Hi,

Well, I think we all have heard of the PD "blood test" that along with every other potential life changers for neurodegenerative diagnostics gets moved to the "in five years" shelf in short order. Maybe this time it is because something better really was on the horizon.

Recall, the insulin and glucose connection that researchers show does and does not exist? Well given my experience it does definitely affect my metabolism or more precisely speeds along my "on" state with levodopa. I also note that an empty stomach is not always my friend when it comes to med efficacy. I just figure well, that could be said of most drugs and since it is a clinical observation no more reliable than my diagnosis.

Looks like there is now molecular proof in a new studies on biomarkers in blood of PWP. In one study, a magic genetic cocktail (7 genetic markers) resulted in a common transcriptional expression in blood samples of those with early PD. Five genes emerged as optimal predictor of PD. The test was given to more advanced patients with 100 % accuracy. Beats the 30% diagnostic error rate we still have which has incidentally been noted as early as 1992.

The other study is far more interesting. It is in the realm of 90- 95% for both sensitivity and specificity It uses genetic splicing which has been implicated in PD so is better than other tests (don't know enough about this to say why- just reporting scientists). I am just going to pull out key findings:

Dopamine biosynthesis and signaling are disrupted in our blood.
Altered mitochondrial function is present in bloodstream.

The biggie is this one:


Biosignatures for Parkinson’s Disease and Atypical Parkinsonian Disorders Patients

Network analysis of the PD biomarkers reveals a network centered on the transcription factors HNF4A and TNF, which have been implicated in insulin regulation.

Transcription Factors are proteins that bind to specific DNA sequences and control the flow of genetic information to our Mitochondrial DNA. That sounds like this nails where genetics factor into PD.

Two other genes that are considered as part of the PD signature mpp2 and ppk2.

[I]This is interesting in light of the fact that patients with diabetes mellitus may have an increased risk of developing PD [58] and more than 60% of the PD patients have impaired insulin signaling and are glucose intolerant [59]... In addition, mitochondrial dysfunction, endoplasmic reticulum stress, abrogation of the ubiquitin-proteasome and autophagy-lysosome systems and inflammation are involved in the etiology and/or progression of both diseases.

One possible explanation for the similarities is that alterations in metabolism in response to environmental factors such as poor dietary practices, heavy metals and pesticides, may lead to insulin resistance, which later develops into diabetes and/or neurodegeneration. In this regard, glucose deprivation induces the aggregation of α-synuclein in dopaminergic cells and leads to cell death [59]. In addition, defects in glucose utilization and sensing occur early in PD pathogenesis [3].

Was anyone hypoglycemic prior to diagnosis?

that's a very interesting article, way over my head though. on one level early detection is hopefully great for finding neuroprotective agents/activities/lifestyle changes - you can measure if the biomarker level stabilizes or goes down way before one can be currently diagnosed and on another level, for us old timers, maybe they can test treatments on cell lines, hopefully our DNA can be partially repaired and/or drugs be developed? it would be interesting to measure affect of forced exercise/etc. on biomarkers. or taking sinemet vs agonists.

likely being a systemic disease is a little depressing though.

personally have never had unusual blood test results from a physical.

This is a promising paper--one that sets up perfectly for validation in the PPMI cohort. At least this is how we envision the PPMI study/data working. Since we are collecting blood RNA in the study, it is follows that an intriguing discovery like this might now go to the next step --ie, verify (or discount) it by assessing in the PPMI cohort/samples. I believe the MJFF staff has been in touch with the investigator to evaluate appropriate next steps. Good stuff...

Debi

We were not dx'd and still have not been, but I will say sugars have always been a problem and as we get further along the PD path, even more so. As in, make you feel sick if you eat them. We have big issues with low blood sugar/needing to eat during the day, but not being able to because food interferes so much with the meds, and it doesn't matter what it is, cracker, salad, fruit, rice, anything.

I have been reading about Alz. being "the third type of diabetes" for years, seems like PD is implicated as well. Makes me wonder if all the high fructose corn syrup and sugar-laden foods and drinks our nations guzzle down, starting when kids can barely walk, has anything to do with the ever-increasing numbers of PWP, Alz, etc.. Not to mention sugar was one of the first foods Dr. Wahl cut out of her diet in "Minding my mitochondria", and still does not eat now.

Has anyone looked at demographics to see how many people have PD in countries where sugar consumption is low? If not, I'll see what I can find.

For someone not well-versed in just how much sugar we eat as a nation, I found this incredible:

•In 1700, the average person consumed about 4 pounds of sugar per year.
•In 1800, the average person consumed about 18 pounds of sugar per year.
•In 1900, individual consumption had risen to 90 pounds of sugar per year.
•In 2009, more than 50 percent of all Americans consume one-half pound of sugar PER DAY—translating to a whopping 180 pounds of sugar per year!

We eat more sugary foods than healthy ones, no wonder we are so sick.

Here's the link for more, including an explanation of how the body handles all of this sugar (not good), and why a lot of our modern day ailments might be linked to excessive sugar intake. Here's the link:

http://articles.mercola.com/sites/ar...r-dangers.aspx

Agreed! This paper is exciting on a few different levels. For starters, they had a fairly large sample size - only 124 people, but for PD research that is a high number. As you mention, this kind of test could be easily replicable in larger group of patients. What I find exciting is this is the first time I have seen genetics applied to sporadic PD and they even (although conjecture) make a reasonable connection to environmental toxins. I read somewhere that PD, Cancers, and Diabetes shared a common disease pathway then they obviously diverge at some point. It seems like if they could study all from this perspective we might make serious ground on cures.

Laura

This might have some interest-

Importance of PGC1α in Parkinson's disease and type 2 diabetes

Here's another article by the primary author
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221408/

The Promise of Neuroprotective Agents in Parkinson’s Disease
Published online 2011 November 21. Prepublished online 2011 October 10.

I was diagnosed as being hypoglycemic a little over a year ago. The doctor (Naturopath) gave me some chromium drops to take to help balance out my blood sugar. I did feel better with the drops, less shaky. At that same time I was taking a lot of other tests as well. This was prior to the DaT scan confirming my PD and I was desperately hoping to find something else (an easy fix) to be wrong with me. Anyhow, I also took a gluten/casein intolerance test and discovered that I am highly intolerant. I was shocked as I didn't have any stomach or intestinal distress when I ate gluten or casein. So, I have cut out gluten and casein 100%, I'm very strict with myself. In doing that, I sort of started a modified version of Terry Wahls diet, also cutting out sugar. I do eat fruit and occasional raw honey. I feel so much better with the gluten/casein and sugar elimination - it's hard to tell which has had the most impact, since I cut out all 3 at once. I certainly don't get the low blood sugar crashes anymore, which just exacerbated my PD symptoms. The dietary changes have not been a cure all for me, but my overall PD symptoms are less and I do feel better. Just wanted to share my info

Thanks, Anagirl. I have been wondering about gluten myself. Do doctors prescribe gluten intolerance tests or do you need another source? I know that just prior to being diagnose and now, I cannot tolerate soy sauce when used in a stir fry but no problem if I have it with sushi. I also have heard weird reactions to yeast but not all the time. You were smart to have it checked out.

I did read that PWP are more likely to develop diabetes but has to do with chronic use of levodopa. It is recommended that we get our glucose tolerance tested once a year. Apparently, untreated diabetes, ulcer, under active thyroid, and gluten intolerance makes our medication less effective and we get more symptomatic.

I did have two borderline blood glucose tolerance tests prior to my diagnosis but got it under control through diet and exercise.

Laura