Malú Tansey, PhD, University of Florida, Gainesville, FL, discusses the areas of potential pharmacological therapy for Parkinson’s disease. These include non-steroidal anti-inflammatory drugs (NSAIDs), cannabinoids, immunotherapy and diabetes drugs exenatide and PPARɣ agonists. However, clinical trials of these drugs have yielded mixed results. Dr Tansey believes this is due to inflammation playing a role in the early stages of Parkinson’s pathology, decades before motor symptom onset. Therefore, the cohort of patients observed in clinical trials is not appropriate for anti-inflammatory treatment. This interview was recorded during an online conference call with The Video Journal of Neurology (VJNeurology).
Certainly some of the drugs that are you know very interesting are some of the non-steroidal anti-inflammatory drugs some of those suggest doing uh epidemiological studies that if you are on those for a long time your uh risk may be lowered but those are not causal associations those look to be a basically implied associations i think the clinical trials that
Were run some of them are positive some of them are negative and so it’s important to figure out if the timing of those are critical um so the the trials i think need to be done in a population of subjects where you really know that you’re starting the intervention at the right time and if you think about it if inflammation starts early which we think may
Start even decades before the motor symptoms based on the clinical ma preclinical models then we may need to start dosing or intervening way before you get your clinical diagnosis in a neurologist’s office and so it’s possible that some of those anti-inflammatory non-steroidal clinical trials may need to start earlier so some of those drugs are of interest and
Some may be repurposed there are other drugs that have been tried in the diabetes field exenatide people are gamma agonists and things like that that are basically um yielding some early promising results a few were a little disappointing again i think the population of patients that they’re being tried in may be a little bit too late and with too much advanced
Disease so that’s kind of going to be the challenge i think for the field to identify the right cohort of patients to try these drugs so that you’re not starting too late or that you’re not using a population that’s too heterogeneous and too mixed right you need to have a population that really has inflammation so you can test that there are others like some of
The cannabinoid uh space that seems to be potentially anti-inflammatory so that you can see if some of the active ingredients that are part of say the marijuana plant may be anti-inflammatory and immunomodulatory those are being tested um there’s immunotherapy that are is aimed at targeting synuclein so it’s the nuclear aggregation so there’s some vaccination
Trials going on that are really interesting there’s a few a few others again that are being used um in the autoimmune space um to target t cells and try to understand if there’s t cells that are seeing um synuclein that are autoreactive similar to the ones that you see in things like rheumatoid arthritis and ms multiple sclerosis so i think we’re learning a
Lot from the autoimmune disorders space and hopefully some of those drugs will be able to be repurposed or redirected towards parkinson’s
Transcribed from video
Potential pharmacological candidates targeting inflammation in Parkinson’s disease By VJNeurology