New diagnostic technology Maastricht company ToxGenSolutions

A cure for Alzheimer's disease is not yet in sight. But understanding of the possible causes is growing, and therapies to slow or delay the brain disease are also now available. Early diagnosis is important for this. ToxGenSolutions, based at the Brightlands Health Campus in Maastricht, is well advanced with such a test that can predict Alzheimer's at least six years before the first symptoms appear. 'This can make a huge difference.'

Alzheimer's is public enemy number one. Harmful proteins attack brain cells resulting in memory loss, dementia and eventually death, among other things. The Netherlands alone currently has about three hundred thousand patients, a number that will at least double by 2050, according to the Alzheimer Nederland Foundation.

World-wide, many millions of people are affected, so it makes sense that scientists and doctors are doing everything they can to find a cure. 'A cure or effective treatment would of course be great,' says Keano Samaritakis, epidemiologist, engineer and researcher at ToxGenSolutions. 'But there is little reason for optimism. We simply still know very little about brain diseases such as Alzheimer's or Parkinson's; there is no cure for now.'

FOCUS ON PREVENTION

Once the first symptoms of alzheimer's are visible, there is little that can be done against the disease. 'Exactly, which is why I think we need to focus on prevention in addition to the search for drugs. There are increasing signs that lifestyle and environmental factors influence the onset and course of Alzheimer's. But also environmental factors such as environmental pollution, climate or stress. If we can now predict that someone will get Alzheimer's, then treatments or other interventions can be more successful and may very well slow the disease.'

HERSENSCAN

So looking for the Alzheimer's gene? Stan Goertz, biologist and business developer at ToxGenSolutions, shakes his head. 'Unfortunately, it's not that easy. Alzheimer's is usually only officially diagnosed with a brain scan. Then you see holes in the brain. Then you also know that a cure becomes very difficult. With micro-RNA, we demonstrate the disease even before holes are visible.' 'And then it's too late,' adds Fabiënne Kremers. She has been working as a biomedical engineer at ToxGenSolutions since last year. 'It is now becoming clear that something can indeed be done about the deterioration process. Chronic diseases including diabetes play a role in the development of brain diseases. Beneficial to the progression is staying physically and mentally active. And almost certainly there are other factors that influence. Air and soil pollution, food, perhaps stress. All of these are under investigation. Early diagnosis and preferably prediction are essential in that regard. Then you can still do something as a practitioner.'

Blood test predicts brain disease years before first symptoms

MICRO-RNA

And that is exactly what the now 10-member team on the second floor of the Brightlands Health Campus, adjacent to Maastricht UMC+, is doing: developing a predictive test. 'The basis for this is micro-RNA,' explains Keano Samaritakis. 'These are molecules that regulate genes. Discovered not so long ago and even a little underestimated. We now know that different micro-RNA plays a major role in the development of diseases such as cancer. And now so do brain diseases like Alzheimer's. We are now very far along in determining which micro-RNA is the trigger for alzheimer'

NEGENTIVE PROCENT

'Preferably triggers in multiples,' Stan Goertz adds. 'Right now we know about two thousand different micro-RNA molecules. Bit by bit we have figured out which ones can be associated with Alzheimer's. Monks' work, for which we have collected and studied enormous amounts of data. Research data and studies from Scandinavia, the US and Europe, among others. And without animal testing. We are talking about several micro-RNA molecules that we can see in the blood that we can use to demonstrate with ninety percent certainty the relationship with Alzheimer's disease.'

Contributions

Sufficiently accurate for the next step, said Erwin Roggen, who started the company in 2015 as a spin-off from Maastricht University. 'We have been working on this for more than eight years now. A European grant through Interreg got us started, then the Alzheimer's Drug Discovery Foundation and the Bill & Melinda Gates Foundation stepped in with substantial contributions. Essential for a start-up, otherwise we no longer existed. Our goal from the beginning was a predictive test. We succeeded. We can now diagnose Alzheimer's six years before the disease manifests itself. That gives patients and their families and caregivers time to prepare, but it also gives doctors room to deploy drugs. Because the disease is then still in its early stages and there may be substances with inhibitory effects. We also know that an active and healthy lifestyle slows the development of the disease in many patients.'

LABORATORIUM

Now this year, ToxGenSolutions plans to bring the invention to market. Work is currently underway on a device that will perform the diagnostic tests using blood plasma. The campus laboratory is also being significantly expanded for further research and development. 'We are currently in a crucial phase where we are actively seeking investors to realize the next step of our growth strategy,' Stan Goertz explains. 'In this we have every confidence. A blood test involves significantly lower costs compared to traditional methods such as outpatient exams and scans. It is a revolutionary step forward in medical diagnostics with a wide range of new applications in the longer term as well.'

New DIAGNOSES

Maria Tsamou, involved with ToxGenSolutions from the very beginning, nods. 'With these micro RNA markers, we can detect many more diseases early, allowing treatments to start earlier. In addition, analysis of our data may provide answers to other questions. For example, why do more women than men get Alzheimer's? Why is Alzheimer's relatively more common in Africa and India than in Europe or the US? What about the effects of pollution? We already know that micro-RNAs react in highly polluted regions. What do social factors such as income and education do? Actually, we are only at the beginning of a completely new way of diagnosing.' A world first from a start-up in Maastricht? Erwin Roggen nods. 'Why not? Why couldn't we lay the foundation for something here in Maastricht that will have global impact? The results we have achieved so far and the strength of the collaborations with international partners exceed all expectations. I am really impressed by what is being done here and with which international parties we are collaborating. At Brightlands we can develop further.'

SPRINGPLANK SOUTH LIMBURG

South Limburg as a springboard? Erwin Roggen: "Definitely. We are looking forward to our next big step: a pilot project here in Limburg. The idea is simple: we are going to collaborate with a few general practices and see how our test performs in a small part of the population. We want to see how people react if they can know early on about their risk of Alzheimer's, especially considering that we don't yet have a treatment for every form of Alzheimer's. It's also important for us to learn if our test can really help detect Alzheimer's earlier. If so, it could mean a lot for how we deal with this disease in the future.'

Source: Number1 By JOS CORTENRAAD | Photography PAUL ROUS