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This week an announcement was made regarding The Edmond J. Safra Accelerating Clinical Treatments for Parkinson’s Disease (EJS-ACT PD) Initiative.
It is hoping to revolutionise the way clinical trials for potentially disease-modifying drugs for Parkinson’s are conducted.
The project is focused on the setting up a multi-arm, multi-stage (MAMS) platform for evaluating new therapies for PD.
In today’s post, we will discuss what MAMS trials involve and the current details of the EJS-ACT PD initiative.
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This week I boarded a train for the first time in 16 months and made my way down to London. It felt a wee bit surreal.
I arrived at Liverpool street station and was immediately shocked by the lack of crowds, the lack of face masks (seriously?!? I’ve had my two jabs as well, but I’m still wearing my mask – you are nuts if you don’t!), and the large number of empty shops. How the world has changed.
In the early morning light, I walked across central London towards St Pancras station – the weather was spectacular and it was an incredible pleasure to stroll through some old stomping grounds.
At St Pancras station, I made my way to the enormous Francis Crick institute, where a group of Parkinson’s researchers and advocates were gathering for a really intriguing meeting.
What was the meeting about?
Continue reading “EJS-ACT PD”
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Connecting genetics and biology is complicated. Researchers around the world have struggled to determine what each functional region of DNA is doing individually, let alone in combination with other regions.
And sometimes when the output of combinations is examined, the results can be unexpected.
Recently, researchers looked at the consequences of having a particular combination of Parkinson’s-associated risk factors… and they were rather surprised by the results
In today’s post, we will review the report presenting their results and consider the potential implications of the findings.
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Bragging rights. Source: Howstuffworks
A while back, I became a little obsessed with peacock feathers.
I didn’t start collecting them and wearing them on Saturday night or anything like that. Rather, I just got really fascinated with how they develop. Each individual feather, that is.
I mean, look at them:
Like all organisms, they are wondrous feats of nature and biology – particularly the jewel-toned ocelli (plural) or eyespots (the vivid circular patterns that seem evenly spread along each feather).
Each ocellus (singular) is created via a combination of individual strands of the larger feather. And each strand is further made up of tiny individually coloured segments. When you get really up close and personal with those eyespots, they look like this:
My obsession centered around “the how”.
How does each strand of the feather know when to start some blue or gold colouration (and when to stop) along those strands? And how do the individual strands coordinate and match up so perfectly to create the marvelous image of the ocellus?
This type of question applies to many areas of biology (for example, how does a regenerating tail of a gecko know when to stop growing?), but remember that at the end of each mating season, the peacock sheds (or molts) its feathers. So these carefully coordinated feathers have to re-grow each year!
Tell me that that is not remarkable.
Remarkable, but what does this have to do with Parkinson’s?
Continue reading “Unmasking LRRK2 and GBA”
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Alpha synuclein is one of the most common proteins in our brains and it has long been associated with Parkinson’s. The protein appears to clump together forming dense clusters ( or “aggregates“) in the Parkinsonian brain, and this may be related to the progressive neurodegeneration.
Researchers have been desperately seeking small molecules that will break up (or dissociate) these aggregates in the hope that it will slow down the progression of PD and allow neurons to return to health.
One example of such a molecule is UCB0599, which is being clinically developed by the pharmaceutical company UCB. This week, UCB presented the first clinical results for UCB0599 from their Phase I trial.
In today’s post, we will look at what alpha synuclein is, review what is known about UCB0599, discuss the results of the study, and consider what comes next.
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Last week at the 2021 American Academy of Neurology virtual meeting a poster was presented by the pharmaceutical company UCB.
Here at SoPD HQ, we have been eagerly awaiting these results.
They were the findings from the first Phase I clinical trial of a new molecule called UCB0599.
What is UCB0599?
UCB0599 is a brain-penetrant, oral small molecule alpha-synuclein misfolding inhibitor.
What does that mean?
Continue reading “UCB at ANN looks A-OK”
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Neurotrophic factors – like Glial cell line-derived neurotrophic factor (or GDNF) – hold great hope for regenerative therapy in Parkinson’s research. New research, however, indicates that simply injecting the protein into the brain may not be enough.
Scientists at Rush University Medical Center (in Chicago) conducted a postmortem analysis of brains from people who passed away with Parkinson’s and made an intriguing discovery.
They found that many of the remaining dopamine neurons appear to not be producing a protein called Ret, which is required for GDNF signaling. In addition, other components of GDNF signaling pathway were missing.
In today’s post, we will review the background of this new study, outline what the study found, and discuss the implications of the research.
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GDNF. Source: Wikipedia
Glial cell line-derived neurotrophic factor (or GDNF) is a topic that gets a lot of reader attention on the SoPD. It is a tiny protein that holds great hope for the Parkinson’s community in terms of providing a potential neuroprotective and regenerative therapy.
GDNF is a type of neurotrophic factor, which are small naturally-occurring proteins that nurture neurons and support their growth. There are different kinds of neurotrophic factors, and the testing of some of them in preclinical models of Parkinson’s has generated encouraging results (particularly in the case of GDNF – click here to read a previous SoPD post on this topic).
But the translation of those initial results in cell culture and animal models of Parkinson’s has been difficult in clinical trials of neurotrophic factors.
This has led to many questions being asked within the research community about the nature of biological signaling pathways involved with neurotrophic factors and whether they might be affected in Parkinson’s.
The majority of the neurotrophic factors that have been tested in models of Parkinson’s and in clinical trials for Parkinson’s belong to a branch that requires the RET signaling pathway to be available to have their neuroprotective effect.
What is the RET signaling pathway?
Continue reading “What is GDNF without RET?”
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Lysosomes are small bags of enzymes that are used to break down material inside of cells – digesting newly absorbed food or recycling old/used proteins and rubbish. Recently researchers have been discovering increasing evidence that points towards dysfunction in lysosomes as a key influential player in neurodegenerative conditions, like Parkinson’s.
There are several Parkinson’s genetic risk factors associated with lysosomal function (GBA being the obvious one), that can increase one’s risk of developing Parkinson’s.
But there is also data indicating that individuals without any of these risk factors may also have reduced lysosomal activity. And recently researchers have identified one possible explanation.
In today’s post, we will explore what lysosomes are, investigate how they maybe involved with Parkinson’s, review what the new data reports, and discuss how this information might be useful.
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Type of endocytosis. Source: Slidemodel
On a continual basis, cells inside your body are absorbing material from the world around them with the aim of collecting all that they need to survive. They do this predominantly via a process called endocytosis, in which a small part of the cell membrane envelopes around an object (or objects) and it is brought inside the cell.
As the section of cell membrane enters the interior of the cell, it detaches from the membranes and forms what is called an endosomes (sometimes it is also called a vacuole). Once inside, the endosome transported deeper into the interior of the cells where it will bind to another small bag that is full of digestive enzymes that help to break down the contents of the endosome.
This second bag is called a lysosome.
How lysosomes work. Source: Prezi
Once bound, the lysosome and the endosome/vacuole will fuse together and the enzymes from the lysosome will be unleashed on the material contained in the vacuole. The digestion that follows will break down the material into more manageable components that the cell needs to function and survive.
This enzymatic process works in a very similar fashion to the commercial products that you use for washing your clothes.
Enzymatic degradation. Source: Samvirke
The reagents that you put into the washing machine with your clothes contain a multitude of enzymes, each of which help to break down the dirty, bacteria, flakes of skin, etc that cling to your clothes. Each enzyme breaks down a particular protein, fat or such like. And this situation is very similar to the collection of enzymes in the lysosome. Each enzyme has a particular task and all of them are needed to break down the contents of the endosome.
Interesting, but what does this have to do with Parkinson’s?
Continue reading “Trying to LIMP-2 the lysosome”
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At the start of each year, it is a useful practise to layout what is planned over the next 12 months. The events that are scheduled for the year to come, so that we can keep an eye out for them. Obviously, where 2021 will end actually is unpredictable, but an outline of what is scheduled over the next 365 days will hopefully provide us with a useful resource for helping to manage expectations.
Here at the SoPD, we are primarily interested in disease modification for Parkinson’s. While there is a great deal of interesting research exploring the causes of the condition, the genetics and biology of the condition, novel symptomatic therapies, and other aspects of Parkinson’s, my primary focus is generally on the science seeking to slow, stop or reverse the condition.
In this post, I will try to map out some of what is scheduled to occur in 2021 with regards to clinical research focused on disease modification for Parkinson’s. I will also note aspects of ongoing research where I will be hoping to see an update on progress. It will be an extremely (read: ridiculously) long post, but it will hopefully give readers a feel for what the landscape looks like for research focused on disease modification for Parkinson’s.
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Cartography is the study and practice of mapping things out. It has been used for centuries to provide graphic representations of what stuff looks like to help us to better understand things.
The word cartography comes from the Greek words χάρτης or chartēs (meaning “papyrus, sheet of paper”) and γράφειν or graphein (meaning “to write”).
According to Wikipedia, the fundamental objectives of traditional cartography are to:
- Set the map’s agenda and select traits of the object to be mapped.
- Represent the terrain of the mapped object on flat media.
- Eliminate characteristics of the mapped object that are not relevant to the map’s purpose.
- Reduce the complexity of the characteristics that will be mapped.
- Orchestrate the elements of the map to best convey its message to its audience.
At the start of each year, the SoPD publishes a horizon scanning post where we take a cartography-like approach towards laying out the landscape of clinical research focused on disease modification for Parkinson’s for the next 12 months.
We try to “set the agenda” and “select traits” to look out for in 2021. We also try to “represent the terrain” and “reduce the complexity of the characteristics” (well,… at least we will try to!) in a manner that will “best convey” to the reader what the next 12 months may look like.
All of this is in an effort in better managing expectations about some of the research results that are coming down the pipe.
Continue reading “The road ahead: 2021”
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A lot of Parkinson’s research has focused on a neurotrophic factor called glial cell-derived neurotrophic factor (or GDNF).
But GDNF only represents a small fraction of a much larger class of neurotrophic factors, called the Transforming growth factor-β (TGF-β) superfamily.
Recently, researchers have been investigating some of the other TGF-β family members in preclinical models of Parkinson’s and they have been making some interesting discoveries.
In today’s post, we will discuss what is meant by neurotrophic factor, explore who else is in the TGF-β superfamily, and look at two recent reports highlighting family members in the context of Parkinson’s.
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Different types of cells in the brain. Source: Dreamstime
Glial cells are the support cells in the brain. While neurons are considered to be the ‘work horses’ of neurological function – passing messages and storing memories – glial cells are in the background making sure that neurons are protected and well nurtured.
There are different types of glial cells, including astrocytes, oligodendrocytes and microglia. And each type has a specific function, for example microglia are the brain’s resident immune cells checking up on the health of the neurons while oligodendrocytes provide the neurons with a protective covering (called myelin sheath) which also helps to speed up the signalling of neurons.
A human astrocyte. Source: Wikipedia
Astrocytes provide nutrients and neurotrophic factors to neurons and make sure the environment surrounding the neurons is balanced and supportive. Glial cells are absolutely critical to the normal functioning of the brain.
What are neurotrophic factors?
Continue reading “TGF-beta: The Parkinson’s superfamily?”
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For a long time a regular request from SoPD readers has been to provide an overview of the clinical trial landscape for Parkinson’s, particularly in the area of drug development.
Such projects are difficult, however, as the landscape is broad and dynamic – lots of different approaches being applied and new entrants continually entering the arena. These are positive features, but to characterise the whole field is beyond my simple cognitive abilities.
But recently three Parkinson’s research advocates (with help from the research department at The Cure Parkinson’s Trust) tackled this challenge, and the output of their efforts was published in the Journal of Parkinson’s disease in July of this year.
In today’s post, we will discuss advocacy, review the current clinical trial pipeline for Parkinson’s, and explore how an analysis of this pipeline could be improved.
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Raymond Carver (Source)
“He understood that it took only one lunatic and a torch to bring everything to ruin”
– Raymond Carver
I enjoy old Raymond Carver short story collections (his 1983 ‘Cathedral‘ in particular).
He is not for everyone, but I like him. Particularly ‘What We Talk About When We Talk About Love‘. It is a story about two couples sitting at a kitchen table, drinking gin, and trying to describe what is meant by love.
I thought of this short story last year when I was asked during a Q&A session at a support group meeting, “What do we mean when we talk about advocacy?” (that was the exact wording).
I didn’t mention Carver in my answer. Rather I listed some of the various ways that people can become advocates for Parkinson’s. And there are many, and it really depends on what you want to do and what skills you have or want to learn (we will come back to this near the bottom of today’s post).
Advocacy comes in many forms. And in today’s post I’d like to share one inspiring example of advocacy.
Earlier this year I played a small role in a wonderful project led by a team of Parkinson’s research advocates who were focused on trying to provide an overview of the clinical trial pipeline for therapies for Parkinson’s, with the goal of raising awareness within the PD community.
The results of their efforts were published in July.
What did they find?
Continue reading “The drug development pipeline for Parkinson’s”
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Glucagon-like peptide 1 receptor (or GLP-1R) agonists are a frontline treatment for diabetes – improving glycaemic control by reducing glucose concentrations in the blood.
In 2008, multiple research groups reported that this class of drugs exhibited neuroprotective properties in models of Parkinson’s. Subsequent clinical trials have provided encouraging data supporting this assertion.
Recently, researchers have found further support for potential beneficial effects in a large epidemiological study.
In today’s post, we will discuss what GLP-1R agonists are, what has previously been done with them in Parkinson’s, and what the new report found.
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In 2012, the Golden Goose Award was awarded to Dr John Eng, an endocrinologist from the Bronx VA Hospital.
Dr John Eng. Source: Health.USnews
The Award was originally created in 2012 to celebrate researchers whose seemingly odd or obscure federally funded research turned out to have a significant and positive impact on society.
And despite the name, it is a very serious award – past Nobel prize winners (such as Roger Tsien, David H. Hubel, and Torsten N. Wiesel) are among the awardees.
Sounds interesting. What did Dr Eng do?
Continue reading “Further support for GLP-1R agonists”
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Each year in September, The Cure Parkinson’s Trust and Van Andel Institute hold the international Linked Clinical Trials (iLCT) meeting.
This is a drug-repurposing initiative focused on disease modification in Parkinson’s. For two days the iLCT committee discuss and debate the virtues of 20+ molecules to decide which should be prioritised for clinical evaluation.
Due to the current COVID-19 situation, the 2020 iLCT meeting was held virtually.
In today’s post, we will discuss what the iLCT program is and provide an overview of what happened at the 2020 meeting.
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The top line results of the PD-STAT clinical trial evaluating the cholesterol-reducing drug simvastatin in Parkinson’s were recently announced (Click here to read more about this). Preclinical data had suggested that this agent displayed neuroprotective properties in models of Parkinson’s, and given its long history of clinical use and agreeable safety profile, simvastatin seemed like an ideal candidate for repurposing to Parkinson’s.
A large Phase II clinical trial was set up and conducted across nation-wide network of 23 hospitals in the UK. It recruited over 230 brave individuals to be treated with the drug for 2 years and undergo regular clinical assessments.
The results of the study found that the treatment has had no impact on slowing the progression of Parkinson’s (Click here to read more about this).
That’s disappointing. What happens next?
Disappointing as the result is, the findings of the study provide us with a definitive answer, allowing us to move forward with testing other drugs of interest.
Simvastatin was a drug that was prioritised by the international Linked Clinical Trials programme, and while this agent might not have shown any beneficial efforts in Parkinson’s the good news is that there are lots of other drugs that have been prioritised by the international Linked Clinical Trials programme and they are now being clinically tested.
What is the international Linked Clinical Trials programme?
Continue reading “The 2020 Linked Clinical Trials meeting”