PARKINSON’S DISEASE


ALTHOuGH THeRe Is sTILL NO DeFINITIVe THeRAPY TO sLOW DOWN THe PROGRessION OF PARKINsON’s DIseAse, NeW THeRAPIes ARe BeING DeVeLOPeD AT A VeRY FAsT PACe…


Promising progress for


PARKINsON’s disease patients


P


arkinson's disease (PD) is a neurological disorder that affects one in 100 people over age 60.


The disease causes a variety of symptoms including motor problems such as tremors, muscle rigidity and slowed movement, and non-motor symptoms such as cognitive impairment, mood disorders, and autonomic dysfunction.


A 2018 report by Parkinson’s Disease uK showed that the estimated prevalence for PD in 2018 was 145,519 for the uK as a whole; with 3,716 people affected in Northern Ireland.


The prevalence of PD increases with age and is also higher for men than for women. For men aged 50-89, prevalence is 1.5 times higher than for women in the same age-group. Because of population growth and an increasingly ageing population, the estimated prevalence and incidence of PD in the uK is expected to grow by around 18 per cent by 2025 and, alarmingly, the numbers are expected to double by 2065.


What causes PD? PD is caused by the loss of brain cells that produce the chemical dopamine. Research over the last few decades


40 - PHARMACY IN FOCus


has focused on finding ways to slow or stop this loss to slow the progression of PD.


Developments It has now been over 200 years since Dr James Parkinson published ‘An essay On the shaking Palsy’, in which he described the signs and symptoms of Parkinson’s disease (PD).


Despite the fact that, 200 years later, there are lots of treatment options out there to help alleviate patients’ symptoms, there are still no disease- modifying therapies to help slow down disease progression.


At present, there are ongoing trials of promising therapies that aim to protect and nurture remaining dopamine-producing cells. But, with half these cells lost or damaged at the point of diagnosis, a cure for PD may also require a therapy that can reverse the damage that has already been done. This is where cell-based therapies that aim to replace those cells come into their own.


Stem cell therapies The first cell transplant trial for Parkinson’s happened in the 1980s and was followed by the first placebo control trial in 2001. These trials


produced both pros and cons for the transplant. While some patients responded very well and experienced improvements in their symptoms, others experienced little or no improvement, with some even developing uncontrollable movements known as dyskinesia.


These trials used cells from human foetal tissue, which is obviously a scarce resource, and so, if transplants were to become a viable treatment, a different source of cells had to be developed.


stem cells can be used in the lab to generate many other types of cells, including dopamine cells. Induced pluripotent stem cells (iPs cells) are derived from adult cells (usually from skin or blood) and can be manipulated to act like stem cells.


There have already been promising studies carried out around the world. In late 2017, researchers from Kyoto university in Japan announced that a study transplanting nerve cells made from iPs cells into the brains of pre- clinical models was promising. The grafted cells were able to secrete dopamine and stimulate neurons in the brain. The implanted cells survived for two years, appeared to


improve symptoms and did not cause ill side effects.


Then, in July 2018, the Kyoto researchers announced plans to start a clinical trial moving the procedure into humans. Researchers inject dopaminergic progenitor cells - cells that develop into neurons that produce dopamine - directly into an area of the brain associated with neural degeneration in Parkinson’s disease. The scientists completed the first transplant in October and plan to complete six additional operations by 2022.


There are currently a number of trials looking that the potential of using different types of adult stem cells for PD happening all over the world.


Deep brain stimulation Deep brain stimulation (DBs) is an intensive treatment in which electrodes are implanted into certain areas of the brain. DBs often targets brain areas, which are critical for movement, such as the subthalamus. Once placed in the brain, the electrodes then send electrical impulses to improve motor dysfunction.


The beneficial effects of DBs on motor function have been well


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48