>http://www.parkinsonsdisease.com/index.htm

>Latest progress in Parkinson's disease
>
>The latest data on foetal neurotransplants, new apomorphine delivery
>systems and new drugs in clinical
>and preclinical trials were reported at the 7th International Symposium on
>Parkinson's Disease in London on March 23rd-26th.
>
>Foetal neurotransplantation
>Academics from several institutions reported continuing success with
>transplanting human foetal neurones into the brains of Parkinson's
patients, >and discussed possible future directions of this approach.
>
>Around 200 patients have received such therapy. It is now well established
>that graft survival, re-innervation and
>dopamine production can be achieved. The clinical benefits, which take
>several months to become apparent,
>include improved fine motor functions and speech, and prolongation of the
>effects of levodopa, the current
>mainstay of treatment for Parkinson's. Patients also experience reduced
>rigidity and akinesias, levodopa-induced
>dyskinesias and "off time" (periods when patients experience sudden
>worsening of symptom control). These
>effects have lasted for more than seven years in some patients.
>
>Results have been variable, however, probably because of the differences in
>the patients' disease states and the
>surgical techniques used. Recovery is rarely complete, and there may be
>functional deterioration over time
>(despite long-term graft survival); this is thought to be due to disease
>progression counteracting the transplant's
>effects.
>
>Speakers discussed several ways to improve the technique. These included
>the use of neurotrophic factors to
>increase graft survival and outgrowth, and to increase the number of grafts
>and situate them in different parts of
>the brain.
>
>Dr C Olanow of Mount Sinai Medical Center, New York, is currently
>conducting a double-blind 36-patient
>Phase III trial of the procedure. Results will be available in 1999.
>
>Diacrin and Genzyme, which are conducting Phase I trials using neurones
>from pig embryos (Neurocell-PD),
>did not present any results at the conference.
>
>New apomorphine delivery systems
>Speakers discussed several new delivery systems for the dopamine agonist,
>apomorphine, currently used for
>patients taking levodopa who experience "wearing off" of symptom control
>between doses. (Britannia, for
>instance, launched Britaject, a prefilled multidose injector pen, in the UK
>last October.).
>
>Dr Richard Dewey from the University of Texas reported on the nasal
>delivery of apomorphine using an adapted
>metered-dose inhaler. He said apomorphine was the treatment of choice as a
>rescue agent for the sudden onset of
>"off time", but that patients may prefer nasal delivery to self-injection.
>Three of the nine subjects in this trial
>withdrew due to severe nasal congestion, but the researcher thought that
>only some patients would be susceptible
>to this side-effect.
>
>Dr Teus van Laar from Leiden University, the Netherlands, announced
>preliminary studies using Iomed's
>transdermal iontophoretic patch system to deliver apomorphine. The drug is
>pumped across the skin by a weak
>battery-generated electric current. In the 10-patient study, the patch was
>left on for one hour, and caused slight
>skin erythema. Dr van Laar concluded that apomorphine levels would reach
>clinical efficacy if the patch were
>used for longer, and that the level of skin irritation may determine the
>clinical usefulness of this technique.
>
>Amgen's GDNF
>Preliminary results from Amgen's 50-patient Phase I trial of glial-
>cell-derived neurotrophic factor (GDNF) are
>expected towards the end of this year or the beginning of 1998, the company
>reported. GDNF has been found to
>upregulate dopamine production and have a neuroprotective effect in animal
>studies. As GDNF cannot cross the
>blood-brain barrier, the company is using an access port developed by
>Medtronic, which allows once-monthly
>administration directly into the brain.
>
>Kyowa Hakko's adenosine antagonist
>The Japanese company, Kyowa Hakko, presented animal data on two adenosine
>A2a antagonists, KW-6002 and
>KF17837. Adenosine A2a receptors are localised to areas of the brain
>implicated in Parkinson's and are thought
>to be involved in motor symptoms and dyskinesias.
>
>The compounds reduced symptoms in several animal models of Parkinson's, and
>the company told Scrip that it
>plans Phase I trials with KW-6002. It also claimed that this compound has
>"much higher potency and selectivity"
>than Schering-Plough's adenosine A2a antagonist, Sch-58261, which is
>reported to be in preclinical studies for
>the treatment of neurological disorders.
>
>Source: Scrip. 9th April 1997
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