Novel Nasal Brushing Technique from the Lab of Dr. Mark Albers

An innovative nasal brushing technique spearheaded by Mark Albers, MD, PhD, is sparking excitement in ALS research. Dr. Albers of Mass General, along with Dr. Eric Holbrook of Mass Eye & Ear, are collaborating on the study, which focuses on TDP-43 pathology.

TDP-43 is a protein that is present in 97.3% of patients with ALS. Dr. Albers explains, “TDP-43 is normally a protein that is inside the nucleus, where the DNA is, in the cell. When it is in the pathologic state in ALS, what we see is that it comes out of the nucleus and mislocalizes and aggregates in the cytoplasm. It’s that presence in the cytoplasm that we think correlates with neuronal dysfunction and ultimately the disease.”

Currently, there is no way to determine whether a living person has TDP-43 pathology. Dr. Albers aims to change that with a novel nasal brushing technique.

The technique takes about five minutes and uses a camera-aided brush up the nose to harvest olfactory neurons for analysis. Dr. Albers says since nose neurons regenerate, those who participate in nasal brushing don’t experience a loss of smell.

Dr. Albers hopes this will be a technique that can help multiple neurodegenerative diseases. In the case of ALS, if a person’s results show they carry TDP-43, they’ll know they are at risk for developing the disease.

Among the questions Dr. Albers hopes to answer are, “While they are in the asymptomatic phase, are there changes that we can detect in the nose, prior to the onset of symptoms? Where does our ability to detect it change?”

He adds that for clinical trial participants, nasal brushing could also help determine if a drug is working or not. “We could do nasal brushing before they start a drug and then again after they have been on the drug for some time to see if the TDP-43 mislocalization has improved or not.”

To learn if you may be eligible for the nasal brushing study, contact olfactionstudy18@mgh.harvard.edu.