More than 100,000 people in Australia live with Parkinson’s—a central nervous system disorder affecting one’s movement and mood. It is a progressive disorder which currently has no cure and few treatments. However, researchers at Parkinson’s UK have a new reason to hope. They are investigating whether early detection and treatment of certain sleeping disorders might prevent Parkinson’s, which would be a massive breakthrough.
The symptoms associated with Parkinson’s appear once the substantia nigra, a part of the brain, gets damaged. This part, found in the spinal cord, comprises brain cells that produce the chemical messenger dopamine. Parkinson’s disease causes the loss of these cells, which reduces the amount of dopamine in the brain. This makes it difficult for the person to move. Unfortunately, the damage is already done when these symptoms become noticeable with more than 50% of the cells already lost.
That’s given rise to a critical area of research: early detection. How do we know if someone will go on to develop Parkinson’s? There is no definitive way at present, but researchers have found that one sleep disorder might provide a way forward. They found that over 70% of the people who experienced Rapid Eye Movement Sleep Behaviour Disorder (RBD) go on to develop Parkinson’s or other neurodegenerative disease in the future. RBD is a sleep disorder that compels you to act out your dreams by kicking, punching, gesturing and thrashing.
People with RBD typically have inflammation in the brain, which can result in damage to brain cells known as microglia. Think of microglia as the bodyguards of your brain. When these cells notice that parasites or injuries have invaded, they rush to the site of the inflammation and put up a fight. They call for backup if things get out of hand. Once they’re done, like reputable fighters, they clean up the war zone, release some healing chemicals and retreat. However, sometimes, they don’t stop fighting even when the enemy has been defeated. They get stuck in the fight club and forgo all its rules. That’s their villain origin story.
More common as we age, this chronic inflammation has the potential to cause Parkinson’s. The Associate Director of Research at Parkinson’s UK, Professor David Dexter, says, “Studies looking at post-mortem brain tissue show that there are many more microglia present in the brain areas affected by Parkinson’s, these microglia are in an activated (attack) state and we can also see that they are releasing inflammatory chemicals.”
Naturally then, the first step to early detection and prevention would be reducing inflammation, and it is this that researchers are working on in collaboration with Pharmaxis (ASX: PXS). The Aussie biotech company has developed an anti inflammatory drug called PXS-4728. It combines an MAO-B inhibitor (which boosts dopamine in the brain) with an anti-inflammatory agent, allowing the drug to have a two-fold effect: it will improve Parkinson’s symptoms and if taken early enough may slow or prevent the progression of the disease.
The drug is currently in Phase 2 clinical trials and Parkinson’s UK, through its Virtual Biotech arm, has contributed in $5 million funding. The drug will be given to people with RBD who are at high risk of developing Parkinson’s. The trials, overseen by leading researchers at Oxford and Sydney Universities will take place across two research sites: in Australia and the UK, and are due to commence in 2023. It will aim to recruit 40 participants who will be randomly split into two groups: 30 will receive PXS-4728, and 10 will receive a placebo for 12 weeks.
Parkinson’s is unanticipated. It is like that one guest who shows up at your door unannounced, taking up space and eating your food. Though there is little you can do once they are there, perhaps knowing about their arrival in advance could help you prepare… or maybe even avoid them altogether.
Parkinson’s is a devastating diagnosis but the clinical work being done by this high level collaboration is being closely watched as a potential new frontier.
Parkinson’s might be incurable, but if all goes as planned, it might become preventable thanks to the trials being initiated by Parkinson’s UK and Pharmaxis.
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