Table 3. List of recommendations to guide new funding strategies.
| Recommendations | Comments | |
|---|---|---|
| R1 | Implement funding for the production and centralized distribution of AD patient-derived cells (e.g., fibroblasts, peripheral blood cells, iPSCs) | Consider establishing NIH-funded centers to provide investigators with patient-derived cells and already reprogrammed iPSCs. However, this might be proven unnecessary if other entities, such as CIRM and NYSFC, will do this on their own |
| R2 | Allocate funding for research proposals aiming at defining & validating early biomarkers of AD | Current biomarkers measure levels of Aβ (in CSF), and levels of phospho-tau and total tau (in CSF). In this regard, neuroimaging technologies by means of MRI and PET (FDG-PET and amyloid imaging) are particularly suitable to allow early detection of AD and assess therapeutic efficacy in vivo. Develop and validate additional portable and non-invasive techniques that can identify predictive biomarkers. |
| R3 | Allocate more funding to research projects focusing on the most prevalent late-onset/sporadic AD | Despite the fact that the majority of AD cases are late-onset, the current number of NIH funded active projects focused on the late-onset/sporadic AD is lower than the number of projects on early-onset and familial AD (81 vs 182, as of July 6th 2015. Data retrieved from http://projectreporter.nih.gov/reporter.cfm) |
| R4 | Allocate funding to centers conducting omics research in human-based settings | This would be relevant considering the need for expensive high throughput technological tools and creation of multidisciplinary teams of experts |
| R5 | Create specific RFAs focused on non-animal/human-based research | One example in this direction to significantly reduce animal experimentation is provided by Europe and UK: for instance, NC3Rs rates projects considering their scientific value as 50% and their contribution to the reduction of animal tests as the remaining 50% of the final score (http://www.nc3rs.org.uk/funding). More directly, a dedicated call should be made for complete and direct alternatives that offer new perspectives and fundamentally ethical approach that do not involve animal experimentation |
| R6 | Increase funding support for basic research studies to speed the discovery process | Recognize the many types and growing applicability of non-animal models in basic research. Dedicated funding should be allocated to high-risk high innovation studies, including the development of non-animal models for research in this area. Not all projects need to be immediately translational in nature |
| R7 | Increase funding to study risk factors and evidence-based prevention approaches to slow the progression of AD | There is an urgent need to increase funding for epidemiological and clinical studies, focused on the impact of specific nutrition, level of physical activity, and level of educational attainment in the onset and progression of AD. Also, increase resources for examining factors across multiple risk and ameliorating variables including: environmental exposure, access to health care, sex and gender, ongoing social and cognitive engagement. Design intervention strategies in large scale cohorts. Dedicate resources to disseminate knowledge of known lifestyle factors to the public at large as well as new incoming information. Randomized clinical trials of individual dietary practices as well as nutritional supplements. Begin with individuals who have low or insufficient nutrient levels and for whom the highest beneficial effects have been observed (Morris, Tangney et al. 2015) |
| R8 | Consider ethno-cultural factors | Epidemiological studies addressing ethnic, cultural variations and implication of lifestyle risk factors would be highly relevant both to smaller communities and lessons that can be extended to the population at large. Collaboration with epidemiological studies in other clinical domains, such as vascular research (Satizabal, Beiser et al. 2016) will be critical for unmasking these complex relationships. |
Abbreviations: CIRM, California Institute for Regenerative Medicine; NYSCF, New York Stem Cell Foundation; CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; PET, positron emission tomography; FDG-PET, fluorodeoxyglucose-PET; RFAs, Requests for Applications.