Parkinson’s Disease: The Golden Age Challenge
Cell Therapy and Parkinson’s Disease
Parkinson’s Disease (PD) is prevalent in almost all age groups and it is evident that males are more prone to Parkinson’s disease. It progresses and worsens with age, older age people have higher prevalence, affecting 1% of the population older than 60 years .
The following table shows meta-analysis of worldwide data for prevalence of Parkinson’s disease with age (all per 100,000 patients) .
|Sr. No.||Age group of participants (years)||No. Of PD patients
(all per 100,000 patients)
Table 1. Meta-analysis of worldwide data for PD prevalence with age
Several other factors like age, sex, dietary habits, infections, environmental toxins and trauma are causative agents known from etiological and pathological studies done in Parkinson’s disease. In addition brain entering neurotoxins, several genetic factors and inheritance are reported to cause Parkinson’s disease.
Treatment Options For Parkinson’s Disease
Parkinson’s disease therapy most likely depends upon the patient’s age, mental status and the disease severity. The disease grows in a progressive manner, so there are different stages and need which are required at Parkinson’s mild, moderate and severe conditions. Patients are generally medicated with a single drug at primary stage of disease but multiple medications are required with the progression of disease. The various categories of drugs useful in treatment of motor symptoms of Parkinson’s disease are Levodopa–peripheral dopa decarboxylase inhibitor (Levodopa-carbidopa, Levodopa-benserazide), Dopamine agonists (Pramipexole, Ropinirole, Rotigotine, monoamine oxidase type B inhibitors (Selegiline, Rasagiline), Catechol-O-Methyl transferase inhibitors (Entacapone, Tolcapone) .
Cell based products are also useful in Parkinson’s disease and have been developed, and gaining popularity over the last few years. Cell therapies for Parkinson’s disease are developed through the concept that Parkinson’s patient have loss of dopamine neurons in substantia nigra of brain and decrease of dopamine functioning (neurotransmitter), hence replacement or regeneration of lost dopamine neurons by transplantation should yield recovery of the associated motor symptoms .
What Is Parkinson’s Diseases
Parkinson’s disease (PD) is a chronic neurodegenerative disorder resulting mainly from progressive loss of dopamine containing neurons in substantia nigra of brain. Accumulation of proteins (lewy bodies and lewy neuritis) in survived dopaminergic neurons are also reported in Parkinson’s affected patients. Parkinson’s disease is predominantly distinguished by the motor and non motor dysfunctions. Motor dysfunctions are characterized by bradykinesia or slowness of movement, postural instability, rigidity, resting and patients suffer from tremor etc . Late onset motor symptoms are falls, freezing gait, difficulties in speech and swallowing. These symptoms are further associated with non motor symptoms like hyposmia, rapid eye movements, sleep behavior disorder, personality changes, pain, paresthesias and depression. The non-motor symptoms may even evidence before the motor symptoms. Urinary disturbances, orthostatic hypotension and neuropsychiatric disturbances (dementia, hallucinations and delirium) are the symptoms that are visible at the later years of the disease.
Motor disability may not be significant symptoms during the early stage of the disease, but if it is untreated it causes serious motor deterioration. Patient walks slow and need support for doing its daily activities. The condition gets worsened by the complications in motor symptoms through motor fluctuations, dyskinesias, gait imbalance, freezing of gait and postural instability which results in frequent fall and increased risk of fractures. In addition to this, patient has lot of difficulty in communication. Usually patients need assistance for daily living activities such as feeding, personal hygiene, dressing, turning in bed, rising from the sitting position and walking at the later stages of the Parkinson’s disease. Patients of old age are mostly affected by overt dementia .
To conclude Parkinson’s disease is neurodegenerative disorder resulting from progressive loss dopaminergic neurons in substantia nigra part of brain. Causative agents for PD include improper lifestyle and habit, environmental toxins, trauma and genetic factors.
Eating neuroprotective, maintaining healthy lifestyle, balanced nutrition, avoiding exposure to PD causing neurotoxins are the measure to be taken for prevention of PD. Drugs are useful to reduce symptoms noticeable in PD. Cell therapy has higher potential for successful treatment of PD if antigenic responses are less for patients. Evaluation study covering safety and functionality of human cell therapy based transplantion into the striatum and substantia nigra of patients with PD is under process.
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