Research carried out at Oxford’s Nuffield Department of Clinical Neurosciences has led to the development of a new blood-based test to identify the pathology that triggers Parkinson’s disease before the main symptoms occur. This could allow clinicians to screen for those individuals at high risk of developing the disease and facilitate the timely introduction of precision therapies that are currently at clinical trial stage.
Parkinson’s disease starts more than ten years before patients come to the clinic with symptoms because their brain cells fail to handle a small protein called alpha-synuclein. This leads to the formation of abnormal clumps of alpha-synuclein which damage vulnerable nerve cells, causing the familiar movement disorder and often dementia. By the time people are diagnosed with Parkinson’s disease, most of these vulnerable nerve cells have already died and alpha-synuclein clumps have formed in many brain regions.
It would be useful if there was a way to predict whether the pathways that handle alpha-synuclein are impaired before the onset of Parkinson’s symptoms. This could help clinicians to identify people most likely to benefit from disease-modifying therapies when they become available.
In the paper, “Neuronally Derived Extracellular Vesicle α-Synuclein as a Serum Biomarker for Individuals at Risk of Developing Parkinson Disease” in JAMA Neurology, Shijun Yan and colleagues in the Tofaris lab revealed the promise of measuring a subtype of extracellular vesicles to identify changes in alpha-synuclein in people who are likely to develop Parkinson’s disease. Extracellular vesicles are nanoparticles that are released by all cell types and circulate in biofluids including blood, transporting molecular signals between cells.
Using an improved antibody-based assay developed by the research group, the test involves isolating those extracellular vesicles originating from nerve cells from blood, and then measuring their alpha-synuclein content. Professor George Tofaris explains, “A robust assay is crucial because neuronally-derived extracellular vesicles constitute less than 10% of all circulating vesicles, and ~99% of alpha-synuclein in blood is released from peripheral cells, mostly red blood cells.”
In the first study of its kind, the team looked at 365 at-risk individuals from four clinical cohorts (Oxford Discovery, Marburg, Cologne and the US-based Parkinson’s Progression Markers Initiative), 282 healthy controls and 71 people with genetic or sporadic Parkinson’s disease.
They found that those with the highest risk of developing Parkinson’s (more than 80% probability based on research criteria) had a two-fold increase in alpha-synuclein levels in neuronal extracellular vesicles and the test could accurately differentiate them from those with low risk (less than 5% probability) or healthy controls. Overall, the test could distinguish an individual with high risk of developing Parkinson’s from a healthy control with 90% probability.
These findings indicate that the blood test, together with a limited clinical assessment, could be used to screen and identify people who are at high risk of getting the disease. In further analysis, the test could also identify those who had evidence of neurodegeneration detected by imaging, or pathology detected by a spinal fluid assay, but had not yet developed a movement disorder or dementia.
In a small subgroup of 40 people who went on to develop Parkinson’s and related dementia, the blood test was positive in more than 80% of cases up to as much as seven years before the diagnosis.
In this group, there was a trend for higher levels of alpha-synuclein in neuronal extracellular vesicles in the blood to be associated with lower alpha-synuclein in the spinal fluid, and a longer interval before the onset of the main symptoms of Parkinson’s disease. This suggests that the nerve cells may protect themselves by packaging excess alpha-synuclein in extracellular vesicles which are then released in the blood.
The research builds on earlier findings by the Tofaris lab, also confirmed in the current study, showing that the biomarker is increased in patients with Parkinson’s disease but not in other Parkinson’s-like conditions.
The Tofaris lab, which is part of the Nuffield Department of Clinical Neurosciences and based in the Kavli Institute for Nanoscience Discovery, previously delineated the pathway which targets alpha-synuclein for destruction inside nerve cells. This pathway may also direct alpha-synuclein outside cells in extracellular vesicles, when intracellular protein turnover is inefficient in conditions such as aging and Parkinson’s disease.
Professor Tofaris said, “Collectively our studies demonstrate how fundamental investigations in alpha-synuclein biology can be translated into a biomarker for clinical application, in this case for the identification and stratification of Parkinson’s risk. A screening test that could be implemented at scale to identify the disease process early is imperative for the eventual instigation of targeted therapies as is currently done with screening programs for common types of cancer.”
More information: Shijun Yan et al, Neuronally Derived Extracellular Vesicle α-Synuclein as a Serum Biomarker for Individuals at Risk of Developing Parkinson Disease, JAMA Neurology (2023). DOI: 10.1001/jamaneurol.2023.4398
News
Scientists Have Uncovered Previously Hidden Microbial Activity on Human Skin
The most abundant microbes on your skin may not be the ones doing most of the work. Human skin supports vast communities of bacteria, fungi, and viruses that can influence its protective barrier, immune [...]
Brazilian Tree Compounds Fight COVID-19 on Multiple Fronts
Scientists found compounds in a Brazilian tree that hit SARS-CoV-2 on multiple fronts, revealing a promising new lead in the search for COVID-19 treatments. Researchers have found that galloylquinic acids extracted from the leaves [...]
Cutting Two Amino Acids Slowed Prostate Cancer in Mice
A newly identified link between amino acid metabolism and cholesterol production may help prostate tumors adapt to hormone therapy. Prostate cancer can find ways around treatments designed to deprive tumors of the hormones they [...]
Largest-Ever Physics Survey Raises New Doubts About Our Model of the Universe
Physicists around the world remain deeply divided on key mysteries of the universe, from dark matter to quantum gravity. The standard cosmological model failed to gain majority support, and no leading theory dominated the [...]
Scientists Just Overturned a 100-Year-Old Belief About Bacteria in the Lungs
New findings raise questions about the role of microbes living in the lungs. More than 35 trillion bacteria live throughout the human body, forming microbiomes in the gut, mouth, lungs, skin, and urogenital tract. [...]
GHCE Concept
From the preface of the book Global Health Care Equivalency in the Age of Nanotechnology, Nanomedicine and Artificial Intelligence, Edited by Frank Boehm: Since the publication of my first book (Nanomedical Device and Systems [...]
Novartis, Ionis drug failure spurs questions
Pelacarsen didn’t protect heart health despite lowering levels of a protein particle, “Lp(a),” in a large clinical trial — a result with important implications for cardiovascular drug research. Dive Brief: An RNA drug from [...]
New injectable treatment helps the brain rebuild after stroke
Biomedical engineers at Duke University have created an injectable biomaterial that may help the brain recover from damage left behind by an ischemic stroke. In experiments with mice, the material transformed the cavity created [...]
Scientists Discover a Hidden “Immune Organ” Inside the Skull
Researchers discovered lymph node-like immune hubs inside skull bone marrow that appear to act as rapid-response centers for the brain. For decades, the brain was thought to operate largely apart from the immune system. [...]
Engineered tRNAs and lipid nanoparticles target nonsense mutation cystic fibrosis
Researchers have developed a potential new approach for treating a form of cystic fibrosis caused by so-called nonsense mutations, combining chemically modified transfer RNAs with lipid nanoparticles designed to deliver the therapy directly to [...]
New pancreatic cancer drug carries a $39,800 monthly list price
A groundbreaking treatment for one of the most common forms of pancreatic cancer has been approved in pill form by the FDA. Revolution Medicines’ oral tablet daraxonrasib, branded as Rasonque, reduced the risk of [...]
Researchers Have Discovered a New Way To Reduce Chronic Nerve Pain
A cancer-linked protein called BRAF may help drive chronic nerve pain, and existing cancer drugs targeting it reduced pain sensitivity in preclinical models. Chronic nerve pain can persist long after an injury and often [...]
Our books now available worldwide!
Online Sellers other than Amazon, Routledge, and IOPP Indigo Global Health Care Equivalency in the Age of Nanotechnology, Nanomedicine and Artifcial Intelligence Global Health Care Equivalency In The Age Of Nanotechnology, Nanomedicine And Artificial [...]
Quantum-Enabled Regenerative Health: Reimagining Wellness, Precision Health and Longevity Medicine
Introduction Healthcare is approaching a frontier where the quantum portfolio could influence not only how disease is diagnosed and treated, but how health itself is measured, modeled, predicted and preserved. Quantum computing, quantum simulation, [...]
FDA Clears First-of-Its-Kind Nonmedication Treatment for PTSD
The FDA has cleared a system that uses brain activity data to personalize magnetic stimulation for PTSD, adding a new nonmedication treatment option. Every day in the United States, approximately 17.5 veterans die by suicide, [...]
FDA approves breakthrough drug to treat advanced pancreatic cancer
The Food and Drug Administration (FDA) approved on Wednesday a drug that could extend the survival of those with metastatic pancreatic cancer. The drug, called daraxonrasib, will be sold under the brand name Rasonque [...]
