Who Will Be the Caretakers?

Two weeks ago, I couldn’t hear myself think over the sound of email notifications and message pings. Frantic DMs were coming in left, right, and center – all focused on a single topic. If, like me, you and your friends spent your early to mid-20s working on Alzheimer’s disease research, then you probably had the exact same experience on July 21.

If you haven’t heard, that’s when allegations of altering research images were made against Sylvain Lesné, a researcher at the University of Minnesota (1). These data manipulations were found in 20 papers, including a Nature paper from 2006 in which a specific form of amyloid-β (Aβ) – Aβ*56 – was identified as a toxic oligomer in Alzheimer’s disease (2). Aβ protein deposits are an archetypal hallmark of the disease and have been pursued by many as a potential target for therapeutic intervention. This falsified data has not only harmed Alzheimer’s research since its publication, but could also foster further mistrust in the scientific and medical communities at a time when public trust in science is needed more than ever.

To put it politely, this breaking news has generated a lively discussion in my friend group, with many of us lamenting the falsification of medical research. What is the cost of this kind of activity? Coming from a previous life in a dementia research lab, I fear that this news will have a hugely negative impact on Alzheimer’s research and beyond.

Consider, for instance, sustainability. This falsification sent many researchers down the wrong path – most couldn’t replicate Lesné’s findings before the recent revelation came to light – draining researchers’ time and money (mainly from public and charity sources) and consuming physical resources such as plastic that will increase the size of science’s already massive ecological footprint. And that’s just one of many areas of concern.

It’s almost certain that multiple research papers published with fraudulent data are still running free. There is even a site dedicated to people posting suspected data manipulations. Hopefully, such instances are rare in pathology circles, but this incident reminds us all of the importance of scientific integrity. Research malfeasance harms patients, clinicians, and researchers alike.

Despite the uproar, discussion, and intrigue on social media, I hope that research into the toxicity of oligomeric Aβ survives unscathed. Although Lesné’s claims must now be disregarded, many Alzheimer’s researchers have stepped forward to highlight the good work being done on oligomeric Aβ and other Aβ species. In addition, some in the field have questioned the importance of pursuing this avenue and don’t support the hypothesis that this species is a focal point of the disease. Such is the nature of complex disease – and the reason the mystery of Alzheimer’s disease, over a century old, has yet to be resolved.

The net of doubt cast by fraudulent research and medical practice is not exclusive to any one field, but hopefully the allegations will not erode trust in laboratory science. From a financial and humanitarian perspective, we can’t afford to waste resources following false leads or undoing the damage done by irresponsible researchers. Although it may seem like common sense, it is vital to emphasize ethical research and clinical practices at every opportunity.

I am reminded of the musical piece “Everywhere at the End of Time” – a concept album designed to portray the experience of Alzheimer’s disease. A key image in the album is that of the Caretaker, a figure who maintains a presence throughout the peaks and troughs of a patient’s worsening dementia. It leaves me wondering – who will be the caretakers of Alzheimer’s disease research? Who will remain steadfast in the trough we find ourselves in? Who will ensure that future investigations are held to the highest scientific and medical standards? Will it be us?