Parkinson's research - what to look out for in 2013

We often get asked how close we are to a cure for Parkinson's and what research is being carried out to achieve this. Dr Kieran Breen, our director of research and innovation, gives us his opinions on what he thinks are the key areas in Parkinson's research to watch out for in the future:

Dr Kieran Breen
All of the currently available Parkinson's drugs treat the symptoms rather than the condition itself. What we urgently need to develop are therapies that will slow down, halt or reverse the death of the nerve cells that happens in Parkinson's. This would, effectively, be a cure for the condition.

Research towards a cure is the primary aim of the current Parkinson's UK research strategy. Understanding how and why nerve cells die will give us vital information about how we can actually focus on treating the Parkinson's rather than the symptoms.

In addition to the research funded by Parkinson's UK, we keep very much up-to-date with other research that is carried out outside of the UK. We also speak with other funders - I had a very productive meeting last week with my counterpart at the Michael J Fox Foundation - as well as with researchers around the world.

It's vital that we all work together to achieve our goal - a cure for Parkinson's. But there is so much going on at the moment that I can only highlight a few areas that I think show particular promise.

Understanding how Parkinson's develops

We have supported a lot of research to try to understand how Parkinson's develops. By really understanding what happens within a nerve cell to cause it to die, we can identify therapies that can treat the condition itself rather than the symptoms. For example, one of the key events in Parkinson's is the development of Lewy bodies in the brain. These are specific changes that occur when a cell starts to die. Lewy bodies are then thought to spread throughout the brain as the Parkinson's progresses. So, if we could target this, we may be able to slow down the progression of nerve cell death.

Another target is a protein called synuclein which clumps together to form Lewy bodies. So this is another avenue that is being addressed to identify chemicals that may prevent Lewy bodies being formed (PDF file).

Drugs prescribed for other conditions

The development of new drugs is extremely expensive and takes a long time. But it may be possible to use drugs that are prescribed for other conditions to treat Parkinson's. Based on results from a Parkinson's UK-funded study, a small clinical trial has been carried out to look at whether the anti-diabetic drug Exenatide may help to slow down the progression of Parkinson's.

Also, a study in the US has suggested that isradipine, which is used to treat high blood pressure, may also slow down the progression of Parkinson's. But we urgently need to do more research to identify other drugs. This is very much on the Parkinson's UK agenda.

Gene therapy and stem cell therapy

There are also other approaches that we can take to develop a cure. For example, gene therapy aims to enable nerve cells to be more efficient in how they work. Some current studies are examining genes that may actually stimulate nerve cells to regrow.

And of course, in the longer term we have the potential of stem cell therapy where we can replace the cells that have died in Parkinson's with new nerve cells. This may still be a long way off, but it's amazing how much progress has been made in this area over the last couple of years.

In fact, the winners of the Nobel prize for medicine this year identified new ways in which we can generate stem cells and this could have a significant impact on the future treatment of Parkinson's.

So, what about 2013?

Well, while there are a lot of promising areas in the pipeline, realistically there is unlikely to be a cure for Parkinson's within the next 12 months, and it's not possible to give an exact timescale of when a cure will come. However, we are committed to building upon our understanding of the basic science of the condition to develop new therapies. Essentially, we will translate the research from lab to life.

This requires investment in some high risk research studies but if they pay off, there could be a very high reward. We can't afford to be 'safe' in our research funding. It is only by being brave that we can make rapid strides forward.

The advances that are being made give me a real sense of hope that, day by day, we are getting closer than ever to a cure for Parkinson's.


Anonymous said...

thank you Dr Breen for your survey. Very informative.

Davech said...

Thanks Keiron very informative.

I realise it is difficult to speculate and come up with definitive dates for a breakthrough/cure but was really looking to understand whether the predictions from a variety of sources of significant progress within the next 5 years is realistic or a pipedream

Davech said...

Thanks Keiron very useful but what I was really looking for was a view as to whether the figures of 5 years for a breakthrough that often get quoted from a variety of sources are actually realistic or simply a pipedream

Anonymous said...

A couple of years ago I stuck my neck out and said that I believed that Parkinsons will be largely curable by the end of the decade. I still stand by that prediction. Dr Breen's progress report is most encouraging. However, it is vital that we re-double our efforts to increase levels of funding so that this vital research can continue.

Kieran Breen said...

Davech, thanks for your post. I would never give a time when I think that a cure will be found. Some people use five years, but this is really a figure plucked from the air and has no basis in fact! We are all working as hard as possible – charities, governments and industry – to bring a cure closer to reality. However, as the symptoms of Parkinson’s are so diverse, it is unlikely that there’ll be a single cure but these will be directed at the personal symptoms.

I’ve been with Parkinson’s UK for seven years, and it’s amazing how research has developed. We know more about the genes involved and how the nerve cells die. The first gene therapy trials are ongoing with some encouraging results. And we have now started to think laterally about developing new uses for old drugs. We are very much committed to building upon the basic scientific knowledge to develop new and innovative treatment. I have no idea how long this will take but you can be assured that we are focussed very much on our ultimate goal of developing a cure and we want to achieve this as soon as possible

Anonymous said...

I urge everyone to support this quest for research to find a cure and raise awareness of the debilitating effects this disease has,apparently it's quite rare 1/100, but even in my relatively small circle of family, friends and acquaintances, it has affected several. It is truly heart breaking to see what impact Parkinsons has had and it would be heartening to have more idea of the causes.

Sheila H.B. said...

Thank you Dr Breen, it has been interesting reading your report and heartening to know of the great medical strides made these last 10 years. It is also good to know that there is dialogue between the different national research groups, hopefully in order that expensive research and trials are no duplicated wasting resources.

Anonymous said...

What are the results of Exenatide trials, please? Thank you

Anonymous said...

Thanks for the update Dr Breen even though it distresses me that the oft quoted estimates of a cure within 5 years are it appears unrealistic

Kieran Breen said...

Although the Exenatide trial has finished, we are still waiting for the results to be published.

This is likely to be within the next 2-3 months. We will inform people as soon as we are told about the outcomes by the researcher.

Nady< I'am here against all the odds> said...

Thanks DR Kieran Breen, My mother is a victim of PD since 7 years. She is on medicines and wanting us to support her for DBS... She is less reactive to medicines and her condition is worsening.. i would wish some cure comes that can be safe and stable.. Wish you luck.. as a software engineer, I can only wish and pray, Nothing much I can do to support your research, If i can, Please let me know.... Also if you could refer me to some good resources for PD related financial help for DBS, It will be helpful..

Anonymous said...

I still find it hard to believe how little progress has been made in a) the treatment and b) the cure of Parkinson's in the last 60 years and frankly it makes me quite angry.

My wife was put on Silidgeline, Madopar (disastrous) Tolcapone (withdrawn), Sinamet (still using), Ripinerole, Amantadine (Involuntary movement) Amytriptalline ( depression) Zolpidem (sleeping).

After several years of use she became desperately sick almost vegetative. On the advice of the neurologist Ripinerole was withdrawn with almost instant improvement.

In due course I decided the Amytriptalline was possibly contributing to incoherence, confusion and hallucinations whilst having no effect on depression and stopped it, again with positive results.

Sometime later the Parkinson's nurse appeared surprised despite access to medical notes that my wife was still on 4 Amantadine pills per day for her dyskinesia which at one time was almost uncontrollable but was helped enormously by the Amantadine. She said she should come off them. I replied that it may have a very adverse effect on her dyskinesia. She did not insist.

However, thinking there must be good cause for concern and suspecting that the medication was the main source of horrendous and upsetting hallucinations I began reducing the dose gradually. Eventually, I was able to withdraw them completely without any serious increase on the dyskinesia which appeared to have considerably abated. The hallucinations also ceased.

Finally, I decided to try and eliminate the Zolpidem which undoubtedly was contributing to general drowsiness and adding to incoherence. I found that if I got her to bed at the right time in the cycle of her Sinamet, she was able to fall asleep almost instantly on going to bed and sleep through the night. Her awareness during the day also improved.

The only medication she now takes is Sinamet and as I and her part time carers can attest there has been a noticeable degree of improvement in her mobility, awareness and general coherence even if these are still limited.

It is now 19 years since she was diagnosed and my wife requires help with all functions. In that time no effective improvements in treatment have been forthcoming and with the exception of Sinamet all the drugs she was prescribed have been more harmful than helpful in the longer term.

This makes me angry and frustrated for her and clearly whatever is being done is totally inadequate.

Anonymous said...

Nady, I am sorry to hear about your mother. Please do not underestimate the benefits of music, exercise and genereal positivity. The more stimulated your mother is the better. Try to live as normal a life as possible and make sure she is surrounded by people who love her and really care for her, preferably at home.

Dr Kieran Breen said...

@Anonymous (22 February 2013 16:32)

I'm very sorry to hear that you and your wife have experienced such a difficult time with Parkinson's drugs. Unfortunately, one of the biggest problems with Parkinson's is how individual the condition is. This makes it very difficult to predict how someone will respond to a particular drug, so choosing the right treatment regime is often a process of trial and error.

We are funding research to address this problem including our groundbreaking 'Tracking Parkinson's' project which is the largest ever in-depth study of people with Parkinson's. One of the key things the study is investigating is looking at how the condition affects people differently - in the way it progresses and in their response to medication. We hope this will lead to better care for people with Parkinson's as doctors will be better able to choose the right drugs for each individual.

Alongside this we are also working hard to develop new and better treatments that can slow or stop the course of Parkinson's, and have fewer side effects than the current drugs.

If you'd like to talk to someone please call our free and confidential helpline on 0808 800 0303. Our trained advisers, including specialist Parkinson's nurses, can provide information and advice about all aspects of living with Parkinson's.

gegard said...

@ Kieran Breen (25 February 2013) - Am I right in thinking that Parkinson's is caused by reduction in the ability of cells to produce dopamine (i.e. kills them), but that this presents in a number of ways that change throughout time? If so, is the research problem really mostly about finding what kills the cells and trying to replace them faster than they die? Thanks.

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