Alzheimer's pioneer: John Hardy

DW: The Hartwig Piepenbrock-DZNE Prize, which you are receiving on Monday, is just the latest in a long list of accolades for you, Professor Hardy. You've been described as "the pioneer" in Alzheimer's research, perhaps even as the man who has solved the disease. Is that true? Have you solved Alzheimer's?

Firstly, I followed, of course, the people who came before me and in fact one of those people is Konrad Beyreuther who is one of the previous awardees of this prize. A pioneer? Even before me there were pioneers who I followed. That's one thing. Have we solved Alzheimer's disease? I think we have provided the frame work where we can see how the disease starts and progresses, and I think that has been very important indeed. I would not describe myself - and I can't imagine anyone else describing me - as the person who solved the disease. It's not solved yet.

The fight against Alzheimer's is more or less the fight against neuronal degeneration. In the case of Alzheimer's sufferers, why do their brain cells die?

We don't know exactly, but what happens is amyloid [protein deposits] start to build up around the nerve terminals of those dying nerve cells. The nerve cells react to them in a way which firstly starts to produce pathology within them - called tangle pathology - and then eventually it kills them. It takes some time but the amyloid built up outside the cells eventually leads to those cells dying. That's the underlying problem. I should say: We don't know what the function of the amyloid protein is, and that's still a big hole in our knowledge.

What kind of advancements have the discoveries that you have made contributed to with regard to the treatment of Alzheimer's?

In terms of the treatment I think they pointed the way to design treatments, they pointed amyloid drugs as the way forward. Some of those drugs are now in clinical trials. There are four or five clinical trials of anti-amyloid drugs at the moment. I really hope that some of those trials will be successful.

You formulated the amyloid hypothesis over two decades ago. How far has Alzheimer's research and treatment come during that time?

Research has come a long way. We understand a lot more about the disease now. We know more genes involved in the disease, we understand different cellular roles in the disease, for example we understand a bit more about the glial cells' role in the disease, we understand the process of cell death better than we did. There has been plenty of progress in understanding Alzheimer's. That process has not yet helped in changing therapies for the disease but I hope that changes soon.

How about with regard to ever finding a cure?

I think we are closer to being able to slow the disease right down. I can't see us ever - in my research lifetime - reversing the disease, but I can see us slowing the disease down or stopping the disease in the foreseeable future, in the next five years, I really hope.

Monday, September 21, is World Alzheimer's Day. Do you think that our world does enough to fight this disease?

No, we don't do enough. We're doing more and actually I think one of the great initiatives here in Germany has been the DZNE [Editor: Deutsches Zentrum für neurodegenerative Erkrankungen] initiative which I think has transformed German science from ten years ago being a bit of a backwater in Alzheimer's disease research to actually being a leading force in dementia research. And that's because the German government has taken initiatives to do with funding. I mean it's very straight forward. Funding matters and Germany has really been a leading proponent of that. But, of course, there needs to be more. We spend much less on Alzheimer's research than we do on cancer research and yet they are both similar size problems. And the answer, of course, is not to spend less on cancer research. The answer is to spend more on Alzheimer's research.

Alzheimer's is a debilitating disease. Anybody with first-hand-experience can certainly attest to that. You have dedicated your work to this affliction for the past 25 years. What exactly keeps you going?

It's a mixture of motives - venal and good motives. Let's talk about the venal ones first. I love a good competition. What I love about research is the competitive nature of it, being the first person to have an idea, the first person to make a finding. Those are things that drive me. But the fundamental reason is to help the families - especially the ones I know - who have got the young onset form of the disease. I give talks to patient groups and, of course, we want to make their lives better so that the next generation does not suffer from these horrible diseases. So, like all things, it's a mixture of motives.