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Gene Therapy For Parkinson's Hitches Ride On Virus
Science Daily - A new clinical trial at Oregon Health & Science University
is examining whether therapeutic genes that hitch a ride with a harmless
virus attracted to nerve cells can reduce Parkinson's disease symptoms.

The year-long trial at OHSU and nine other sites around the country involves
pairing an inactive virus known as AAV2 with a gene that causes nerve cells
to produce neurturin, a protein that may improve the function of
dopamine-producing cells and protect them against damage.
Parkinson's disease is caused by a deficiency of nerve cells that produce
dopamine and is associated with such symptoms as tremor, muscular stiffness
and slowness of movement.
Previous studies have shown that laboratory animals given the gene produce
neurturin for at least a year, with no decline in expression, said lead
investigator John "Jay" Nutt, M.D., professor of neurology in the OHSU
School of Medicine and director of the OHSU Parkinson Center of Oregon.
"It looks like it's permanent once you get it in there," he said. "We think
the neurturin will coax (nerve cells) back into full functioning."
AAV2-NTN is considered harmless in humans because genes that allow it to
replicate have been removed. "This is a virus that's not known to cause any
human diseases," Nutt explained. "It's a virus that almost exclusively goes
into neurons, so it targets neurons."
The study drug containing the gene-virus duo, or "gene transfer agent," is
called CERE-120. It was developed and is manufactured by San Diego-based
Ceregene Inc., which also is funding the multicenter trial.
The drug is administered during a surgical procedure in which injections are
made directly into the putamen, the part of the brain where dopamine nerve
terminals are deteriorating because of Parkinson's disease. Eight injections
are made - four on each side of the brain - at different elevations to
assure all of the putamen is covered with the agent.
Fifty-one people are being recruited for the study, including four to eight
participants at OHSU. They will be assigned to one of two groups: One that
receives treatment with the study drug; and one that will have a surgical
procedure meant to simulate that used to give the study drug, but without
the drug.
Two-thirds of the study group will receive the study drug. If results
confirm the continued safety and effectiveness of the study drug following
the conclusion of the trial, another study will be opened to allow subjects
who received the placebo surgery to be treated with CERE-120. Participation
will be made available to all subjects deemed suitable for the surgical
procedure by the participant's doctor.
Nutt cautioned that CERE-120 isn't a miracle drug that restores nerve cells
destroyed by Parkinson's disease.
"This is not going to be something where (participants) wake up after the
operation and say, 'Thanks, doc. I needed that,'" he said. "What we think
it's going to do is restore the function of dopamine neurons that have been
injured by the disease, but not killed. So if the cell has been destroyed
and reabsorbed into the body, it's gone and there's nothing we can do."
Functional restoration could mean less severe symptoms when patients are off
their standard Parkinson's disease medications.
"We're looking to see what Parkinson's disease looks like when they've been
without their medications overnight," Nutt said. "We'll be clinically
evaluating the signs of Parkinson's disease symptom changes, if there are
any at all, and how the quality of life has improved."
The trial also is a test of whether therapeutic genes can be delivered into
the nervous system, made to function and beneficial against neurological
disease.
"If this fails, there are two questions: Did the gene really take, or have
we not selected the right gene?" Nutt said. "Maybe we didn't select the
optimal gene to affect Parkinson's disease."
Participation in the study is expected to take about 13 months, involving a
one-month eligibility evaluation period and 12 months of follow-up visits.
For more information about the CERE-120 study, call 503 494-7231.
Note: This story has been adapted from a news release issued by Oregon
Health & Science University.

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Rayilyn Brown
Board Member AZNPF
Arizona Chapter National Parkinson's Foundation
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