- [Dr. Patrick]: Let's move on to the next question in the section, which is, "What are your
thoughts, if any, on the potential benefits of sulforaphane or even other isothiocyanate
activators of NRF2 for Alzheimer's disease? There's been just repeating
preclinical evidence that amyloid beta, you know, is decreased and that, you know,
isothiocyanates and sulforaphane seem to have a positive effect on Alzheimer's disease."
- [Dr. Fahey]: Yeah. So this is a case where I need to give Dr. Patrick's listeners a data dump
of papers. There's a huge amount of literature that, you know, would be fun to post links to
from animal models and cell culture work. Let me start... Actually, I just found this...or I just
rediscovered this this morning. Let me start by citing a clinical study,
and then go back to some of the animal study work.
So as all of you know, animals, mostly rats and mice, are used
to spare having to do some of these experiments on people. And so
what usually happens, what frequently happens, maybe COVID-19 is going to be an exception,
but what frequently happens is you have cell culture work, you have...or in vitro work,
where you add chemicals to cultured human cells or animal cells in a petri plate,
you get positive effect or not, then you move to trials where you, like it or not, sacrifice
mice to the cause of science. And if you're lucky enough and there's a rodent model of a disease,
you get some results. And then maybe you'll do a preclinical study to verify safety,
and then you'll go to a full-fledged clinical study to look at efficacy.
So a lot of animal studies, I'll get back to a few citations, but there is one
now, there's one posted clinical trial in China in
Zhejiang University. And it will be looking at 160 subjects with early Alzheimer's. And they're
going to be giving sulforaphane. It was posted for a start date of sometime in May of 2020,
I doubt that's happened because of COVID. Most clinical trials are on pause. I do want to make...
So you can find this on clinicaltrials.gov, that's a website that categorizes all of the
U.S.-approved clinical trials and many around the world. You can find it and read about it yourself.
If you do that, be careful. Because, you know, I think this may well be a good and interesting
study. But when you look at what they're giving, they're giving dietary supplement sulforaphane.
And they say they're giving 2,550 milligrams once a day. And half of the people are
getting a placebo. I won't go into the math, but that amount is enough to kill a horse.
And so that's between 10 and 100, closer to 100, times what I would recommend giving to a person.
So my only guess is that they're talking about the weight, 2.5 grams or 2,500 milligrams,
of a supplement tablet. And there's not information on this website that lets us know
what they're actually giving patients or how much sulforaphane they'll actually be getting. But,
you know, it may well be a very interesting study, so we should keep our eyes on it.
But to go back to the animal work, with a former doctoral student, Anita Panjwani,
we did a review a couple of years ago looking at actually all of the neurodegenerative
diseases, like Parkinson's and Alzheimer's and Huntington's, and the neurodevelopmental diseases,
like autism, and looking at the evidence for sulforaphane. And it's extensive. And, you know,
things like HDAC inhibition...histone deacetylase, sorry, inhibition. Enhancement of BDNF,
brain-derived neurotrophic factor. Certainly a reduction in amyloid beta. And the list really
goes on and on, the things that other people have done. I have not been directly involved in that.
Then there are a couple of reviews from...even more recently from last year,
which I'll send to Rhonda, you know, talking about, for example, sulforaphane protecting
cultured neural cells from the toxicity of methylglyoxal, which is a precursor of AGEs,
or advanced glycation end products, that are very clearly associated with Alzheimer's disease.
Models that show reduced neuronal cell death due to amyloid beta
exposure due to activation of peroxisomes, these are things that help detoxify.
So they're a very, very long list and just the reviews, the review articles, have pages
and pages of evidence. So I will share some of that with Rhonda, but it's very encouraging.
10 years ago we were, Paul Talalay and I, were invited to work with a group in the Netherlands
that was going to be a big multicenter Alzheimer's prevention trial
using sulforaphane. 10 years ago, or 2011. It was a multimillion-dollar trial. Funding never... I
don't know if funding started and stopped, but it never actually happened. And I'm not aware of
other Western follow-up studies. As I say, I just found this study in China that is being conducted,
I should say, by some researchers who have done some good animal model work and published
a bit before, a lot before. So I have high hopes for the China study, but we'll see.