Clinical immunologic approaches for the treatment of Alzheimer's disease

Recent clinical trials of active vaccination against -amyloid (A ) have succeeded in clearing A plaques; however, further understanding of immunization with regards to inflammation and other hallmarks of Alzheimer s disease pathology is required. Antibodies generated with this first-generation vaccine may not have had the desired therapeutic properties or targeted the 'correct mechanism, but they have opened the way for new clinical approaches, which are now under consideration. Passive administration of monoclonal antibodies directed to various regions of A peptide and/or administration of immunoconjugates of only small fragments of the N-terminal region may lead to the development of an improved second generation of A vaccines. Amyloid immunotherapy offers genuine opportunities for disease treatment; however, such an approach towards treating and preventing Alzheimer s disease patients requires careful antigen and antibody selection to maximize efficacy and minimize adverse events.