title: Alzheimer's therapeutics: translation of preclinical science to clinical drug development.
abstract: Over the past three decades, significant progress has been made in understanding the neurobiology of Alzheimer's disease. In recent years, the first attempts to implement novel mechanism-based treatments brought rather disappointing results, with low, if any, drug efficacy and significant side effects. A discrepancy between our expectations based on preclinical models and the results of clinical trials calls for a revision of our theoretical views and questions every stage of translation-from how we model the disease to how we run clinical trials. In the following sections, we will use some specific examples of the therapeutics from acetylcholinesterase inhibitors to recent anti-Aβ immunization and γ-secretase inhibition to discuss whether preclinical studies could predict the limitations in efficacy and side effects that we were so disappointed to observe in recent clinical trials. We discuss ways to improve both the predictive validity of mouse models and the translation of knowledge between preclinical and clinical stages of drug development.
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. asavone1@jhmi.edu
authors.forename: Alena V
authors.initials: AV
authors.lastname: Savonenko
authors.forename: Tatiana
authors.initials: T
authors.lastname: Melnikova
authors.forename: Andrew
authors.initials: A
authors.lastname: Hiatt
authors.forename: Tong
authors.initials: T
authors.lastname: Li
authors.forename: Paul F
authors.initials: PF
authors.lastname: Worley
authors.forename: Juan C
authors.initials: JC
authors.lastname: Troncoso
authors.forename: Phil C
authors.initials: PC
authors.lastname: Wong
authors.forename: Don L
authors.initials: DL
authors.lastname: Price
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D000818:Animals; D004195:Disease Models, Animal; D015195:Drug Design; D004353:Drug Evaluation, Preclinical / Q000379:methods*; D006801:Humans; D057170:Translational Research, Biomedical / Q000639:trends*