Experts report on the latest developments in Parkinson's research
Parkinson's research has made considerable progress recently and for the first time there are realistic hopes of nipping the development of the disease in the bud. Experts report on new possibilities for early detection and therapy at the annual congress of the German Society for Neurology in Leipzig.
It was not until the beginning of September that an international study with German participation published in the scientific journal "Science" showed that the development of Parkinson's could possibly be stopped with an asthma drug, the German Society for Neurology (DGN) reports in a press release on the contents of its annual congress. Another milestone was the development of a skin test for the early diagnosis of the disease. "Parkinson's research is currently rapidly gaining knowledge," emphasizes Professor Jens Volkmann from the Neurological University Clinic in Würzburg in the DGN communication.
Alpha Synuclein vital
At the DGN annual congress, Parkinson's expert Professor Volkmann presented groundbreaking current research that opens up new possibilities for diagnostics and therapy. It is becoming increasingly clear how genetic and environmental factors drive alpha-synukleinopathy and thus the neurodegeneration that forms the basis of Parkinson's disease. These findings also open up new possibilities for diagnostics and strategies for causal therapies, according to Prof. Volkmann.
Search for new drugs against Parkinson's
What was surprising and equally groundbreaking was the discovery that common asthma medications in the form of beta2-adrenoceptor agonists reduce the risk of Parkinson's disease. In a newly developed cell model, the study authors had analyzed 1,126 substances with possible modifying effects on the transcription of the alpha-synuclein gene, including common pharmaceuticals, reports the DGN. Because the first described monogenic Parkinson's variant (PARK1) "is based on a triplication of the alpha-synuclein gene with a corresponding overexpression of the protein."
Asthma drugs have a positive effect, beta blockers have a negative effect
The researchers found in their investigations that "agonists of the beta2 receptor significantly reduce transcription while beta blockers significantly increase it," the DGN said. In the follow-up experiments on wild-type mice it became clear that treatment with a beta2-agonist significantly reduced alpha-synuclein expression in the substantia nigra, which suggested functional relevance for Parkinson's disease.
Effect of the asthma drug in the population detectable
The further analysis of a population register with data from four million Norwegians and an observation period of eleven years showed that “taking salbutamol reduced the risk of developing Parkinson's disease by a factor of 0.66, while taking propranolol it increased significantly, ”reports the DGN. Accordingly, the effect of the asthma drug can also be demonstrated empirically in the population.
"The work is significant because it presents a modification of alpha-synuclein transcription as a new disease-modifying pharmacological therapy approach that would also theoretically be possible with common and fairly well-tolerated asthma drugs," reports Prof. Volkmann at the DGN annual congress. Such a therapy could intervene earlier in the pathogenesis than treatments available today.
Intestinal flora involved in the development of Alzheimer's
Further relatively new findings from Parkinson's research show that the gastrointestinal tract plays a special role in the development of the disease. Most recently, the research of the Dresden working group around Dr. Francisco Pan-Montojo on the Rotenon model of the mouse "suggests that pathological alpha-synuclein deposits could arise in autonomic nerve fibers of the intestinal wall and spread via retrograde transport in the dorsal vagus nucleus and from there to other brain regions in accordance with the Braak stages", reports the DGN. A vagotomy (cutting through individual branches of the vagus nerve) significantly delayed the spread of the alpha-synuclein deposits. A recent Swedish registry study also showed that there is a significantly lower risk of developing the disease "if a trunkal vagotomy was performed at least five years before the onset of symptoms," the DGN announcement.
Disease symptoms decreased overall
The importance of the gastrointestinal tract in Parkinson's was also confirmed by another study by US researchers, the expert said. This has shown that the intestinal flora plays an important role for neurodegeneration in Parkinson's disease. In the mouse model with animals that were overexpressing alpha-synuclein, sterilization of the intestine by antibiotics resulted in reduced alpha-synuclein deposits in the brain. There was also less “neuroinflammation due to reduced microglia activation” and the disease symptoms decreased overall. When the intestinal bacteria from Parkinson's patients were transferred to the sterile mouse model, the symptoms of the disease intensified.
Early detection using a skin test
The breakthrough in early detection of Parkinson's could, according to Prof. Volkmann, be brought about by a skin test conducted by German neuroscientists led by Dr. Kathrin Doppler and Professor Claudia Sommer from Würzburg and Professor Wolfgang Oertel from Marburg. In high-risk patients with the so-called REM sleep behavior disorder, they were able to identify the biomarker alpha-synuclein in the skin and thus detect Parkinson's disease years before the disease visibly breaks out, reports the DGN. In view of the easy access to skin biopsies and the high specificity of the examination, the method has the potential to "identify Parkinson's patients in the prodromal stage of the disease and to win them over to clinical studies to test disease-modifying medications." treat the latest methods. (fp)