This Blood Molecule Predicts How Fast ALS Will Progress
ALS or Lou Gehrig’s disease, is characterized by awful, progressively worsening symptoms and no cure. However, a team of researchers in Japan says it may have found a potential path toward new treatment options, and it started with something as ordinary as a blood sample. Their new paper points to a compound that slowed ALS progression when tested in mice, and the path to it began with a strange pattern hiding in patients’ blood.
ALS damages the nerve cells controlling muscle movement. Over time, patients lose muscle strength and eventually the ability to move, swallow, and breathe on their own. There is no cure, and current treatments only modestly slow the disease for most patients. Doctors have also noticed that ALS patients often burn through calories abnormally fast and develop blood sugar problems even before major symptoms set in, hints that something is off with the body’s metabolism well beyond the nerves themselves. That backdrop helped motivate this research team’s decision to dig into patients’ blood chemistry.
This study, published in the journal JCI Insight, worked backward in a clever way. Instead of starting with a drug and testing it on patients, the researchers started with signals already present in the blood of people living with ALS, then used those clues to guide a search for compounds worth testing.
Higher Levels of One Blood Molecule Signal Faster ALS Decline
Researchers compared blood samples from ALS patients whose disease was progressing quickly with samples from patients whose disease was progressing more slowly. One group of molecules stood out: N-acyl taurines, or NATs, showed up at higher levels in patients with faster-progressing disease, and those levels tracked closely with both quicker functional decline and shorter survival.
Here is where the story gets a little counterintuitive. Higher NAT levels tracked with worse disease, but the researchers came to suspect that the rise was not the problem itself. NATs belong to a signaling network in the body called the expanded endocannabinoid system, and the team’s working theory is that the increase might be the body’s attempt to push back against the disease, a compensatory response that simply is not strong enough on its own. That idea, rather than treating NATs as a straightforward villain, shaped everything that came next.
A team affiliated with several institutions in Japan carried out the research, including Nagoya University Graduate School of Medicine, Juntendo University Graduate School of Medicine, Aichi Medical University, and the Sohyaku Innovative Research Division of Mitsubishi Tanabe Pharma Corporation. The paper’s corresponding authors, Masahisa Katsuno and Daisuke Ito, are based in the Department of Neurology at Nagoya University Graduate School of Medicine.
PF-04457845 Extended Survival in Mice With ALS
Blood findings helped researchers narrow their focus to several metabolic pathways, with NAT signaling standing out as the most promising lead. From there, they screened 29 compounds capable of influencing those pathways, testing each one in lab-grown cells carrying ALS-linked mutations. One compound, PF-04457845, emerged as a standout performer. It works by blocking an enzyme called FAAH, which normally breaks NATs down, so blocking it pushes NAT levels even higher.
That result lines up with the compensatory theory: boost the body’s own defense mechanism instead of suppressing it. Researchers then moved to motor neurons grown from stem cells donated by three ALS patients, watching the cells under a microscope for signs of health, like intact nerve fibers and low levels of cell damage. The compound preserved those signs of health compared with untreated cells. Finally, they tested it in mice bred to develop ALS-like disease, giving the compound daily for weeks and tracking survival, grip strength, and balance, a standard early step before any treatment can be considered for human trials.
According to the study, mice given the compound lived longer and kept more muscle strength than untreated mice. The results suggest the blood signal may reflect a biological pathway that researchers can influence with treatment, though the compound has not been tested in human ALS patients.