Posted by Agnivo Niyogi
11th April was World Parkinson’s Disease Day. It is one of the many neuro-degenerative diseases that are the causes of mortality among many people. But does everyone know what is the disease? How is it caused and what are its remedies?
The mechanism by which the brain cells in Parkinson’s are lost may consist of an abnormal accumulation of the protein alpha-synuclein bound to ubiquitin in the damaged cells. The alpha-synuclein-ubiquitin complex cannot be directed to the proteasome. This protein accumulation forms proteinaceous cytoplasmic inclusions called Lewy bodies. (Ubiquitin is a protein that binds to proteins that are to be degraded in a cell. It is a step that might lead to apoptosis or programmed cell death.Proteasome is the “compartment” where this degradation happens). The latest research on pathogenesis of disease has shown that the death of dopaminergic neurons by alpha-synuclein is due to a defect in the machinery that transports proteins between two major cellular organelles — the endoplasmic reticulum (ER) and the Golgi apparatus. Certain proteins like Rab1 may reverse this defect caused by alpha-synuclein in animal models.
Parkinson’s disease is a chronic disorder that requires broad-based management including patient and family education, support group services, general wellness maintenance, physiotherapy, exercise, and nutrition. The disease cannot be reverted back to normal state but can be controlled.
The most widely used form of treatment is L-dopa in various forms. L-dopa is transformed into dopamine in the dopaminergic neurons by L-aromatic amino acid decarboxylase (often known by its former name dopa-decarboxylase). However, only 1-5% of L-DOPA enters the dopaminergic neurons. The remaining L-DOPA is often metabolised to dopamine elsewhere, causing a wide variety of side effects. Due to feedback inhibition, L-dopa results in a reduction in the endogenous formation of L-dopa, and so eventually becomes counterproductive.
Treating Parkinson’s disease with surgery was once a common practice, but after the discovery of levodopa, surgery was restricted to only a few cases.
Gene therapies are being investigated in laboratories around the world. Extensive research is on for pinpointing the genes which control the dopamine metabolism and its defects in the central nervous system. And strategies are being worked on for providing a solution to this disease.
In conclusion i would just say that we need to educate people about these diseases and not run away from them. Patients suffering from any ailment need love and compassion. And empathy. Let us give them at least that much to begin with…..if not anything else!