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Immune Cells Implicated In Parkinson's Disease

Medical News today - Scientists in France and the US discovered that a type 
of immune system cell may facilitate the development of Parkinson's Disease 
and that targetting part of the immune system with drugs could be a new way 
to treat the disease.

The study, which is published in the Journal of Clinical Investigation was 
the work of lead author Vanessa Brochard of the Experimental Neurology and 
Therapeutics department at the INSERM medical research institute at the 
Hôpital de la Salpêtrière, Paris, France, and colleagues from other research 
centres in France and the US. Brochard also works at the Université Pierre 
et Marie Curie in Paris.

Parkinson's disease is a neurodegenerative disorder that affects the motor 
system. Symptoms include tremor, slowed movements, rigidity and impaired 
balance and coordination caused by a reduction in dopamine producing cells 
in the brain.

Scientists already knew that Parkinson's disease was accompanied by changes 
to dopamine and non-dopamine brain cells and their signalling pathways, plus 
inflammatory changes to microglia (innate immune cells in the central 
nervous system), and infiltration of T lymphocytes (cells of the adaptive 
immune system) into the brain. However, until this study, it was assumed 
that some of these changes (the microglial and T cell infiltration) were the 
result of injury rather influencers of primary events.

This study suggests otherwise and provides compelling evidence that "both 
activated microglia and T lymphocytes make a significant contribution to 
neurodegeneration", wrote Stanley H. Appel of Department of Neurology, 
Methodist Neurological Institute, Houston, Texas, USA, in an accompanying 
commentary. Even if these events are not the primary cause of Parkinson's 
Disease, at the very least they worsen the inflammatory process and help 
extensive damage to develop from a small population of stressed dopamine 
cells, said Appel.

In their study, Brochard and colleagues used postmortem evidence of human 
patients to show that CD8+ and CD4+ T cells but not B cells had invaded 
their brains. They then used mice that had been given a neurotoxin to induce 
symptoms of Parkinson's (the MPTP mouse model) to show that it was almost 
exclusively the CD4+ T cells that arbitrated the accelerated death of 
dopamine cells but this only happened when the FasL cell death triggering 
protein was expressed and not when the Ifn-? inflammation cytokine was 
expressed.

The study gives further evidence that the immune system can both protect and 
attack the brain. Although the study opens the door to developing new 
treatments for Parkinson's Disease that target the immune system, there is 
still a lot of work to be done. Much of the evidence relies on what happens 
in mice, which does not necessarily translate to humans, and it is by no 
means clear at which stage of inflammation development intervention should 
occur. Another important step will be to identify which of the 
subpopulations of CD4+ T cells in the human immune system are responsible 
for killing dopamine cells and which protect them.

As Appel explained, Brochard and colleagues went some way toward this by 
showing that the immune system T helper cells Th1 and Th17 may be useful 
targets for minimizing hostile environments for brain cells, either by 
targetting them directly, or by suppressing some of the signalling pathways 
that control them.

"Infiltration of CD4+ lymphocytes into the brain contributes to 
neurodegeneration in a mouse model of Parkinson disease."

Vanessa Brochard, Béhazine Combadière, Annick Prigent, Yasmina Laouar, Aline 
Perrin, Virginie Beray-Berthat, Olivia Bonduelle, Daniel Alvarez- Fischer, 
Jacques Callebert, Jean-Marie Launay, Charles Duyckaerts, Richard A. 
Flavell, Etienne C. Hirsch, Stéphane Hunot.
J. Clin. Invest. Published online December 22, 2008.
doi:10.1172/JCI36470

Rayilyn Brown
Director AZNPF
Arizona Chapter National Parkinson Foundation
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