This is sort of a new area, thinking about vaccines. So the key for the vaccines, I think, is finding exactly what to put in the vaccine, which is where we have the computational platform that allows us to find targets that are unique to the toxic forms of these different proteins like alpha-synuclein, amyloid beta, so then that your antibody response doesn’t interfere with the normal properly folded form of the protein...
This is sort of a new area, thinking about vaccines. So the key for the vaccines, I think, is finding exactly what to put in the vaccine, which is where we have the computational platform that allows us to find targets that are unique to the toxic forms of these different proteins like alpha-synuclein, amyloid beta, so then that your antibody response doesn’t interfere with the normal properly folded form of the protein. So there’s always this safety risk because with a vaccine, once you vaccinate it, you can’t take it away. With a monoclonal antibody, you could stop dosing. But with a vaccine, once the immune response is underway, you can’t take it back. So it’s, I think, very important that the vaccine elicits antibodies that will only target what you want it to, the misfolded toxic form of proteins, not the normal protein that the neurons need to survive. So that’s one challenge which our platform has allowed us to overcome. And then for clinical trials, ideally you would want to prevent disease and vaccinate before people even have symptoms. And now that’s becoming a real possibility with all the new blood-based biomarkers. You could see the day where you would go for a physical, you would take blood, and if your biomarkers are moving in the wrong direction, you don’t have symptoms yet, but maybe you’re headed for disease, you could get vaccinated. But doing a trial like that is very challenging because the trial would have to be like, I don’t know, 10, 20 years to see if you’ve prevented disease. You would have to do a very large number of patients because not everybody is going to develop disease. So that’s for prevention, that’s a major challenge. So I think what most vaccine developers are doing right now is vaccinating people who are starting to show symptoms. And then just like with the monoclonal antibodies, what you could hope to see is that you would stop progression of disease. So once we have this proof of concept, I think then we could move into the larger prevention trials.
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