{"id":397,"date":"2015-07-06T14:54:45","date_gmt":"2015-07-06T14:54:45","guid":{"rendered":"http:\/\/joshmitteldorf.peachpuff-wolverine-566518.hostingersite.com\/?p=397"},"modified":"2015-07-07T01:35:59","modified_gmt":"2015-07-07T01:35:59","slug":"can-anything-be-done-about-parkinsons-disease","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/joshmitteldorf\/2015\/07\/06\/can-anything-be-done-about-parkinsons-disease\/","title":{"rendered":"Can anything be done about Parkinson’s Disease?"},"content":{"rendered":"

There\u2019s nothing that will help everyone.
\nBut there\u2019s probably something that will help you.<\/i><\/p>\n

This is the emerging paradigm of individualized medicine. \u00a0We are in transition from a past when we looked for \u201cthe cure\u201d (antibiotics, vaccines) that would work universally to a future in which blood tests and computer analysis will determine exactly the right treatment for your individual metabolism. \u00a0While in that in-between space, the key will be personal experimentation. \u00a0Seek out reports of \u201cmiracle cures\u201d in which something worked spectacularly well for just a few patients, while failing to help the others. \u00a0Find ten such miracles, and try them on yourself, one at a time. \u00a0Experiment to see what works for you.<\/p>\n

Today\u2019s column is motivated by news I received Friday about a long-time friend whose Parkinson\u2019s is creeping out from medical control. \u00a0At 68, George is active and young in outlook.<\/p>\n

 <\/p>\n

Parkinson\u2019s Background<\/b><\/p>\n

Symptoms of PD include tremors, slow and uncertain movements, loss of motor control, shuffling. \u00a0There often is cognitive impairment, especially at later stages.<\/p>\n

The cause of PD is the loss of neurons in a particular region of the mid-brain called the substantia nigra<\/a> (SN), where nerve signals are translated into chemical signals. \u00a0One of the functions of these nerve cells is to secrete dopamine<\/a>, a neurotransmitter.<\/p>\n

We\u2019re all losing neurons, but we don\u2019t all have symptoms. \u00a0Maybe at age 50 our hand isn\u2019t quite as steady as it was at age 30, but it\u2019s nothing we would talk to a doctor about. \u00a0By the time \u201csymptoms\u201d appear, over 70% of the dopaminergic neurons are gone.<\/p>\n

[LEF article on Parkinson\u2019s<\/a>]
\n[Background and new ideas from the Buck Institute\u2019s SAGE web site<\/a>]<\/p>\n

\"\"It is agreed that the cause of PD is the loss of these nerve cells. \u00a0We might assume from the fact that that they are nerve cells in the brain that they perform their secretion function in a way that is smart, in response to activity and stimuli. \u00a0And yet, the standard medical treatment for Parkinson\u2019s does not address the loss of this population of nerve cells, with the many functions they perform, nor does it even attempt to deliver dopamine in a smart and targeted way. \u00a0The best treatment medicine has to offer is to flood the brain with supplementary dopamine.<\/p>\n

A few decades ago, it was thought that no new nerve growth takes place in the brain after adolescence. \u00a0We now realize that nerve growth continues lifelong, although neurogenesis<\/a> slackens with age and does not keep up with nerve loss. \u00a0There are stem cells in the brain, and these can mature as neurons, or as glial cells or astrocytes<\/a> that contribute vitally to brain chemistry.<\/p>\n

A real cure for PD would be to re-grow the lost nerve cells of the SN. \u00a0Why not use stem cell therapy to regenerate the nerves? \u00a0This was a promising line of research about a decade ago [in rats<\/a>, in people<\/a>]. \u00a0But when stem cells were injected into the brains of Parkinson\u2019s patients, they withered on the vine. \u00a0They were perfectly good stem cells, but something was telling them to slack off.<\/p>\n

This is the converse of a theme that researchers have encountered in many contexts. \u00a0Put an old cell in a young environment, and it acts young; conversely, put a young cell in a old environment and it acts old. \u00a0There are signal molecules–presumably carried in the blood plasma–that carry messages about age. \u00a0(This leads us back to the work of Amy Wagers and Mike and Irina Conboy and Tom Rando and Saul Vileda and Tony Wyss-Coray, all building a foundation for anti-aging therapies based on blood factors. \u00a0I have repored on the subject here<\/a>, here<\/a>, and here<\/a>.)<\/p>\n

Although enthusiasm has waned for stem cells as a one-stop cure for PD, the research community is continuing to refine the technology<\/a>. \u00a0A transition is in effect from fetal stem cells, limited in availability by Bush-era regulations, to stem cells derived from the patient\u2019s own cells, which have the advantage of being a perfect genetic match. \u00a0Stem cells do not have to be injected into the brain, because they have a remarkable ability to find their way to the place they are needed. \u00a0The most effective delivery at present is through the nose<\/a>, or (more invasive) guided via a catheter that is threaded through arteries that lead to the brain.<\/p>\n

 <\/p>\n

Cell Senescence and PD<\/b><\/p>\n

Are the lost brain cells that cause PD dying simply because their telomeres run out? \u00a0This would not seem a likely connection to make, since telomeres shorten with cell replication, and in the brain,\u00a0cell replication is slow compared to blood, skin or even muscle cells. \u00a0But in a new article from Buck Institute<\/a> last week, Megumi Mori reviews an unexpected connection between cell senescence and PD, documented by Judy Campisi\u2019s research group<\/a>. \u00a0Astrocytes are star-shaped glial cells, the background support substrate for the brain which create the proper chemical environment for neurons. \u00a0Astrocytes grow and are replaced continually during a lifetime, and hence their telomeres shorten with age. \u00a0Aging astrocytes become senescent cells, and secrete inflammatory toxins–the so-called Senescent-Associated Secretory Phenotype, or SASP<\/a>. \u00a0Senescent astrocytes and these toxins have been linked to PD.<\/p>\n

 <\/p>\n

What can be done to prevent and to treat Parkinson\u2019s Disease?<\/b><\/p>\n

Returning to the theme at the top of this page, I ask what options can people try to prevent PD or to slow its progression.<\/p>\n