’s. By the time symptoms occur, it is too late to treat the disease adequately.
ADx has developed a test for measuring the proteins in cerebrospinal fluid that indicate an early stage of Alzheimer's disease. How does the test work exactly?
Koen Dewaele: "You need a good antibody to measure the toxic proteins. We inject peptides, based on tau, in mice. Their immune system produces antibodies against these peptides and we add an extra component to enhance this response. The lymphocytes are extracted from the spleen of the mouse and fused with a cancer cell line. In this way we get an immortal cell line that always makes the same antibodies. Next, we use these antibodies in an ELISA test system to determine the Tau quantitatively. If a certain amount (threshold) is exceeded, this indicates disease. "
Can you detect all patients who have Alzheimer's?
"Not all forms of dementia are due to Alzheimer's. There is also vascular dementia, and dementia due to accumulation of Lewy bodies, such as in Parkinson's. In some cases dementia occurs without an assignable cause. In 70% of cases, dementia is due to Alzheimer's disease pathology, i.e. aggregates of β-amyloids and Tau. We can detect those cases.”
What is your marketing strategy?
"We are working with a German partner, Euroimmun, to produce our tests on an industrial scale and place them on the market. Our test is CE marked and is mainly used by the pharmaceutical industry. They are looking for objective criteria to screen patients that will develop Alzheimer’s. Those patients can participate in clinical trials where new drugs are being developed for Alzheimer's. The test is also used by neurologists who want to make an early-stage diagnosis. This can, for example, be done by Prof. Dr Engelborghs in ZNA Middelheim or ZNA Hoge Beuken for 165 euros.”
Research funds for Alzheimer’s were cut in half.
"This is true, because the results of the studies for the development of drugs against Alzheimer's until now were not successful. This is largely due to the fact that 30% of the subjects with dementia don’t show pathology of Alzheimer's disease, but were included in the clinical trials. This can be remedied with our diagnostic tests. The downsizing of the research funds is for us a setback as well as an opportunity, because people now start to realize the necessity of using biomarkers for diagnosis. Fortunately, ADx has its own funds. We currently have a number of investors, including Euroimmun, and we also received a number of grants. Most importantly, we want to do a capital increase before summer. We will welcome new selective shareholders, hopefully an industrial partner too."
What's in the pipeline?
“Currently we are able to determine whether someone has the pathology to develop Alzheimer’s, but it is no indication when the symptoms will occur. It can take years. We are now working on a test to predict when symptoms will occur. We have seen that cognition declines when the synapses start to die. This can be evaluated by mapping the concentration of neurogranin. We see a clear correlation between the concentration of this protein and the functioning of the patients.”
Suppose I run the test and I get diagnosed with Alzheimer's. As I understand it, there is no medication to help me?
“No, there is no medication that will really slow down the disease. That is why we are careful in communicating the existence of the test to patients. It is a heavy verdict and the clinician has no real treatment options.”
What are your ambitions in the long term?
“We want to develop diagnostic tests for other neurodegenerative diseases such as Parkinson's and ALS. Also, we have the ambition to be able one day to biochemically diagnose depression and schizophrenia, as these are also diseases in which the biochemical processes in the synapses are disrupted. If we understand the pathology of these diseases, a more accurate diagnosis can be made and more specific medication could be developed. The brain is the least-known organ. Expect a big revolution over the next 50 years.”
We would like to become a world-renowned company in neurodiagnostics for all neurodegenerative disorders, including schizophrenia, depression and Parkinson's.
The number of people with Alzheimer's disease or any other form of dementia has exploded. There are now about 47.5 million patients worldwide and The World Health Organization (WHO) predicts this number will be tripled by 2050, to 135.5 million people. Doctors, scientists and politicians debate the possibilities of enhanced international cooperation to curb the disease. Although dementia cannot yet be cured, patients should receive better emotional and physical support, says the WHO. In addition, the organization thinks the efforts to detect the disease in an early stage should be increased and wants to focus on a more targeted treatment of the physical suffering that accompanies dementia. Alzheimer's disease is the most common form of dementia by 60-70 percent.