A new study by Israeli researchers could be a step towards the diagnosis of Parkinson’s disease years earlier than is currently possible, which could potentially open the door to successfully fight the disease’s progress.
A team from the Hebrew University of Jerusalem has isolated a key factor that is a common symptom of the degenerative disease: constipation.
Although chronic constipation is a common problem as people get older and is often not a sign that something is specifically wrong, it is also directly linked to Parkinson’s, and it sometimes occurs in patients up to 20 years before they are diagnosed with the disease. word.
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Doctors currently do not have a validated laboratory-based methodology to definitively diagnose Parkinson’s disease, and it is diagnosed primarily on the basis of motor symptoms indicating that the patient is suffering from the disease, including tremors, stiffness and problems with walking, balance and coordination.
By the time these symptoms are clearly visible, the brain has lost too many dopamine cells to recover. Currently available treatments are the symptoms of the disease rather than stopping its progression.
Professor Joshua Goldberg of the Department of Medical Neurobiology of the Hebrew University (thanks to Joshua Goldberg)
But early diagnosis can be critical. Many promising treatments failed in the trial phase, but according to Joshua Goldberg, a professor at the Hebrew University who led the recent study, it may not be because something was inherently wrong with the treatment – but simply because the diagnosis was made too late. for a possible cure to be helpful.
The Hebrew University – published Wednesday in the journal Science Advances, led by Professor Goldberg of the Department of Medical Neurobiology in collaboration with Professor Jochen Roeper of the Goethe University in Frankfurt, Germany, took advantage of constipation as a potential early marker.
Parkinson’s has long been linked to the formation of small deposits of protein waste in brain cells called Lewy bodies, named after Dr. Friedrich Lewy, who discovered it in 1912. It is not clear whether these protein deposits are the cause of the degenerative disease or a symptom thereof. In fact, according to Goldberg, it could be a bit of both.
However, the living bodies can not be easily detected in living patients, and their occurrence in the brain was observed only posthumously in those who suffered from the disease. It is therefore not widely used as a diagnostic tool.
An illustrative image of a patient with Parkinson’s disease (Obencem; iStock by Getty Images)
One of the first places where Lewy bodies occur in the brain is an area that affects gastrointestinal activity – specifically the upper digestive tract.
Prof. Goldberg’s team tried to identify the specific underlying mechanism that links the presence of Lewy bodies in the brain to constipation. Non-Parkinson’s constipation – the type that is not controlled by brain issues – is usually in the colon rather than the upper digestive tract. Scientists therefore hope that identifying the mechanism responsible for constipation in the upper gastrointestinal tract will enable them to indicate cases of concern.
In its study, the research team found a way to detect the way Lewy bodies affect the upper digestive tract by using a specific protein, alpha-synuclein, which is known as the main component of Lewy bodies.
The team overexpressed alpha-synuclein in mouse brain cells that modulate activity in the upper digestive tract.
“The result was that over-expression of the protein caused these brain cells to shrink and slow down their electrical activity,” the study found. The mice then indeed developed constipation of the type associated with Parkinson’s.
A model to slow down the digestive system after the expression of alpha-synuclein proteins in the brainstem, as part of a study focusing on early diagnosis of Parkinson’s disease among those suffering from constipation. (J. Goldberg / J. Roeper)
“It is therefore likely that this is the process that also occurs in people in the early stages of Parkinson’s disease,” according to the study.
“As far as we know, this is the first time anyone has described a causal chain of events related to how alpha-synuclein proteins affect brain cells and the early symptoms we have known for a long time, before this disease,” Goldberg said. potential of discovery.
‘Think of a 55- to 60-year-old patient suffering from constipation. ‘We could one day design a test based on the neural changes we’ve discovered to determine if there’s a neural factor at play that may indicate Parkinson’s,’ he said.
Goldberg stressed that early diagnosis would probably not be based solely on constipation, and that a series of tests would be used that would be summarized to indicate the early presence of the disease.
This can then allow potential curative treatments to be administered before massive cell death develops in the brain, leaving the patient permanently and increasingly disabled.
While acknowledging that this is still hypothetical, he said: ‘One day in the future, we are confident that we will be able to identify a range of biomarkers – including physiological ones, such as the one we are proposing – that will enable us to identify the disease much earlier than we are currently able to. ”
