There are more than 800 clinical studies currently being conducted to understand the mechanisms and possible new treatments of Parkinson’s, the second most frequent neurodegenerative disease, after Alzheimer’s. In the care line, there are at least 150 medications under evaluation, in addition to the search for biomarkers that favor early diagnosis.
One of the most promising discoveries so far was the presence of a protein, called alpha-synuclein, which accumulates in neurons and accelerates degeneration, impairing the production of dopamine. As Parkinson’s is caused by a significant decrease in this neurotransmitter – which contributes to the body’s automated movements – when there is a reduction, motor control ends up being impaired, causing slowness, muscle stiffness and the characteristic tremors of the condition.
According to neurologist André Felício, a physician and researcher at Hospital Israelita Albert Einstein, preliminary studies suggest that this accumulation of the protein could accelerate the degeneration of cells, culminating in the disease. In addition, the possibility of medications that can “clean up” the excess of these proteins in the neural cells is being studied.
Genetics against Parkinson’s
Another possibility under evaluation is gene therapies, which have also been receiving attention in recent years, according to Felício.
One such study, published in the scientific journal Nature, showed that T cells (specific to the immune system) of individuals with Parkinson’s are “programmed” to attack the alpha-synuclein protein early in the disease. The problem is that T cells can also damage neurons, in a process similar to what occurs in autoimmune diseases.
The idea, then, would be to create mechanisms to inhibit this action, by identifying the specific genes of T cells programmed to attack the protein, preventing them from damaging nerve cells.
The expert says that the research currently underway is promising, but still needs time to develop. “Currently, most of them are in phase 2”, he points out.
Clinical studies (as research carried out on human beings are called) are divided into different stages. Phase 2 studies mean that the substance or treatment is being evaluated in a group of patients with the condition, to determine safety, the most indicated dose and also the effectiveness. If the results in this phase are positive, the research moves to phase 3 – when the product is compared to the options already available.
Parkinson’s has no world
Data from the World Health Organization (WHO) estimate that there are approximately 16 to 19 cases per 100,000 people per year. The entity highlights the condition as a burden for Public Health, as it calculates an increase in the coming years. Alongside Alzheimer’s, another neurodegenerative condition, Parkinson’s is expected to overtake cancer as the most frequent cause of death by 2040, according to the WHO.
According to neurologist André Felício, the current treatment protocol provides care for both motor and non-motor symptoms. Medications are generally used to increase the amount of dopamine available in the patient’s nervous system, relieving the physical signs of the disease.
There are also non-pharmacological medications and therapies, such as physiotherapy, which help in the control of secondary problems, such as gait disorders, balance and pain.
The specialist reinforces, however, that the treatment depends on an individual assessment. “We need to observe what symptoms the disease causes in the individual and how this impacts quality of life. From there, we offer a personalized treatment to reduce this impact”, he explains.
Another option that can be used, depending on the patient’s needs and the evaluation of the responsible physician, is surgery. In it, electrodes are implanted to modulate the brain’s electrical stimuli in some regions that affect the disease.
“Currently, neurostimulators are able to reduce the severity of the disease and the amount of medication needed, in addition to being more technologically robust, with different (directional) electrodes, and lasting for decades”, says the neurologist. (With information from Einstein Agency)