Neurodegeneration
Neurodegenerative disorders, particularly Alzheimer’s disease (AD), other forms of dementia and Parkinson’s disease (PD), are among the biggest health care challenges of the 21st century. There are now over 250,000 dementia patients and 40,000 patients of Parkinson’s disease in the Netherlands. Because no treatments can stop these neurodegenerative disorders amid the backdrop of an aging population, numbers are expected to rise further quickly. This poses a direct threat to the sustainability of our entire health care system. The development of treatments that stop, prevent or at least slow down the degenerative processes is crucial to reduce future costs associated with neurodegenerative disorders and hence keep our health care system viable.
Neurodegenerative disorders share a profound pathophysiological and clinical complexity. For the majority of patients, multiple causes in concert lead to the development of disease, which unfolds over the course of years, probably decades. A careful clinical evaluation is the corner stone for a valid diagnosis of any neurodegenerative disorder. Moreover, it provides fundamental insight into the basic mechanisms that are critical for the development and validation of animal models and biomarkers. To date, treatment is limited to alleviation of symptoms, but our ultimate goal is to recognize disease before it manifests clinically, understand disease mechanisms and subsequently modify the disease process to prevent progression to a full blown disease state. This goal can only be achieved by improving early diagnostics, understanding clinical heterogeneity and mixed pathologies, and unraveling underlying mechanisms in patients and relevant model systems.
Neuroinfection and –inflammation
The aim of the neuro-inflammation and –infection program is to conduct clinical and translational research of international distinction, in parallel with compassionate and innovative care of the highest quality. The focus of the research is on multiple sclerosis, meningitis & encephalitis, and inflammatory neuropathies. In these areas, VUmc/VU (MS Center Amsterdam) and AMC (Neuroinfections Amsterdam) have leading roles both national and international, both from a clinical and a research perspective. Research on the blood-brain-barrier, a crucial dominator of multiple sclerosis and meningitis, is strongly encouraged. Innovative projects outside these areas of primary interest are welcomed, though. Translational research should performed through an integrative approach running from bedside to molecule and vice versa.
Neuroinflammation is considered crucial in multiple sclerosis, infection, and inflammatory neuropathies, but the concept of neuroinflammation is important in many other neurological diseases, i.e., neurodegenerative disease. In these areas, prospective clinical cohort studies, randomized clinical trials, and experimental research needs to combined with groundbreaking, translational approaches using clinical data, human samples, next generation sequencing, in vitro techniques, and mouse models. By using in vitro and in vivo disease models new targets for therapies can be tested. In the various lines of nowadays research, unique models have been developed that facilitate target finding for new therapies and for testing mechanisms and preclinical effects of new emerging therapies. Subsequently, a broad range of further clinical research from first-in-man studies to large national and international multicenter clinical trials need to be executed.
