Paul Schulz

Title

The immune sys­tem in Alzheimer’s dis­ease: Friend or foe? 

Abstract

Alzheimer’s dis­ease (AD) is char­ac­ter­ized by amy­loid plaque depo­si­tion, neu­rofib­ril­lary tan­gles, vas­cu­lar changes, free rad­i­cal pro­duc­tion, and immune sys­tem acti­va­tion. Increas­ing evi­dence sug­gests that neu­ronal loss in AD is strong­ly linked to immune sys­tem acti­va­tion, par­tic­u­lar­ly by microglia and astroglia. While these cells attempt to com­bat plaques and tan­gles, they inad­ver­tent­ly cause harm, lead­ing to bystander neu­ronal death. Addi­tion­al­ly, con­di­tions that acti­vate the immune sys­tem, such as infec­tions or sep­sis, can accel­er­ate AD pro­gres­sion — mak­ing immune acti­va­tion a foe in this context. 

Con­verse­ly, immune sys­tem acti­va­tion can also act as a friend in AD treat­ment. Anti-amy­loid anti­body ther­a­pies, which stim­u­late the immune sys­tem to clear plaques, sig­nif­i­cant­ly slow cog­ni­tive decline. Fur­ther­more, rou­tine viral and bac­te­r­i­al vac­ci­na­tions appear to reduce AD risk, poten­tial­ly by acti­vat­ing the periph­er­al immune sys­tem while sup­press­ing CNS immune respons­es. This immune inac­ti­va­tion may be pro­tec­tive against AD. 

Thus, the immune sys­tem plays para­dox­i­cal roles — both friend and foe — depend­ing on the cir­cum­stances of its acti­va­tion or sup­pres­sion. This dis­cus­sion will explore the data behind these oppos­ing effects and spec­u­late on mech­a­nisms dri­ving the immune system’s dual roles in AD. 

Biog­ra­phy

Paul Schulz, M.D., is a pro­fes­sor of neu­rol­o­gy at McGov­ern Med­ical School at The Uni­ver­si­ty of Texas Health Sci­ence Cen­ter at Hous­ton (UTHealth). 

He received his com­bined BA-MD degrees from Boston Uni­ver­si­ty in 1984. He did a med­ical intern­ship there, and moved to Bay­lor Col­lege of Med­i­cine for his res­i­den­cy in Neu­rol­o­gy. He stayed for a lab­o­ra­to­ry fel­low­ship in cel­lu­lar neu­ro­phys­i­ol­o­gy after which he became an assis­tant professor. 

Lat­er, he was an asso­ciate pro­fes­sor of neu­rol­o­gy, neu­ro­science, and trans­la­tion­al biol­o­gy and mol­e­c­u­lar med­i­cine. Dr. Schulz was also the vice chair of edu­ca­tion for neu­rol­o­gy, the deputy chair of the Methodist neu­rol­o­gy ser­vice, and direct­ed the Cog­ni­tive Dis­or­ders Clin­ics at Bay­lor and the Hous­ton Vet­er­ans Admin­is­tra­tion Hospital. 

Demen­tia Pro­gram 
In 2010, Dr. Schulz moved to Mis­ch­er Neu­ro­science Insti­tute, where he sees patients who have cog­ni­tive, behav­ioral, or mood dis­or­ders. His group is inves­ti­gat­ing risk fac­tors for demen­tia in order to under­stand why it devel­ops, includ­ing both envi­ron­men­tal and genet­ic factors. 

They use imag­ing, epi­demi­o­log­ic, and genet­ic approach­es and have iden­ti­fied sev­er­al risk fac­tors. They are also inves­ti­gat­ing ways to diag­nose demen­tia ear­li­er, per­haps before symp­toms devel­op, in order to deter­mine whether inter­ven­tions in the presymp­to­matic stage might delay or pre­vent the devel­op­ment of dementia. 

His group has ear­ly data sug­gest­ing that the treat­ment of some risk fac­tors may reduce the prob­a­bil­i­ty of devel­op­ing demen­tia. Dr. Schulz has received numer­ous awards and has been an invit­ed speak­er at major sci­en­tif­ic meet­ings world­wide. He has been exten­sive­ly pub­lished in the sci­en­tif­ic lit­er­a­ture and has been fea­tured on tele­vi­sion and radio shows. 

https://​www​.utphysi​cians​.com/​p​r​o​v​i​d​e​r​/​p​a​u​l​-​e​-​s​c​h​ulz