Neuroprotective therapy in Parkinson disease
 

Sounds like there's hope in the progress of tx of PD. Or is it just wishful thinking?

Hannah



Am J Ther. 2006 Sep-Oct;13(5):445-57.

Neuroprotective therapy in Parkinson disease.

Chen S, Le W.
1Institute of Neurology, Ruijin Hospital, Shanghai 2nd Medical University, Shanghai, China; 2Institute of Health and Sciences, Shanghai Institutes for Biological Sciences, CAS/Shanghai 2nd Medical University, P.R. China.

During the past decade, there has been a remarkable progress in our understanding of the biology of Parkinson disease (PD), which has been translated into searching for novel therapy for PD. Much focus is shifted from the development of drugs that only relieve PD symptoms to new generation of remedies that can potentially protect dopaminergic neurons and modify the disease course. Several novel therapeutic approaches have been tested in preclinical experiments and in clinical trials, including molecules targeting on genes involved in the pathogenesis of the disease, neurotrophic factors critical for dopaminergic neuron survival and function, new generation of dopamine receptor agonists that may possess neuroprotective effects, and agents of antioxidation, antiinflammation, and antiapoptosis. The results of these studies will shed new light to our hope that PD can be cured in the future.

PMID: 16988541 [PubMed - in process]


http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

I don't understand what this all means can you explain it for me please and tell me about what it means in the treatment of parkinsons.

Someone else may be able to answer more clearly, but what I understand it to be saying is that rather than being stuck on symptom relief treatments, new treatments are being worked on that protect the dopaminergic neurons and prevent their death.

These methods include anti-oxidant, anti-apoptosis and anti-inflammatory treatments as well as gene therapy to turn off the disease process.

I guess what they're saying is that rather than focusing on symptom treatment, some real, promising steps have been made to alter the disease course itself.

To be perfectly, harshly frank
 

Hopeful if you plan on being alive and have a few motor neurons and an anterior cingulate cortex left about 20 years from now. Read the notice. Did it say they'd actually found anything? Note carefully, "these studies will shed new light to our hope" says absolutely nothing. Many friends here were misled by such language to believe that, for example, Mirapex, a dopamine agonist, was neuroprotective, which means to prevent the dying off of brain cells in the particular areas of interest. Mirapex helped some tremors, cut down on the use of some Sinemet (levodopa/carbidopa, our "gold standard," which carries its own evils), caused compulsive gambling (proven) and caused weight gain (proven), as well as other examples of poor impulse control. Many lost house, home, and family to the gambling or sexual compulsion. I face surgery in three weeks with an extra 100 pounds along for the ride, and on, and on, and on.

There is a reason for Thelma's deeply compassionate answer. Please read everything on www.grassrootsconnection.com and here for about three years. We are fully aware of our prospects and know how to find the information.

Thank you for your concern. I hope this was helpful.

New Treatments
 

I think you got it largely right Hannahbanana,
I believe it is saying research is concentrating more on recovery, regeneration and protection of neurons, rather than just alleviate the symptoms of PD. They give examples of new agonists which are neuroprotective, compounds which prevent cell death (antiapoptosis), antioxidants and anti inflammation agents, and growth factors which renew and protect neurons etc.
I think research is going in a better direction these days.
Ron

HB, while you're here..
 

I need a response to my thread about history, started yesterday on this forum.

Thank you.

Jaye

Ron, how many of these are available to you today? What has been proven to be neuroprotective in standard clinical testing? Have I been out of circulation for so long?

Jaye

the greatest danger we all face...
 

...is getting into the box that mainstream medicine offers us. The lead of this thread is an example. Just, what? Six months ago? The US neurologist's association was reported as declaring that no protective strategies exist? (That's not exactly what they said but is how it was spun.) Yet this lead seems to say the opposite. So who do we believe? My answer would be the one which offers hope.

A very uncomfortable fact is that we have a problem with our brains and one of symptoms is apathy. Combine that with forces that push us to be "good patients" and we have a problem. As Jaye points out, twenty years from now just doesn't get it.

The nice man in the white coat offers us a nice box. It's tempting. Warm. Dry. Rather a comfortable box. All except for that lid...

The cure is around here somewhere...

Ms. Moderators...
 

Would it be possible to have a "sticky" for things that offer immediate hope such as unexpected findings about existing drugs? Recent reports on hydralazine, for example. Ancient drug for blood pressure. Oh, whatta you know, looks like it protects and repairs brain cells! There was another about an old TB drug. Ron has pointed out similar reports for other blood pressure meds. All those get lost quickly.

neuroprotective, neurorestorative...
 

terrific ideas - two concerns. as far as i know, no one has come up with a clinical trial design satisfactory to most as an accurate measure of the neuroprotective capability of a particular compound - there are a couple of designs out there - one utilizes a delayed start and the other utilizes a washout period at the end - however, the results of trials using these designs are considered inconclusive becauase inevitably whatever they are testing has a symptomatic effect, and they say it is not possible at this point to distinguish between that and actual neuroprotection. unless something has changed, I agree with Jaye - no one's ever actually proved that something was neuroprotective, and who knows how long that will take.

my second concern is that judging from the shift in focus from symptomatic therapies to potentially neuroprotective therapies, one would be inclined to conclude that the treatment of symptoms is well under control. But i don't think it is - levodopa has an extremely finite (for most people and particularly those who who plan to live another 30-40 years) period of usefulness sans caveats - and then one is stuck managing both the symptoms of the disease *and* the side effects of the medication, til one dies or has DBS - whichever comes first.

in my opinion, less money and precious time should be devoted to therapies meant as adjuncts to levodopa and/or reformulations of levodopa itself (because let's face it - they have been consistently failing to fix this seriously flawed drug for about 40 years - time to say *enough!*) and yes, less money on potentially neuroprotective therapies *until* they devise a method of evaluating the capability of neuroprotection that most of them agree is valid - otherwise, they are going to continue churning out trials that are deemed inconclusive, and that doesn't help anyone much - well, not PWP at least. instead, at least some off this money should be redirected toward exploring non-levodopa-centric therapies, therapies the don't compete with the disease itself for the title "most disabling," and, don't, ultimately, require brain surgery to fix.