Unveiling Iatrogenic Alzheimer's: A Potential Threat in Medical History

In a groundbreaking revelation, scientists have shed light on the possibility of iatrogenic Alzheimer's disease (AD), a form acquired through medical procedures. Alzheimer's, known for amyloid-beta (Aβ) deposition and neurofibrillary tangles, has long been considered a complex interplay of genetic and environmental factors. However, a recent study underscores the environmental acquisition of AD, prompting a reevaluation of preventive measures in medical settings.  

The study results were published in the journal Nature Medicine.

The study, which builds upon previous findings on the transmission of Aβ pathology, focused on individuals who, as children, received cadaver-derived pituitary growth hormone (c-hGH) contaminated with both Creutzfeldt–Jakob disease (CJD) prions and Aβ seeds. While prior reports detailed Aβ transmission in iatrogenic Creutzfeldt–Jakob disease (iCJD) cases, the latest research delves into cases where recipients not only survived iCJD but also later developed dementia and biomarker changes consistent with AD.  

This discovery challenges the conventional understanding of AD as primarily a result of genetic predisposition. Instead, it introduces the concept of iatrogenic forms of the disease, emphasizing the need for a nuanced approach in addressing AD's various manifestations. The study suggests that AD, like Creutzfeldt–Jakob disease, may have acquired forms resulting from environmental exposure during medical interventions.  

While iatrogenic AD is acknowledged as rare, the implications are far-reaching. The study stresses the importance of revisiting and reinforcing preventive measures to minimize accidental transmissions through medical and surgical procedures. The recognition of iatrogenic AD highlights the potential risks associated with certain medical interventions, necessitating a critical examination of safety protocols in healthcare settings.   Importantly, the study clarifies that there is currently no evidence suggesting the transmission of Aβ between individuals in daily life activities. The risk is primarily associated with specific medical treatments, particularly those involving growth hormone derived from cadavers.  

Furthermore, the research warns of potential challenges in therapeutic strategies targeting Aβ assemblies. As Aβ assemblies exhibit structural diversity comparable to conventional prions, there's a possibility that therapeutic interventions may inadvertently select minor components, leading to the development of resistance. This cautionary note underscores the delicate balance required in developing effective and safe treatments for AD.  

In conclusion, the revelation of iatrogenic Alzheimer's introduces a new dimension to the understanding of the disease. As the scientific community grapples with these findings, the imperative for stringent preventive measures and the careful consideration of therapeutic strategies becomes paramount in the ongoing battle against Alzheimer's disease.

Further reading: Banerjee, G., Farmer, S.F., Hyare, H. et al. Iatrogenic Alzheimer’s disease in recipients of cadaveric pituitary-derived growth hormone. Nat Med (2024). https://doi.org/10.1038/s41591-023-02729-2