28 January 2011. The location alone left nothing to be desired, at least for snow-weary New England attendees who only the day before had been digging out from under 24 inches of white. But much more than palm leaves swaying in the breeze along a sandy beach distinguished the 5th Human Amyloid Imaging (HAI) conference, co-organized by Keith Johnson of Massachusetts General Hospital in Boston. Notably, a lineup of female speakers pushed the research envelope into the new and fiendishly complex terrain of multimodal and connectivity imaging. Their goal: Begin to get a grip on understanding how amyloid in the brain intersects with age, ApoE, cognitive reserve, glucose use, and many other factors in a person’s long slide toward Alzheimer’s disease.
Held in Miami Beach on 14-15 January 2011, this HAI conference for the first time unfolded as an independent meeting, having been linked to the American Academy of Neurology’s annual conference before. The organizers briefly wondered if HAI alone would draw people in a field where conferences big and small are growing in number. They need not have worried; the meeting filled to capacity, late registrants found themselves on a waitlist, and the program for the first time expanded to easily fill a second day.
At HAI, 18 of the meeting’s 47 speakers and session chairs were women. They spanned the scientific career ladder, from graduate students (e.g., Wenzhu Bi of the University of Pittsburgh Medical School and Elizabeth Mormino at the University of California Berkeley) to postdoctoral fellows (e.g., Kristen Kennedy of the University of Texas University in Dallas), staff scientists (e.g., Jessica Langbaum at the Banner Alzheimer’s Institute in Phoenix, Arizona, and Susan Landau of Berkeley), physicians (e.g., Noora Scheinin at the Turku PET Centre, Finland); from assistant professors (e.g., Prashanthi Vemuri of the Mayo Clinic in Rochester, Minnesota), professors (e.g., Julie Price of the University of Pittsburgh Medical School), senior PIs (e.g., Agneta Nordberg of the Karolinska Institute in Stockholm, Sweden, and Susan Resnick, National Institute on Aging), and a company CEO (Dawn Matthews of Abiant Inc.). Discussion panels followed each session, and one such panel featured the unusual sight of a lone man (Michael Devous from University of Texas at Dallas) seated next to five formidable women.
Sponsored by unrestricted educational grants from the usual suspects—that is, the companies that develop amyloid imaging agents and some pharma companies that make AD drugs—HAI awarded a Young Investigator prize and 11 travel fellowships to young scientists in this rapidly growing field. Patrizia Vannini of Brigham and Women’s Hospital, Boston, nabbed the former for her talk on how a brain area involved in both the default-mode network and episodic memory loses its agility when amyloid conspires with age (see Part 2 of this series). The latter went to Vemuri, Scheinin, Kennedy, Langbaum, Annie Cohen of UPitt; Stefan Foerster of the Technical University Munich, Germany; Jaana Koivunen of the Turku PET Centre; Dong Young Lee of Seoul National University College of Medicine; Karen Rodrigue of UT Dallas; Liang Wang at MGH; and Guofan Xu at the University of Wisconsin, Madison.
The program in Miami ran the gamut from fresh-off-the-bench data on exploratory mechanistic studies to a discussion with clinical leaders of how far the field has moved toward consensus on the best use of amyloid imaging in clinical trials. This arc from basic to therapeutic research was punctuated by studies that image astrocytes together with amyloid, one finding a surprise effect of taking antidepressant medication on brain amyloid, and an attempt to pin down just what microbleeds might have to do with amyloid deposition.
Perhaps the biggest change in this field in the past year has been that a growing number of research labs are branching out from amyloid PET-only studies and are now using PET as but one tool to probe what’s going on in the brains of both normally aging people and those who are on the road to AD. The finding, now reproduced several times, that a large fraction of aging people have fibrillar amyloid deposits in their brains has raised pressing questions about which other factors determine how well, and for how long, the brain can withstand its damaging effects. Scientists believe that multipronged research, ideally in the same people over time, will answer these questions. This research combines amyloid PET with FDG-PET to get a sense of how neurons fare metabolically when amyloid is around, with increasingly challenging cognitive tests to pin down subtle deficits, and with various paradigms of functional MRI to probe brain networks. The goal is to understand how the brain works, how its function relates to amyloid buildup, and to tease apart how aging interacts with genetics, brain reserve, and vascular disease.
On the industry front, company scientists and academic researchers contracted to test their ligands continued to present, as they did last year, studies they view as steppingstones toward regulatory approval. The HAI conference unfolded amid intense anticipation of an upcoming FDA Advisory Committee meeting. It was to give a thumbs up or down on a New Drug Application (NDA) for clinical application of the farthest advanced among a small handful of commercial amyloid PET tracers currently being developed, i.e., Eli Lilly’s AV-45/florbetapir, which was recently renamed Amyvid. (That meeting has since rejected approval of the NDA as is, but recommended eventual approval for Amyvid provided the sponsor meets further stipulations; see ARF related news story.) For more on HAI, see Part 2, Part 3, Part 4, Part 5, Part 6, and Part 7.—Gabrielle Strobel.
- Miami: Amyloid in the Aging Brain—What Does It Mean?
- Miami: Multimodal Imaging, New Way to Test Amyloid Hypothesis
- Miami: Astrocytes, Antidepressants, Microbleeds, and More
- Miami: Updates on J-ADNI, 18F Tracers, Biopsies
- Miami: Is Human Amyloid Imaging Ready for Clinical Trials?
- Miami: HAI Amyloid Imaging Conference Abstracts
- Committee Shoots Down Florbetapir, Raising Bar for Field at Large