Seelos Begins Animal Study Investigating SLS-007 as Parkinson’s Treatment

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SLS-007 animal study

Seelos Therapeutics has begun a preclinical study in rodents to test a gene therapy approach to deliver its investigational candidate SLS-007, a potential treatment for Parkinson’s disease. Results are expected by late this year or early 2021.

One hallmark of Parkinson’s disease progression is the formation of Lewy bodies, abnormal protein clusters that form in brain cells and disrupt their regular function. These clusters are toxic to nerve cells and are thought to underly the development of Parkinson’s. A major component of Lewy bodies is the protein alpha-synuclein.

SLS-007, which was developed originally by a team of researchers at the University of California, Los Angeles, is a family of molecules, known as peptide blockers, that are designed to lessen alpha-synuclein aggregation.

Specifically, SLS-007 targets the non-amyloid core region of the alpha-synuclein protein, which is more prone to aggregation.

Previous, in vitro studies — experiments conducted outside of a live animal — showed that SLS-007 had the potential to block Lewy body formation by preventing the clustering of alpha-synuclein.

This was accomplished by preventing the propagation and seeding of alpha-synuclein, a process in which a small amount of the protein provides the template for the aggregation of normal protein into larger clusters, or clumps.

“In in vitro models, halting or slowing the aggregation of alpha synuclein dramatically slowed the formation of Lewy Bodies which are the hallmarks of the pathogenesis of Parkinson’s,” Raj Mehra, PhD, chairman and CEO of Seelos, said in a press release.

Having established the potential benefit of SLS-007 as a disruptor of Lewy body formation, the researchers now have begun to investigate the treatment in mice.

The team will use a transgenic mouse model that previously was designed to study the propagation of alpha synuclein. Researchers will test a modified, harmless form of a virus, called an adeno-associated virus (AAV1/AAV2), as a vehicle (or vector) to deliver SLS-007.

Two specific peptides that comprise SLS-007, called S62 and S71, have been tagged with a unique marker that will allow researchers to track their activity. Production of the AAV vectors already has been completed by Seelos.

Researchers will assess the ability of SLS-007 to protect dopaminergic neurons in these mice. The study also will determine the pharmacokinetics, pharmacodynamics, and target engagement of SLS-007 in mice.

(Pharmacokinetics refers to the movement of a medication within the body while pharmacodynamics refers to the interactions between the body and a compound.)

Research on SLS-007 will augment Seelos’ ongoing studies of SLS-004, an investigational gene therapy that uses another harmless virus, called a lentivirus, to deliver an enzyme called DNA methyltransferase 3A that is thought to limit the production of alpha-synuclein.

“This program [SLS-007] should complement SLS-004 in which we also recently began studies,” said Mehra.

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3 Nurse Educators Win Parkinson’s Foundation Grants for Local Projects

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Parkinson's Foundation award

The Parkinson’s Foundation announced the three winners of this year’s Nurse Faculty Award, giving about $10,000 to each of these nurses to support projects that might better the lives of Parkinson’s patients in their communities.

Each winner is a graduate of the organization’s 50-hour accredited Edmond J. Safra Visiting Nurse Faculty Program, which works to improve Parkinson’s disease (PD) care across the U.S. by providing additional training and support to nurse educators.

“Nurses are vital in caring for people with Parkinson’s in all settings, from a clinic to an emergency room,” Elizabeth Pollard, the Parkinson’s Foundation vice president, chief education and training officer, said in a press release. “The Parkinson’s Foundation …  is excited to continue providing our Edmund J. Safra Visiting Nurse Scholars with an opportunity to develop their independent projects and provide unique tools to further educate nurses to improve PD care.”

Donna G. Hood, PhD, RN, is an awardee. A chronic illness researcher and director of the Division of Nursing at Louisiana Tech University, she will use her award to expand the school’s Parkinson Resource Center program, established through a Foundation grant to support underserved communities in rural Louisiana and southern Arkansas.

The award will double to four the number of participating undergraduate students, provide Parkinson’s patients across the region with resources, mentor future nursing leaders, and help support the program’s replication.

“We have excellent students who have expressed their desire to join us as future nursing student scholars, and we are excited to see this program grow and see how this impacts the Parkinson community in our region and beyond as these student scholars become our future PD champions,” Hood said.

An associate professor of nursing at Seattle University, Mo-Kyung Sin, PhD, RN, will use her award to gauge the impact of the school’s nursing student ambassador program on students’ knowledge of, and competence in, Parkinson’s care. The program includes educating juniors about Parkinson’s care and related case studies, a one-day intensive Parkinson’s education segment, and a group project for six selected seniors who plan to become neurologists.

The project will help develop nurses trained in Parkinson’s care.

Awardee Stephanie Stewart, MSN and a board-certified registered nurse, will launch Navigating the Parkinson’s Journey, aimed at improving life quality by helping patients feel more connected to each other. The program will open in St. Joseph, Missouri, and findings will be accessible to anyone interested. Stewart is an assistant professor of nursing at Missouri Western State University.

Open exclusively to those who complete the Edmond J. Safra Visiting Nurse Faculty Program, the award supports projects that enhance the scholars’ ability to teach about Parkinson’s, or that increase Parkinson’s knowledge among nurses, students, or patients. The award is for a maximum of $10,000 annually. More information is available here.

Parkinson’s disease affects nearly 1 million people in the U.S. and 10 million individuals globally.

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No Matter Your Age, We’re in This Together

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fires, silent symptoms, marriage, tasks, bucket lists, forgetfulness

I recently read that Parkinson’s disease affects an estimated 1 in 100 people over age 60. When I started my Parkinson’s journey, I was in high school.

I didn’t know that what was happening to me was something known as Parkinson’s disease. I didn’t even know what Parkinson’s disease was or what it was capable of. I was a young’un in the community, unaware that there were Parkinson’s communities, too.

My symptoms were minor at the time, but they existed. Sometimes they were hard to ignore, but ignore them I did. 

I soon had small children to distract me. As they began to grow, so did the number of calendar entries, which led to more distractions. Meanwhile, I continued to ignore my symptoms, but eventually, it became obvious I couldn’t ignore them any longer, so I scheduled a doctor’s appointment.

I’ve often thought about the transition from young-onset Parkinson’s disease to “normal” Parkinson’s. Is there a time of transition, or does one simply slide from one into the other? If diagnosed with young-onset Parkinson’s, when does it become “regular” Parkinson’s? 

According to the statistic I previously mentioned, what I refer to as “normal” Parkinson’s disease occurs at the age of 60 or older. Young-onset Parkinson’s is said to occur generally between the ages of 21 and 50. In rare cases, it has been diagnosed at an earlier age than 21.

I have spent the last decade journeying through the years that Parkinson’s statistics seem to pay little attention to: 50- to 60-year-olds. But rather than feeling overlooked or left out from the Parkinson’s crowd during my 50s, I feel blessed. This is because I discovered early on what was happening inside of me. I learned earlier than most that life, and those with whom we share it, should never be taken for granted. 

Many live as if life will never end. But people with a disease are aware their bodies are giving out. 

It’s been said that Parkinson’s disease usually progresses more slowly when diagnosed at an earlier age. Being attuned to this fact, I have strived to to get as much out of life as I can. 

My life may not compare to someone else’s in terms of activities. I haven’t climbed mountains, run marathons, ridden an ostrich, or caught a greased pig as a means to advocate and go all out for Parkinson’s awareness. Those weren’t the opportunities afforded me, nor do I think they are my purpose in having this disease. We are not all called to do the same things. Some of us climb our mountains, some walk the trails, others swim the seas, and some, like me, write about it.

One of my favorite opportunities in living fully is spending time with my family, especially my grandkids. By seizing the opportunities to care for my little “grands,” my energy has come on strong when I needed more of it. I think there is something magical about grandkids that makes magic like that happen.

Whatever your opportunities or choice in how you spend your precious time are, seize every moment. You may be a young-onset person with Parkinson’s or a person with “regular” Parkinson’s. You may be floating somewhere in the middle, trying to navigate life in your 50s. Wherever you are, keep moving forward, keep pressing on, and don’t give up. We’re in this together, no matter how old we are.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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Equfina, Known as Xadago in US, Approved in S. Korea as Levodopa Add-on

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therapy approval

Equfina (safinamide) has been approved in South Korea as an add-on therapy to levodopa for Parkinson’s disease patients who experience “off” episodes, Eisai, which is marketing this medication in parts of Asia, announced.

The approval makes South Korea the first country in Asia outside of Japan to sell Equfina.

Under the brand name Xadago, the add-on therapy was approved for the same indication in Europe in 2015 and in the U.S. in 2017. In Canada it is marketed under the name Onstryv.

“Off” periods in Parkinson’s are characterized by the reappearance or worsening of motor symptoms — such as tremors and dyskinesia (involuntary movements) — due to a gradual decline in levodopa’s effectiveness throughout the day.

Safinamide, developed by Newron Pharmaceuticals, increases the level and function of dopamine — the neurotransmitter, or signaling molecule, missing in those with Parkinson’s — in the brain. It does so by inhibiting the enzyme monoamine oxidase B that normally breaks down dopamine, and also by inhibiting (blocking) transporters that are responsible for its uptake, meaning its absorption and retention.

Safinamide also inhibits an excessive release of the neurotransmitter glutamate.

Equfina’s approval in South Korea was based on clinical results from the SETTLE Phase 3 study (NCT00627640). The global trial enrolled 549 patients experiencing off episodes while on a stable regimen of levodopa plus benserazide or Lodosyn (carbidopa).

Participants were randomized to either oral safinamide (50 mg per day, increased to 100 mg per day if tolerated) or a placebo as an add-on therapy for 24 weeks.

The study’s main goal was changes in mean daily “on” time (the period in which motor symptoms are efficiently controlled) about six months of treatment or placebo use.

Results showed that adding safinamide to levodopa significantly increased the length of “on” periods without dyskinesia by almost one hour (57.6 minutes) compared with placebo.

Adverse treatment reactions were seen in 28.5% of patients in the safinamide group and in 27.6% of those given a placebo, with the most frequent including dyskinesia, nausea, and somnolence (sleepiness).

Newron entered a licensing agreement with Meiji in 2011, granting the company exclusive rights to manufacture and commercialize safinamide in Asia. Based on a licensing agreement between Eisai and Meiji, Eisai now has exclusive rights for developing and marketing safinamide in much of Asia.

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MJFF Offering Comprehensive Guide for Newly Diagnosed Patients

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MJFF guide

The Michael J. Fox Foundation (MJFF) is offering a guide to help people newly diagnosed with Parkinson’s navigate the early days of their disease, and better prepare for the future.

Called “If I Knew Then What I Know Now: The Michael J. Fox Foundation Patient Council’s Guide for People Newly Diagnosed with Parkinson’s,” the resource is meant to provide encouragement, insights, and practical strategies to those living with this disease.

This year alone, about 60,000 people in the U.S. are expected to be diagnosed with Parkinson’s. Compounding matters, many of those diagnoses will come during a global pandemic.

The free 32-page guide was written by five members of MJFF’s Patient Council, which represents the patient perspective and works to educate the community.

Rachel Dolhun, MD, MJFF’s vice president of medical communications and a movement disorder specialist, also contributes tips for managing life with Parkinson’s. Among topics covered are disease information and specialists, building a support system, diet and exercise, and research participation.

“A Parkinson’s diagnosis brings many questions and concerns and a series of inevitable hurdles,” Soania Mathur, MD, guide contributor and Patient Council co-chair, said in a press release. “We may not have a choice in our diagnosis, but how we face those challenges is ours to determine.”

The guide comprises short, mostly first-person articles categorized into sections. A section called “I’ve Got What?” covers the diagnostic process, second opinions, the Parkinson’s journey, inheritance, and causes of Parkinson’s disease.

Another section, “Managing Emotions in the First Days,” has essays about disease acceptance, the relationship between symptoms and stress, and reasons for hope.

“Coming to terms with my Parkinson’s was not something that happened overnight,” one contributor  wrote. “I had to tell myself many times that my diagnosis was here, it was happening now, and it was unavoidable. And that I needed to start planning for what would come next.”

Added Michael J. Fox, the actor who founded MJFF after being diagnosed with Parkinson’s in 1991 at age 29: “My first thought was, ‘What the hell happened to me? What am I going to do?’ That took time to work through, but I found out that if I could accept what my situation was, and be honest about it, I could move forward.

“And my happiness grows in direct proportion to my acceptance,” Fox said.

In “Taking Control of Parkinson’s Disease,” authors discuss the best sources for advice, symptom management, early medication and treatment, caregiving, and making the most of doctor appointments. There is also an article about clinical trial participation, and a column by Bill Rasmussen, a Patient Council member and founder of the U.S. sports channel ESPN, who was diagnosed in 2014.

The guide also includes a question-and-answer section, titled “How and When Will I Know I’m Ready to Share My Diagnosis?” Another section addresses early onset PD, generally defined as a Parkinson’s diagnosis before age 50.

The publication also provides a listing of MJFF resources, covering many aspects of life with the neurodegenerative disorder.

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Rethinking Exercise With Parkinson’s

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I hate facing the effort it takes to start daily exercise. I hate the way I feel the next day — like I have been pummeled with nunchuks. But ever since my Marine Corps training I have enjoyed the benefits of exercise. I know it is hard to get up and engage in physical activity. This is particularly true when facing the motor hesitation of Parkinson’s. It is hard to exercise facing the level of discomfort that is going to follow. This is particularly true when the post-exercise stiffness is compounded by the rigidity associated with Parkinson’s. Yet, despite these difficulties, the benefits of exercise far exceed the temporary increase in discomfort.

Starting exercise after being sedentary combined with neuromuscular malfunctions requires special considerations. The Marine Corps boot camp approach just is not going to work. Last time I tried that I ended up with multiple muscle injuries. A new approach to exercise came from three ideas: mindful movements, little things practice, and long movements adapted from Lee Silverman Voice Treatment (LSVT) exercise recommendations.

In the study “Effect of Exercise on Motor and Nonmotor Symptoms of Parkinson’s Disease,” the authors report that “LSVT BIG therapy is designed to overcome amplitude deficits associated with PD. This therapy improves proprioception through increasing amplitude together with sustained attention and cognitive involvement by mentally focusing on individual movements.” In other words, I am concentrating on where my body is and what it is doing, and I’m paying attention by focusing on the task at hand.

My new exercise program incorporates activities that focus on long and slow movements while I’m simultaneously engaged in a mindful focus on the little things. This new exercise program is also tied to something that will continually motivate me to move past the Parkinson’s hesitation to start. I discovered, in some ways rediscovered, the answer with landscape gardening.

What is great about landscape gardening is that there are so many different types of motor tasks that need to be accomplished: shoveling, hauling with a wheelbarrow, planting, raking, clipping, and pruning. Knowing that I need more light physical activity for both warming up and for bad days, where I can only put in short durations, I am installing a white gravel Zen path. The small gravel pieces, less than an inch in diameter, are incredibly easy to rake with long mindful movements. Light and easy warm-up exercise has become mandatory for me before any physical activity. The one day I forgot resulted in strained muscles that required too much time to heal. The good thing is I now know what strained muscle pain feels like and how it is different from Parkinson’s muscle pain and different from post-exercise pain. I now know why the light warm-up exercise in a mindful state needs to happen before I tackle the larger landscape gardening projects.

Getting back into exercise after being sedentary for so long requires patience — lots and lots of patience. I see so many things in my vision for our yard. But I know if I push myself in that old boot camp way I am going to end up injured and unable to accomplish my vision. But patience means slowing down and slowing down feels like I am not accomplishing “great” things. If I think I am not accomplishing then I am not successful, and if I cannot be successful, then I feel no need starting at all. It is a devious cycle that ignores the practice of “little things” and becomes a reason to not exercise. Mindful, light motor exercise activities break that cycle. Like Tai Chi and yoga, the long, mindful movements help motivate me out of sedentary life and into a balanced exercise regime.

Gardening is also good for the mind and what is good for the mind is good for the body. My approach to gardening is different now. My first impression of the change is that my actions are calmer, framed in sacred intent. But, in all honesty, I am still sorting all that out. Using this new approach to exercise, while being creative with landscape gardening, is making a huge difference in my health. We just did a teleconference with my new primary provider and Mrs. Dr. C said, “He’s the healthiest he’s been in four years.”

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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Stopping Trimetazidine May Ease Parkinson’s Symptoms, Improve Quality of Life, Study Says

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trimetazidine and Parkinson's symptoms

Discontinuing trimetazidine treatment in people with Parkinson’s disease may lessen their motor and non-motor symptoms and improve their quality of life, a study has found.

The study, “The Impact of Trimetazidine on Disease Severity and Quality of Life in Parkinson’s Disease,” was published in the journal Scientific Reports.

Trimetazidine, which is sold under the brand name Vastarel and also available as a generic, is an antianginal medication used as add-on therapy for treating stable coronary heart disease — conditions that cause a reduction of blood flow to the heart. It is approved for this indication in Europe and other countries but not in the U.S. 

Previous studies have shown trimetazidine to have adverse effects on motor function, including causing reversible parkinsonism, tremor, and orofacial dyskinesia (involuntary repetitive movements of the mouth and face). It can also worsen symptoms of existing movement disorders like Parkinson’s disease.

These effects may be caused by the medication’s piperazine core, a chemical compound also found in antipsychotic medications that have been reported to induce parkinsonism and worsen Parkinson’s symptoms. 

Piperazine is thought to block the action of dopamine receptors, which play an important role in movement regulation. 

Based on previous studies, in 2012, the European Medicines Agency recommended against the administration of trimetazidine to patients with Parkinson’s disease.

However, recent data show that this recommendation is not followed strictly enough, and trimetazidine is still being prescribed to people with movement disorders.

Researchers at University of Pécs in Hungary have now evaluated the impact of trimetazidine treatment on the severity of clinical symptoms and its effects on health-related quality of life in people with Parkinson’s disease. 

The study included 42 patients with Parkinson’s disease, at a mean age of 71.1 years, who had been prescribed trimetazidine. All patients were also taking oral anti-parkinsonian medications.

At the start of the study, patients had been taking trimetazidine for a mean of 6.5 years, at a mean dose of 72.1 mg. Participants underwent detailed neurological and neuropsychological assessments.

Trimetazidine was stopped and patients were again reevaluated three months later. Their oral antiparkinsonian treatment was kept stable until the follow-up.

Results showed significant lessening of Parkinson’s clinical symptoms at follow-up, measured by the Movement Disorder Society-sponsored Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), a four-part assessment of motor and non-motor Parkinson’s symptoms.

Clinically relevant improvements were observed upon discontinuation of trimetazidine according to changes in scores of different parts of the MDS-UPDRS, compared with the beginning of the study: a 25.7% change in part 1, which relates to non-motor experiences of daily living; a 23.8% change in part 2, which assesses motor experiences of daily living; a 28.5% change in part 3, a motor examination that included notable lessening in disturbances of posture, gait (walking) problems, and postural instability; and a 30.1% change in part 4, which also measured motor complications.

Trimetazidine discontinuation also lessened Parkinson’s disease severity in 16 patients (38.1%), including two whose motor symptoms completely disappeared. However, in these two cases, “discontinuation of antiparkinsonian medications resulted in the reemergence of Parkinsonian symptoms,” the researchers wrote.

They also noted an overall lessening of non-motor symptoms, especially sleep problems and depression. 

“The use of [trimetazidine] in patients with [Parkinson’s disease] and the negative impact of the drug on the severity of Parkinsonian symptoms seem to be clinically meaningful problems,” the researchers wrote.

Additionally, patients experienced better health-related quality of life, as measured using the 39-item Parkinson’s Disease Questionnaire, which assesses patient-reported health status and quality of life.

Stopping trimetazidine and using alternative antianginal treatment did not cause any cardiovascular events in these patients up to 12 months of follow-up.

“Our results provide clinical rationale for avoiding the use of [trimetazidine] in [Parkinson’s]. [Trimetazidine] seems to worsen the severity of Parkinsonian symptoms in a clinically meaningful manner and have a negative impact on the [health-related quality of life],” the team wrote. 

“Therefore, discontinuation of the drug in patients with [Parkinson’s] seems to be a clinically adequate therapeutic intervention,” they concluded.

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Subtle Alterations in Postural Behavior May Help Diagnose Parkinson’s Earlier

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Postural behavior

People with Parkinson’s have postural adjustments even at early stages of the disease when clinical symptoms of postural instability are not evident and despite the use of antiparkinsonian medications, a recent study shows.

Researchers believe these findings suggest that postural behavior may be used as an early indicator to diagnose the disease.

The study, “Postural Behavior in Medicated Parkinson Disease Patients: A Preliminary Study Searching for Indicators to Track Progress,” was published in the Journal of Central Nervous System Disease.

Parkinson’s disease usually is diagnosed based on the presence of classic  motor symptoms. But other signs of the disease are present sometimes years before motor symptoms are evident, though still insufficient to make a definite diagnosis.

Identifying patients in this earlier phase would ensure they receive treatment early, before their disease progresses to more advanced stages and significantly affects daily activities.

Generally, Parkinson’s patients with early disease are classified as not having postural instability. But modern technologies are more sensitive to subtle impairments in balance, and potentially may identify changes in postural behavior that take place even in earlier stages of disease.

To clarify the presence of postural changes in early Parkinson’s disease, and whether these changes can be used to diagnose the disease before motor symptoms are evident, researchers at the Western Michigan University and collaborators at the Federal University of Piauí, Brazil, investigated two groups of Parkinson’s patients, and compared them to a group of healthy controls.

Participants included nine patients with early disease — defined as a Hoehn and Yahr Stage rating scale up to 2, which means their balance was not yet affected — and nine patients with mid- to advanced disease (a Hoehn and Yahr Stage of 2.5 or higher, whose balance was already compromised).

These patients were all taking antiparkisonian medication, allowing researchers to account for the effects of medication on balance, which the team believes is a clear limitation of prior studies that lacked a standardization on this parameter. Controls included nine healthy subjects matched by age, who had no history of sensory, muscular, or neurological disorder.

Participants were asked to perform two simple postural tasks: stand quietly on a force platform with arms crossed, with eyes open or closed. Each task took 120 seconds. During that time, the platform collected information regarding participants’ center of pressure, including body sway trajectory (how the center of pressure moved), sway amplitude (how far in each direction it went), sway velocity (how fast it moved), and sway jerkiness (how shakier body sway was).

The team found that most measures were similar across patients and controls when they did the test with their eyes open. But Parkinson’s patients already showed greater sway velocity and jerkiness compared to controls in this task. Late-stage patients also had more overall sway movement and greater sway amplitude.

When the task was done with eyes closed, patients also had higher sway jerkiness — though sway was only laterally shakier — compared to controls, but not higher sway velocity. Those with advanced disease also had greater sway amplitude.

No significant differences were seen between groups of Parkinson’s patients in either task. Also, while controls and early-stage patients swayed more, faster, and shakier when they stood still with their eyes closed, no differences were seen in advanced patients with eyes open and closed.

The findings show that Parkinson’s patients have alterations in postural behavior starting in early stages of disease, and despite the use of dopaminergic medication. “This finding indicates that balance control is affected even before clinical signs surface,” the researchers wrote.

“Therefore, postural markers used in this study are [of] great importance to improve early diagnosis of postural instability in PD [Parkinson’s disease], record progress of balance control, and assess fall risk. They should also be implemented in clinical trials of pharmacotherapy and balance training protocols specific to populations diagnosed with PD,” they concluded.

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Going Through the Fires of Parkinson’s … and Blooming

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fires, silent symptoms, marriage, tasks, bucket lists, forgetfulness

In the same way a wildfire can take your breath away, so can a flower. Especially if it’s standing amid charred, blackened earth. Once there stood tall majestic black oaks, madrone, manzanita, and pine trees. Now there remains only ghostly profiles of those trees, their leaves and bark burned bare.

My husband and I were driving back to southern Oregon after visiting my in-laws in California. We passed through several areas where recent wildfires had claimed the rights to dry vegetation. Pine trees stood out like tall, black charcoal pencils, their tips pointed upward. 

As we drove through the wasteland, which seemed void of any life, I began to notice something. Small areas of yellow mixed with orange sat scattered on the hillside. Clumps of pretty flowers stood out demanding attention.

Upon returning home, I looked for information on the flower I saw. I didn’t find that one, but I did find information on another flower called the fire poppy. 

The fire poppy, considered by some to be the most vibrant of all wildflowers, emerges only after a wildfire. The seeds have been dormant in the ground, waiting for the right conditions to pop through scorched soil. The seeds can lie in wait for decades before fires prompt them to start the growing process. 

So, what are the growing conditions that cause these flowers to come alive? They are much the same as any other seeds, with one exception: they need the elements of a wildfire. 

It sounds crazy, but if you think about it, it’s not so crazy. Some of the most captivating things, like gold, must go through a purification/refining process by fire to stand out from the rest.

We who shuffle around day to day with Parkinson’s disease are being refined and purified. A wildfire has swept through our lives in the form of a diagnosis that left us jarred and shaken. We grieve that we may never grow again, dead to all we have ever known. 

Somewhere deep within the hallowed ground of our spirit, tiny seeds await. They are ready to sprout and push through the crusty, ashen earth. The wildfire has passed. The rains and the sunshine have come. New growth is busy beneath the soil, preparing to make an appearance.

My 5-year-old grandson loves to help me in my garden. He has planted many seeds with me. He gets so excited as he waits with great expectation of what will one day bloom and grow. 

It reminds me of the fire poppies. They don’t bloom until they have been through the fire. And when they do bloom, they will be beautiful and stand out. 

Just like you. 

You, who have been through the scorching of Parkinson’s fires. You, who have come through more beautiful than ever. 

Making beauty out of ashes. That’s what wildfires can do.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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Parkinson’s Patients Have Many More Opportunistic Microbes in Their GI Tract, Study Reveals

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opportunistic microbes

Scientists have discovered, for the first time, that patients with Parkinson’s disease have a much greater number of opportunistic disease-causing microbes living in their gastrointestinal tract, compared to people without the disease.

Further studies are needed to determine if these opportunistic microorganisms may be involved directly in the onset and development of the disease, researchers noted.

The study, “Characterizing dysbiosis of gut microbiome in PD: evidence for overabundance of opportunistic pathogens,” was published in the Nature Partner Journal Parkinson’s Disease.

Although the specific causes of Parkinson’s are still not fully understood, it is believed the disease results from a combination of genetic and environmental factors.

In 2003, German researchers led by Professor Heiko Braak proposed that non-inherited forms of Parkinson’s actually develop first in the gut, driven by the presence of harmful microbes that then travel to the brain using the network of nerves that innervate the gastrointestinal (GI) tract, called the enteric nervous system.

“Although many aspects of Braak’s hypothesis have gained support in recent years, there is no direct evidence that a pathogen [disease-causing microbe] is involved,” researchers wrote.

However, researchers from the University of Alabama at Birmingham and colleagues now have found that individuals with Parkinson’s have a much higher number of opportunistic pathogens living in their GI tract, compared to people without the disease.

“The exciting question is whether these are Braak’s pathogens capable of triggering PD [Parkinson’s disease], or are they irrelevant to PD but able to penetrate the gut and grow, because the gut lining is compromised in PD,” Haydeh Payami, PhD, professor of neurology at the University of Alabama at Birmingham, said in a news story.

Normally, opportunistic microbes are harmless. However, under certain circumstances they may become dangerous and cause infections, particularly in those who have a compromised immune system, or a disorder that disrupts their gut lining.

Although previous studies reported a series of alterations in the composition of microorganisms found in the GI tract of patients with Parkinson’s, these opportunistic microbes have never been found before.

“We suspect the reason we were able to detect these microorganisms is that they are rare and we had a much larger sample size and power than prior studies,” Payami said.

Payami and her colleagues carried out the largest microbiome-wide association study — studies that aim to determine if certain microbes can be associated with a specific disorder — in patients with Parkinson’s to date.

Using advanced gene sequencing and bioinformatic tools, they analyzed data from two independent datasets: one containing data from 197 individuals with Parkinson’s and 130 individuals without the disease (controls); and another containing data from 323 Parkinson’s patients and 184 controls.

Consistent with previous studies, their analyses revealed that compared to controls, patients with Parkinson’s had much higher numbers of carbohydrate-metabolizing probiotic bacteria belonging to the Lactobacillus and Bifidobacteria genera in their GI tract.

Conversely, and also in agreement with previous studies, patients had lower numbers of microbes that produce short-chain fatty acids, including several belonging to the Ruminococcaceae and Lachnospiraceae families.

Analyses also showed, for the first time, that patients with Parkinson’s had much higher levels of opportunistic microbes in their GI tract compared to controls, including those belonging to the Porphyromonas, Prevotella, and Corynebacterium genera.

Importantly, the 15 bacteria genera that were found to be associated with Parkinson’s disease were observed in both datasets. Alterations in gut bacteria composition seen in patients with Parkinson’s was found to be independent of sex, age, body mass index (BMI), level of GI discomfort, diet, and geographical region.

“In conclusion, we uncovered robust and reproducible signals, which reaffirm and generate leads for experimentation into cause and effect, disease progression, and therapeutic targets,” the researchers wrote.

“There is more to be learned with larger sample sizes with greater power, longitudinal studies to track change from prodromal [early] to advanced disease, and by next-generation metagenome sequencing to broaden the scope from bacteria and archaea to include viruses and fungi, and improve the resolution to strain and gene level,” they added.

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