Experimental Therapy Shows Preliminary Promise for Easing Parkinson's Disease
NEW YORK (AP) _ An experimental treatment for Parkinson's disease seemed to improve symptoms _ dramatically so, for one 59-year-old man _ without causing side effects in an early study of a dozen patients.
The gene therapy treatment involved
slipping billions of copies of a gene into the brain to calm overactive brain
circuitry.
The small study focused on testing
the safety of the procedure rather than its effectiveness, and experts
cautioned it's too soon to draw conclusions about how well it works. But they
called the results promising and said the approach merits further studies.
"We still have quite a bit more
testing to do," said Dr. Michael Kaplitt of
Kaplitt and collaborators report their
results in this week's issue of the British medical journal, The Lancet.
They're not alone in trying gene
therapy for Parkinson's. In April, another team told a medical meeting that its
experiments, which delivered a different kind of gene to a different part of
the brain, also appeared safe and gave a preliminary hint of benefit.
More than half a million Americans
have Parkinson's. They endure symptoms that include tremors, rigidity in their
limbs, slowness of movement and impaired balance and coordination. Eventually
they can become severely disabled.
Nathan Klein, a 59-year-old freelance
television producer in
Klein was the first patient to be
treated with Kaplitt's gene therapy procedure in
2003, and he said his symptoms gradually subsided afterward. Nowadays, he said,
apart from freezing now and then when he wants to walk, the symptoms are
basically gone.
"I'm elated," said Klein,
who continues to take his regular pills for the disease. "It's
unbelievable."
Kaplitt, who has a financial interest in Neurologix Inc., which paid for the research, noted that
the 12 patients in the study still have Parkinson's symptoms. The amount of medication
they were already taking for their symptoms didn't change significantly in the
year after the surgery.
Current medicines can control
symptoms, but can't stop the disease from getting worse over time, and they can
produce troublesome side effects like uncontrollable movement.
Some patients gain relief from a
surgical treatment called deep brain stimulation, in which electrodes are
placed in the brain and connected to a programmable stimulator.
Kaplitt's procedure was aimed at achieving
the same goal as that surgery, calming overactive circuitry in the brain. It
gets overactive because it loses the normal supply of a chemical called GABA.
The gene therapy was designed to make the brain produce more GABA.
For the gene therapy surgery, a tube
about the width of a hair was threaded through a hole about the size of a
quarter at the top of the skull. The tube delivered a dose of a virus
engineered to ferry copies of a gene into cells of a brain region called the subthalamic nucleus. The gene copies enable the cells to
pump out more GABA.
The Lancet paper reports that over a
year, patients showed no side effects from the procedure. What's more, they
showed improvements in an overall assessment of symptoms like tremors,
stiffness and walking problems.
The improvements were evident at a
checkup three months after the procedure and persisted to the end of the study,
one year after the surgery, researchers reported. By that time, the overall
amount of improvement from before surgery was about 24 percent when measured at
times that patients were off their normal medication,
and 27 percent at times when they were on medication.
Most of the effect appeared on just
one side of the body. Because of concerns about safety with the untested
procedure, the researchers treated only the brain circuitry controlling one
side of the body.
Dr. Karl Kieburtz
of the University of Rochester Medical Center, who
didn't participate in Kaplitt's work, said the lack
of any apparent side effects is itself significant.
But he urged caution in interpreting
the evidence of benefits in symptoms. Other experimental therapies that looked
good at such a preliminary stage have failed to pan out in more rigorous
studies, he said, so more research is needed.
Future studies could include a
head-to-head test against deep brain stimulation to see which relieves symptoms
better, said neurosurgeon Dr. Guy M. McKhann of the
Dr. J. Timothy Greenamyre
of the
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On the Net:
Lancet: www.thelancet.com
Information on Parkinson's disease:
www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm
Copyright
2007 The Associated Press.