Can we detect Alzheimer’s disease decades before symptoms start?

Tomas R. Guilarte, Dean of the Robert Stempel College of Public Health and Social Work and professor of cognitive neuroscience and imaging at Florida International University, looks into how this might be done.

Tomás R. Guilarte, Ph.D., joined FIU in 2016 after serving as the Inaugural Leon Hess Endowed Chair Professor and Chairman of the Department of Environmental Health Sciences (EHS) at Columbia University School of Public Health in the City of New York. Prior to Columbia University, he received his Ph.D. and was a professor with tenure in the EHS department at the Johns Hopkins University Bloomberg School of Public Health where in 2018 he was inducted into the prestigious Johns Hopkins University Society of Scholars.

His current research explores the impact of environmental pollutants on brain health and neurodegenerative disease, specifically Alzheimer’s disease. His research has been continuously funded for more than 24 years by grants from the National Institute of Environmental Health Sciences. He has garnered more than $40 million in research funding and has received many awards since arriving at FIU including: 1) the Hispanic Organization of Toxicologists (HOT) Distinguished Toxicologist Award (2018), which celebrates a toxicologist of Hispanic origin for his or her outstanding professional achievements; 2) In 2019, he was selected by NBC News as Top 20 Latino Making a Difference in the United States; 3) he received the Metal Specialty Section Career Achievement Award (2020) by the Society of Toxicology (SOT), the largest professional organization of toxicologists in the world with members from over 70 countries; 4) In 2020, he was inducted into the Academy of Science, Engineering, and Medicine of Florida; 5) In 2022, he received the SOT Translational Impact Award which recognizes a scientist whose recent outstanding translational research has improved human and/or public health in an area of toxicological concern within the last 10 years.

As dean of the FIU Stempel College, he has transformed the educational and research enterprise and increased ranking and reputation. In 2016, FIU Stempel College was not ranked by U.S. News & World Report and today the school is ranked No. 35 amongst public universities. He led the launch of a fully Online Master of Public Health (MPH) which ranks No. 11 by PublicHealth.org and has catapulted the NIH research funding of the college to No. 15 amongst public schools of public health, according to the Blue Ridge Institute of Medical Research. In the last 5 years, FIU Stempel College has secured $131.8 million in research grants. One of his most proud achievements has been the continuous rise of the First Time In College (FTIC) 4-year graduation rate from 52% in 2016 to 85% in 2025.

Alzheimer’s disease develops silently for years before symptoms such as memory loss or confusion appear. By then, the brain has already sustained major damage.

My team, which includes doctoral student Daniel Martínez Pérez, has been studying a protein called TSPO, long linked to brain inflammation. What we discovered in an Alzheimer’s mouse model is that TSPO rises much earlier than anyone thought – long before symptoms begin.

Using advanced imaging in a mouse model of familial Alzheimer’s, we saw TSPO spike in the hippocampus as early as six weeks of age – the equivalent of a human teenager.

The increases occurred in microglia. These are the brain’s immune cells that cluster around amyloid plaques – the tell-tale plaques that develop in the brains of people with Alzheimer’s.

We then confirmed these results in human brain tissue donated by carriers of the “paisa” mutation. Carriers of this mutation, who mainly live in Colombia, South America develop symptoms in their 30s and 40s and die in their 50s. Even in advanced stages, TSPO remained elevated around plaques.

This means TSPO could serve as an early warning sign of disease activity. But it also raises new questions: is TSPO fueling brain damage, or fighting it? Could targeting it with drugs slow progression?

To find out, we are now using an Alzheimer’s mouse model in which we have genetically removed the TSPO gene to see the impact on Alzheimer’s progression. We are also expanding our studies to late-onset Alzheimer’s, which accounts for the vast majority of cases.

The goal is simple: if we can delay progression by even five years, millions of people could live longer, fuller lives – and the global impact of Alzheimer’s could be dramatically reduced.

Read More:[Springer Nature] – Amyloid-β plaque-associated microglia drive TSPO upregulation in Alzheimer’s disease[FIU News] – Can we detect Alzheimer’s disease decades before symptoms start?Daily Mail Article

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit academicminute.substack.com

Tomas R. Guilarte, Florida International University – Can We Detect Alzheimer’s Disease Decades Before Symptoms Start?

The Academic Minute

Tomas R. Guilarte, Florida International University – Can We Detect Alzheimer’s Disease Decades Before Symptoms Start?