Are emerging treatments in Parkinson’s disease curative or just buying time?

Parkinson’s disease is a neurodegenerative disorder that varies in disease progression and severity, and currently affects roughly one in 500 people. The main cause of Parkinson’s disease is still unclear. However, both Lewy bodies (LB) and Lewy neurites (LN) have been discovered in brain areas, and contain the protein alpha synuclein (aSyn), an accumulation of which leads to protein misfolding. Aggregates of misfolded aSyn generate a proteinopathy that results in progressive neuronal loss. Levodopa, dopamine receptor agonists, monoamine oxidase inhibitors, and catechol-O-methyltransferase inhibitors remain the mainstay of symptomatic treatment; however, a curative option is yet to be discovered, necessitating a renaissance in Parkinson’s disease research. This niche, in the literature and market alike, led to the development of a Parkinson’s disease vaccine that aims to inhibit aSyn accumulation, ultimately inhibiting neurodegeneration. Hence, this agent is suspected to be a disease-modifying treatment. The vaccine successfully passed preclinical studies and animal testing, where vaccinated animals showed superior cognitive functions compared to unvaccinated controls when assessed in the Morris water maze test. The vaccine then passed Phase I clinical trials assessing safety and tolerability (at doses of 15-75µg), and was found to elicit an immune response in 86% of patients. Further phase II trials were undertaken for multiple system atrophy (MSA), which exhibits a similar phenomenon of aSyn accumulation in oligodendrocytes. These recent findings continue to educate scientists with respect to Parkinson’s disease and the process of safe, effective vaccination, and suggest that active vaccination has potential therapeutic advantages for Parkinson’s disease.