It seems as though every time I turn on the TV there are commercials for new types of medication. Unfortunately, for some devastating conditions there haven’t been updated medications in 30 years or more. One of these is the neuromuscular condition, Parkinson’s Disease. Currently Parkinson’s Disease is still treated with dopamine replacement therapy (L-dopa and other agonists) as well as blocking the dopamine from reentering the cell that released it. This type of treatment only helps to manage the early symptoms and does not cure Parkinson’s Disease.
Is it time to target a new area of the disease other than the low levels of dopamine? It is obviously an important part of the disease process, but has been shown to only be one component in an ever-expanding network of dysregulation and inflammation that is a park of Parkinson’s Disease.
One idea among the scientific community is that toxic molecules spread slowly through the brain, irreversibly damaging neurons and tissue, ending up in the area of the brain with many dopamine neurons. This is when the symptoms that many people associate with diagnosable Parkinson’s Disease appear such as the change in motor movements including tremors. This occurs because a molecule called alpha-synuclein is misfolded and combines with collections of immune cells to form Lewy bodies. You may have heard of these before when referencing dementia (Lewy body dementia). This idea states that changes in areas such as gene expression, environmental toxicity, and dysregulation of cellular organelles such as mitochondria (the “powerhouse” of the cell according to high school biology) leads to the formation of these toxic Lewy bodies. Scientists believe that the Lewy bodies begin to develop at the nerve from the nose (olfactory) and back of the brain before progressively moving into higher functions in the cortical regions which results in some of the changes in movement regulation as well as many cognitive functions.
Usually diagnosis occurs at a much later stage than the beginning of the Lewy body formation. Perhaps both diagnosis and treatment could be studied to lead to biomarkers to find and/or target for earlier diagnosis and more effective treatment. The formation of Lewy bodies may also lead to the breakdown in function of other cellular processes, so treatment that focuses on this may be able to address symptoms and etiology (causes of the disease) from multiple angles, showing promise in the diagnosis and treatment of Parkinson’s Disease after a long drought in drug development progression.
The abandoned area of drug development—Parkinson’s Disease
