Issue link: https://viewer.e-digitaledition.com/i/1156103
ENDING PARKINSON'S: Experts Look to Prevention, Treatment and Reversal RECENT SCIENTIFIC ADVANCES POINT TO A HOPEFUL FUTURE FOR PEOPLE WHO HAVE OR COULD DE VELOP PARKINSON'S DISE A SE, ACCORDING TO A RE VIE W PUBLISHED IN THE JOURNAL OF PARKINSON'S DISEASE. " Never before in history has the pace of discovery and clinical trials aimed at modifying Parkinson's disease progressed so frantically. It is truly an exciting era scientifically, and hopefully, this excitement will translate into novel therapies that can benefit patients." — PATRIK BRUNDIN, MD, PHD, ASSOCIATE RESEARCH DIRECTOR AT VAN ANDEL RESEARCH INSTITUTE BY JOSH GARCIA "THE PATHOGENETIC MECHANISMS of Parkinson's disease are being revealed," explains Tom Foltynie, MBBS, MRCP, PhD, Professor of Neurology at the University College London Institute of Neurology and co-author of the review. These include alpha synuclein protein aggregation, inflammation and the discovery of T-cells reactive to alpha synuclein. Dr. Foltynie believes these discoveries will help researchers identify which treatment methods are most likely to prevent, stop or even reverse the effects of Parkinson's disease within the next 20 years. Here are a few of those possible methods. IMMUNOTHERAPY Promising avenues for preventing Parkinson's are public health initiatives, such as vaccination programs, to counteract the yet-to- be-identified environmental triggers believed to be responsible for the development of the disease in many instances. "The heritability of Parkinson's disease is estimated at only 20–30%," explains Patrik Brundin, MD, PhD, Associate Research Director at Van Andel Research Institute in Grand Rapids, Michigan, and guest editor for Dr. Foltynie's review. "Therefore, one or more environmental triggers of the disease must exist." REPURPOSED DRUGS In a review published in Trends in Neurosciences, Dr. Brundin hypothesizes that Parkinson's disease pathogenesis involves triggers, facilitators and aggravators. "How can we best target the aggravators?" he asks. "At this moment in time, repurposed anti-diabetes drugs such as exenatide show promise in slowing the disease. We can anticipate multicenter trials with exenatide soon, and they will give us an answer as to whether this is going to be the first disease-modifying drug for Parkinson's." Though the mechanism by which it does so has not been identified, exenatide may slow or even reverse the progression of Parkinson's, researchers believe. CELL THERAPIES In combination with exenatide, cell therapies could hold the key to reversing the effects of Parkinson's disease. "The addition of cell therapies may be able to repair damaged circuits, as well as act as a reservoir for abnormal alpha synuclein to be sequestered," Dr. Foltynie says. "We have seen proof-of-concept data that cell therapies can be effective in anecdotal cases." n 1 8