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WEDNESDAY, Oct. 21 -- An unprecedented worldwide study has clinched the case 
that the gene behind Gaucher disease, a rare neurological disorder, is also 
involved in Parkinson's disease.
"For those of us who work with rare disorders, it is heartwarming to come up 
with insights that are applicable to more common disorders," said Dr. Ellen 
Sidransky, a senior investigator in the U.S. National Human Genome Research 
Institute, and leader of a study reported in the Oct. 22 issue of the New 
England Journal of Medicine.
Gaucher disease affects no more than one in 100,000 people in most populations, 
with an estimated 5,400 cases in the United States. As many as 3 million to 4 
million Americans are estimated to have Parkinson's disease.

Gaucher disease develops in people who have two defective copies of a gene 
designated GBA. It codes for production of an enzyme that breaks down 
glucocerebrosidase, a fatty substance normally found in the body. The faulty 
gene allows accumulation of the substance, which can harm the spleen, liver, 
lungs, bone marrow and even the brain.
Discovery that the two conditions have a common genetic element cannot be 
applied immediately to relieve the stiffness, trembling and other symptoms of 
Parkinson's disease, Sidransky said.
"We have to be cautious about jumping into clinical applications," she said. 
"This gene plays a more common role in Parkinson's than other genes, but it is 
not necessarily predictive of Parkinson's disease. It is a risk factor rather 
than a gene that predicts the disease."
"The work will teach us about the mechanisms of Parkinson's disease, and once 
we understand the mechanisms we can come up with therapies that can help 
patients with Parkinson's disease. And it could ultimately lead to better 
therapies that could help patients with Gaucher disease," Sidransky said.
Several smaller studies have suggested the genetic link between the two 
conditions, "but there have always been questions based on their size and 
controls," Sidransky said. "Once and for all, we have put together a large 
enough number so that no one will question the results."
The study she led involved 16 institutions around the world. A listing of the 
institutions and researchers filled a complete page on the journal in fine 
print.
Those researchers examined the frequency of GBA variants in 5,691 people with 
Parkinson's disease, including 780 Ashkenazi Jews, an ethnic group in which 
Gaucher disease is more common. Their data was matched with genetic 
information from 4,898 disease-free individuals, including 387 Ashkenazi Jews.
At least one of two common GBA variants was found in 3.2 percent of the people 
with Parkinson's disease, but only 0.6 percent of the disease-free 
individuals. Among the Ashkenazi participants, 15.3 percent of those with 
Parkinson's disease carried a GBA variant, compared to 3.4 percent of disease-
free Ashkenazi individuals.
In addition to increasing the risk of Parkinson's disease, presence of a GBA 
variant was associated with early onset of the condition, four to five years 
sooner than ordinarily seen, the study found.
"Its importance is that it may indicate a new pathway to explore for the 
etiology [cause] of Parkinson's disease, and ultimately a target for drug 
discovery," said Dr. Karen Marder, a professor of neurology at Columbia 
University Medical Center, and one of the researchers in the trial.
The discovery raises some possible issues about genetic counseling, Marder 
said, but more work must be done before that can influence medical practice.
"This is among the most important susceptibility factors for Parkinson's that 
has ever been discovered, but it is premature to talk about using it in 
clinical practice," she said.
More information
Symptoms and treatment of Parkinson's disease are described by the U.S. 
National Institute of Neurological Disorders and Stroke.

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