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Parkinson's Disease & PINK1

Background: Parkinson's disease is a neurodegenerative disorder. (For more about this common and very important
neurological disease, please see the Parkinson's Disease article.) It is known that mutation of a gene on chromosome 1
causes a rare familial form of Parkinson's disease called PARK6.

Research: Mutation in another gene on chromosome 1 have been discovered to be associated with PARK6. The gene is
different from the PARK6 gene and is called PINK1. The PINK1 gene encodes a protein active in mitochondria, units in
the cell that convert food into energy. This remarkable discovery provides a direct molecular link between mitochondria
and the pathogenesis of PD.

Comment: "For many years, it has been suggested that there is a connection between Parkinson's disease and
mitochondrial dysfunction. We've never really understood what defects inside the mitochondria might lead to
dysfunction. Now this points to a protein, or set of proteins, that when altered can induce the disease. This is a
process that we didn't know existed, and it could be involved in the more common forms of Parkinson's disease." (Dr.
Robert Nussbaum, the National Human Genome Research Institute at NIH)

Comment: We have spent a fair amount of time mulling over this paper in the journal Science and think we now understand
it. Although the research may seem exotic, we have come to the conclusion that it may have important consequences for
Parkinson disease. It represents a new direction.

Barbara K. Hecht, Ph.D.
Frederick Hecht, M.D.
Medical Editors, MedicineNet.com

New Genetic Clue to Parkinson's Found

By Ed Edelson
HealthDay Reporter

THURSDAY, April 15 (HealthDayNews) -- Identification of a gene that causes a rare, inherited form of Parkinson's
disease could revolutionize research on the condition and other neurological disorders, researchers report.

"It is a completely novel and, to my mind, completely unexpected gene/protein to be involved in Parkinson's disease,"
said Dr. Nicholas W. Wood, a professor of clinical neurology and neurogenetics at the Institute of Neurology in London
and lead author of a report on the discovery in the April 16 issue of Science. "It opens the door to a whole new area
of Parkinson's disease, and perhaps other neurodegenerative disease research."

Parkinson's disease is a progressive disorder caused by degeneration of nerve cells in the part of the brain that
controls movement. First described as "the shaking palsy" in 1817, it affects an estimated 500,000 Americans, with
50,000 new cases reported each year. The most famous Parkinson's patient is Pope John Paul II.

The first symptoms of the condition generally occur at about age 60. The gene described by Wood and collaborators in
three European countries and the United States was identified in three families in which the disease appears much
earlier in life.

Close study found that members of those families all had a mutation of a gene designated PINK1, which makes a protein
active in mitochondria, cellular units that convert food into energy. A first guess is the normal version of the gene
protects mitochondria in brain cells against damage, but that is just a starting point, Wood said.

"We need to know more about what the protein does normally, as well as when it is mutated," he said. "This will involve
structural chemistry, biochemistry, cell and animal model systems."

Another question is the role the gene might play in the common form of the condition, Wood said.

"I do not think primary pathogenic mutations in this gene are likely to contribute to lots of common forms of
Parkinson's disease, but we will need to sequence a lot of individuals to be certain what proportion of cases are due
to mutations in this gene," he said.

The discovery has some potential applications to the detection and treatment of Parkinson's disease, Wood said.

"Initially, I think it will be most useful as a genetic test, to sequence at-risk individuals and counsel the
families," he said. "However, this new area does of course open the way for potential novel therapeutic targets."

It's an important finding because it helps confirm a suspicion about the role of mitochondrial malfunction in
Parkinson's and other neurological diseases, said Dr. Robert Nussbaum, chief of the genetic diseases research branch of
the National Human Genome Research Institute, a part of the National Institutes of Health. His group helped identify
one of the families in the study.

"For many years, it has been suggested that there is a connection between Parkinson's disease and mitochondrial
dysfunction," Nussbaum said. "We've never really understood what defects inside the mitochondria might lead to
dysfunction. Now this points to a protein, or set of proteins, that when altered can induce the disease. This is a
process that we didn't know existed, and it could be involved in the more common forms of Parkinson's disease."

SOURCES: Nicholas W. Wood, M.D., Ph.D, professor, clinical neurology and neurogenetics, Institute of Neurology, London;
Robert Nussbaum, M.D., chief, genetic diseases research branch, National Human Genome Research Institute, Bethesda,
Md.; April 16, 2004, Science

SOURCE: Daily Health and Medical News
http://www.medicinenet.com/script/main/art.asp?articlekey=32114

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