Caveats: I am not a doctor, nor a scientist and English is not my mother-tongue.
Here are some take home points:
Scientists are obsessed by SOD1 (2% of all ALS cases) as a model for ALS. However there is overwhelming evidence this is a fruitless pursuit.
There are nearly no treatments:
- For all pALS, a very imperfect treatment is Nurown, but it exists!
- For SOD1 pALS (2% of all cases), there are two treatments that are in clinical trials.
- For the other (98%) pALS there are no drugs in the pharmaceutical pipeline. However for most pALS (TDP-43 / 95% of all cases) there are genetic therapies that have recently been published by scientists, but if no one tries to defend them, it will take another 10 years before they are marketed.
The ALS research is bizarre, scientists often contradict colleagues but nobody seems to care. The consensus still cites theories that have been disproved since decades, like glutamate excitotoxicity. ALS is certainly not one homogeneous disease, but it is still treated as such by scientists. Animal models of ALS have little value in translation of drugs to humans, but moreover often ALS research is done on insects (that have an exoskeleton), or even on unicellular organisms. There is no formalism anywhere, little effort to falsify any thesis.
What can you expect to find in this book:
A brief description of ALS and its common variants (PLS, PMA, etc): ~7 pages
A description of the cell in general, from an ALS point of view : ~15 pages
A strong focus on the neuronal cells, again with ALS in mind: ~34 pages
The main themes in ALS research (dying forward, excitotoxicity, virus, etc): ~40 pages
Main achievements of ALS research (SOD1, TDP-43, discovery, etc): ~113 pages
A focus on clinical trials and 28 drugs: ~37 pages
Different kind of therapies (MSC, ASO, etc): ~20 pages
A possible new therapy for ALS (if only a company had the will to investigate it!): ~20 pages
Futures therapies that are researched now (creating or grafting new neurons): ~17 pages
This is not an easy read, so I tried to explain terms, provide a large section on the neuronal cell at the beginning, and wrote 276 footnotes.
There are no speculations, nor pseudo scientific babble. I am not overly kind either with ALS scientists, clearly they can do much better.
Jean-Pierre Le Rouzic