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               Scientific Eminence
          agrees with Dr. Maccioni's
      nomination for the Nobel Prize

revistachilena.com exclusively interviews Dr. George Perry, an eminence specialized in the matter to which Dr. Maccioni is nominated for the Nobel Prize.


Doctor, how do you visualize the status of Alzheimer´s research worldwide. Are there any innovative avenues toward pharmacological or non-pharmacological interventional tools to control progress of the disease?

Dr. Perry points out that this is not an easy question.
There's two basic trends in Alzheimer's disease.

There's one that has a very simplistic view that the pathology of the disease, particularly that the amyloid changes are driving the disease, and their removal will reverse the disease.

On the other trend, which is less prominent, but now is more accepted, that the disease is multifactorial and there are many contributors.
The first approach (amyloid) has been shown therapeutically to fail back completely, to fail in therapy. And the second approach has not received as much funding or as much interest.

Some of that relates to how proteins assemble, which are not the only studies, but it also includes things like oxidative stress, inflammation, microbiome, virus and the toxins in the environment, air pollution.

All of those areas have been studied but have not received as much money and have been less exploited in therapeutic trials.
And I see this as a really key time during Alzheimer's research because the dominant idea, the amyloid idea, has been demonstrated clearly to fail.

And it's leading to the emergence or prominence of competing ideas, but there are more material needs for those type of competing ideas involved in the protein, but in a more sophisticated view than just that it drives the disease by itself?
I think that's I think answers your question.

My second question is how the Journal of Alzheimer's Disease, of which you are the editor in chief, has impacted the scientific knowledge of the disease. And how is the impact in the clinical research of Alzheimer's disease?

The Journal of Alzheimer Disease publishes more than any other journal in the Alzheimer's field and is the most cited by any journal in the field.
The editorial meeting of the Journal last March, is that it tries to encompass the full range of ideas regarding Alzheimer's disease.
We were some of the first to publish work on toxins in the environment such as air pollution and Alzheimer's disease.
Some of the first to publish again that my microbes could be important in the disease. So, we try to really focus on innovation and set.

And in terms of clinical research and clinical trials, that is something we publish. 
I wouldn't say that is a dominant piece that's more those type of articles generally will find themselves more in clinical neurology journals, but also we do publish clinical trials.

Doctor, my following question is: Do you foresee any advancement in neuroscience research in Latin America within the next 20 years. What´s about both basis and clinical investigations in Alzheimer’s disease.

Alzheimer's disease has undergone a major growth in Latin America over the last 20 to 30 years.

And I would say within Chile, Chile was actually the leading country in Alzheimer's disease in Latin America and still is the leading country.

The  reason is that in the past, people thought that the impact of Alzheimer's disease was bigger in developed countries and was not such an issue for developing countries, countries with younger ages like Mexico or many other countries.

And now there's a realization of the obvious that countries with young people are going to age and they're going to have even greater impact of Alzheimer's disease because the number of people affected is growing in the developed world, especially countries with very, very stable populations, like some countries in Europe.

Alzheimer's disease is actually decreasing because the population is old and is stabilized at an old age.
And in Latin America, it is changing to be in older as time goes on.

So I think that realization has led to a greater emphasis.

Further, I just heard today, and I know for some other statistics that Alzheimer's disease in the developed world is becoming a bigger issue in terms of cause of death in the world.
It may be number three in England and maybe number two, I don't know what the number is in Latin America.
So as countries develop, they move away from dying of infectious disease and childhood diseases to degenerative diseases of aging.
And Alzheimer's disease is the only one of those in which we have no cure or effective treatment.

I really am. I told you that number.

Now, If you were an advisor on science policies in Latin America, which major ideas would propose to awake neuroscience in this region?. 

I think the most important thing when you have limited resources is to really develop your true strategic plan of investors. In other words, not to do everything in neuroscience that's possible.

But nothing hinder people from doing it.

But in terms of putting resources, money in education and all emphasis, it's important to develop programs that people and the country can specialize so that you can have exceptional work in your country.
In the past, it would depend not for Chile so much, but they tend to have more in the tropics.

They have an emphasis on tropical medicine and parasite.

Well, in neuroscience, I think we have to look at each condition, whether there's certain hereditary diseases, because they have tremendously a financial impact.
So, Alzheimer's disease definitely fits into that category.
The financial impact of Alzheimer's disease is one of the greatest of any condition.
Financial, social, etc. it is very large.

And but that really requires governmental policy in conjunction with scientists to know what is realistic, the training of people, research facilities, etc..
Chile has a tremendous amount of excellent neuroscientist's in several fields, and that's also true in other places in Latin America.

But in those cases it's important to analyze or is what's being done in Latin America, what is novel and unique to Latin America, or it copies of what is occurring within the first world.

Why Latin America lacks of Nobel Prizes in the fields of Medicine and Chemistry. Lack of creativity?
Bad policies?, or economic restraints?.

Well, I suspect many different reasons.
One is economic because many of the people that are very productive people in Latin America decided to move to Europe or the United States and do the research there, you know, like Cesar Milstein moved to Cambridge, etc..

Sometimes these are not politically stable, so scientists left.

And then if you look at the other piece, you have to look at the way the prize is nominated.
It means that the more important institutions have a greater influence in selecting the prize.

But again, I'm not so aware of how the prize was selected.
I just know that directors of major institutions can nominate people for the prize in medicine and other places in science.
And I don't know how many Latin American institutions are included with a request.

So if you don't get it, you don't already.

And I know the Nobel Prize winners are also asked about nominating people.

So if you don't have prior winners, you don't have institutions that are requesting, you know, whether you whether you do along those lines.
You know, along that line as an aside, to address some of the issues of inequalities in South America.
To be sure The Journal of Alzheimer's disease, actually waived our charges for a publication for this coming month for all of South America so that the financial issue would be removed from the issue.
But I think it's much more than financial.
I think it's about connections, resources, the fact that the most talented Latin Americans very often go for training or go to work in Europe or the United States.

But you say connections too…

Most prizes and awards are given based on people's connection with other people.

Yes, of course it is, of course.

It's who it's a lot of who you now.

Frankly, do you believe Latin America has leaders that have generated major breakthroughs in neuroscience and Alzheimer´s research.

You know, Dr. Maccioni has made several world class discoveries While he did the fundamental work in understanding “Tau protein”, which was discovered by several people, he became included, but he put this in terms of cellular neuroscience, he is the most prominent cellular neuroscientist in South America.

There are other people that are very good at rather I do not comment about their names.
Also in Chile.
Previously, Argentina had very strong science, but it had more problems in recent times because of economic and political instability.

And I know less about other countries and I do know some scientists and. How big in Mexico, I work with many different groups.

But again, one of the issues that Chile has been politically very stable for a long time, relatively long time, many of the countries in Latin America are so unstable, it's created environment.
It's been less than optimal for doing so.
I know Chile.
I know Chile has experienced some problems in recent times.

But prior to that, Chile seemed to be the most stable country in Latin America.

Yeah, but anyway, we have some economic problem for, to me, big project like this, mainly because, you know, correct.

And that issue one is money.
But more than the money is stability.
If you have money and you're unstable, it doesn't make that much difference either.
It's both things that are they're necessary support for people. And also when you're the most talented students, fellows, leaked to the United States of Europe.
So that has a brain drain away from the country.
And Chile has many well-trained people.
But if they leave, that doesn't allow them to develop either.
You Know Dr. Maccioni left the country during that period and then decided to return.
That isn't very typical.
Yeah, those people live in his status would never return.


Well, my last question, what do you think of Dr. Maccioni´s  nomination for the Nobel Prize in the field of medicine and physiology based of his contribution to generate the new paradigm of understanding Alzheimer's disease and his substantial contribution to Alzheimer's research?

Yeah, you know, I remember that question very well in the picture.
You know, that's a judgment issue of whether people think that that is sufficient or not sufficient.
His contribution to the field is outstanding.
He's developed many biomarkers and his contribution to Latin American Science is tremendous, I mean that since he is the leading person for Alzheimer's disease and his contribution regarding the TAU proteins involved, and using the biomarker and developing a novel theory, this is a tremendous contribution.

But on the other hand, other people have come up with theories.

The key thing of whether that theory is valid is demonstrating therapeutically.
That has value for patients.

So, yeah, it seems that he (Dr. Maccioni) will be appropriate for winning the Nobel Prize.

It's possible, but I don't have an opinion.
I would rather not be quoted yes or no. Is that OK?

If you say, you know, if to say contributions in Latin America and building Latin American science, as you know, from Mexico all the way down, as tremendous as a leader as providing focus and research with regard to Alzheimer's disease, his contributions are very important in many regards in this novel idea, it is very important.
But the key thing in terms of winning the Nobel Prize, I think the most important thing is should he to be nominated?.

I think it's very appropriate, the committee can decide his nomination compared to other people.

Certainly, I could write a compelling case for him.
But if you're asking, do I think that he will win it? I really don't know, because, you know, when you put that, you put me on the spot because I consider Ricardo (Dr. Maccioni) to be a good friend who I respect very much.

But I really don't know if history is shown to be correct based on predicting clinical benefit for patients, then I think it is worthy to be considered without doubt.
It fits into what many other people are doing, exceptional work.
If you look at his work in terms of contribution to different regions of the world.

That would be a region, the reason for nomination and what he did in terms of really moving Chilean and Latin America science to greater prominence.





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