Transcript - Research achievements: hopes for a cure
Hopes for a cure - audio interview
Today's treatments can help manage most of the symptoms of
Parkinson's – but they cannot stop, slow down or reverse the
progression of the condition.
Research funded by the Parkinson's Disease Society [now
Parkinson's UK] has pioneered 2 of the most promising prospects for
a cure – cell transplants and gene therapy.
Consultant Neurologist, Dr Roger Barker, explains how
cutting edge research is pushing forward our understanding of the
disease and bringing us closer to finding a cure.
Dr Roger Barker:
The Parkinson's Disease Society has been funding research for 40
years and I think there's no doubt that over the last 40 years
we've moved forward massively from where we were in the late 1960s.
Then drugs for Parkinson's disease had only just started being used
in the clinic, whereas now no-one would think twice about the fact
that there a whole array of drugs that they can take for their
condition.
The treatment for Parkinson's disease is relatively good but the
problem is that we don't have anything that which can slow down or
stop the disease in its tracks. So while we can help people with
the symptoms, especially in the early stages, as the condition
progresses sadly those treatments become less effective and there
are problems that arise with them.
So ultimately, ten to fifteen years down the line it becomes
more difficult to get the control we would like with these
patients. And all of these drugs are designed to help control
symptoms, they are not able to tackle the disease itself. That is
the real challenge for Parkinson's - getting to the core of what's
wrong so that we can undo it and stop the disease.
Transplantation of cells into the brain of people with
Parkinson's as a way of trying to treat it has been going on for
almost 25 years now. I think what one can say in general is that
when it works it works very well but it doesn't work very
consistently. So that's the big challenge. How can we select
patients that are going to do well, how can we put the cells into
the brain in a more consistent fashion, so that we can get better,
more robust results.
Upstairs in the brain repair centre we have various different
laboratories, so we're just outside the cell biology lab which
where we grow the cells including some of the stem cells. And on
our left is where we grow the human embryonic stem cells, and on
our right is where we grow the more conventional types of
cells…
Stem cells are cells which have the capacity to divide. So from
a limited source of cells you can actually derive large numbers.
There are many different types of stem cell, each of which brings
its own merits and disadvantages.
The great advantage with stem cells is not only do you have a
ready source of tissue but you have the capacity to manipulate them
and derive from them a much more homogeneous population of cells.
By that I mean a population of cells that look much more like each
other, unlike the foetal tissue where we just have to take what we
can find.
If we can derive relatively homogeneous groups of cells which we
need, namely dopamine cells in the first instance, then I think
we've got much more chance of making a real impact on Parkinson's
disease. We could then transplant more patients because we'd have
more tissue, we would also know much more accurately what we'd be
putting in to those patients.
Another approach to treating Parkinson's has been the use of
gene therapy. The way that has been structured is to try and use
genes designed either to help dopamine nerve cells grow more
effectively or actually to change the abnormal circuits within the
brain. So there have been a number of trials which have tried to do
this in patients with mixed results.
The overall strategy is sound, I think the problem at the moment
is that we're not quite sure what is the best gene therapy. Will it
be to deliver growth factors, or to change brain circuitry, or to
make dopamine more effectively in the brain? And which patients
will it work for most effectively?
I would say that gene therapy has a great future but at the
moment its very much in its early days. I think negative results
shouldn't be viewed with a great deal of pessimism but actually as
a sort of natural expectation when a therapy is so early in its
development.
The driving factor for my own research is the hope that I can
help people that I see in the clinic every day of the week. Seeing
people struggle with their condition is very upsetting as a medical
practitioner. Whilst we can clearly make major impacts with drugs,
it would be lovely to be able to offer people something that's
actually going to change the future for them and their
condition.
The Parkinson's Disease Society funds research that is
focused on transforming people's lives. So far we've invested more
than £40million in cutting edge research since the charity was
founded in 1969.
This research has led to major advances but we still
need to find a cure for Parkinson's - better treatments that mean
everyone can live a life free from the symptoms of the
condition.
The Parkinson's Disease Society is a charity which
relies on the generosity of individuals, groups and organisations
to fund its work. To find out more about how you can get involved
please visit us at:
www.parkinsons.org.uk/support
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