How the Targeting of Enzymes in Immune System can delay in Parkinsons’ Progression

Parkinson’s Disease (PD) is a long-term and age-related neurodegenerative disorder. Approximately 10 million people have PD worldwide. PD affects the central nervous system as the nerve cells in the brain don’t produce enough of dopamine. This causes impairment of the body’s motor functions. People with PD normally have symptoms that begin gradually, mostly on one side of the body. Subsequently, it affects both the sides.

PD usually arises in people above 60 years of age. It is chronic and progressive. Parkinson’s disease Pathogenesis shows that various environmental causes along with genetic risk factors contribute to its occurrence. Yet the exact causes are being investigated.

Parkinson’s Disease symptoms include - 

• Tremors in  hands, arms, legs, jaws and face
• Stiffness and rigidity  of the arms, legs and trunk
• Slowness of movement
• Poor balance and coordination

As symptoms worsen, PD patients may face trouble in walking, talking and even executing simple tasks. They may also experience other health issues like depression, sleep problems or difficulties in chewing, swallowing or speaking. Though PD has no permanent cure, a lot of research is going on slowing its progression.

Delaying Parkinson’s Progression by Targeting Enzymes in Immune System

Recent studies reveal that autoimmunity may have a role in the progression of PD. There is an enzyme called HDAC2 that is found in the immune cells of the brain. This enzyme regulates a crucial cellular mechanism known as epigenetics which controls the availability of certain genes. These genes are either read and translated into active proteins or silenced and hence made unavailable. According to the latest research, inhibiting the activity of this enzyme may prevent degeneration and death of nerve cells as seen in PD cases.

HDAC2 plays a key role in acting as potential therapeutic targets for several neurodegenerative diseases including PD. It is found that samples of microglia (immune cells) and dopamine-producing nerve cells in brain tissues collected from PD patients have high levels of HDAC2. This is in comparison to the corresponding levels in similar samples of healthy people.

It is interesting to note that HDAC2 levels correlated with the amount of LN3 (a marker of microglia activity) in PD samples. This is suggestive that HDAC2 may be linked to the greater pro-inflammatory and abnormal activity of microglia, when transitioning from protective brain cells to ones that attack and thereby damage healthy nerve cells.

Experimental cells replicating microglia behaviour also show increased levels of HDAC2 when pushed to a pro-inflammatory state. For quite some time now, it has been known that within pro-inflammatory environments microglia are responsible for the constant regulation and release of neurotoxin cytokines. Such environments are found in the substantia nigra in PD cases.

Thus the research findings support that HDAC2 may be specifically targeted and inhibited for reducing the effects of genes which cause neuroinflammation. Specifically, targeting HDAC2 gene expression levels in substantia nigra’s microglia can assist in reducing the progression of PD.

Latest medical innovations and evolving knowledge suggest various interventions and rehabilitation techniques for PD. This gives a new ray of new hope to patients living with this progressive neurological disease along with their families. PD is a complex disease that affects each individual differently. So PSP can help in deploying customized strategies and techniques applicable in daily life for coping up with PD limitations. PSP involves a comprehensive approach to the patient’s medical, functional and behavioural needs. This includes nursing care, nutritional counselling, rehabilitation techniques, speech and occupational therapies and fall -prevention measures.

PSP’s focus thus promotes independence and safety of PD patients for leading a better quality of life with lesser constraints.

Types of Exercises that should be a Part of a Parkinson's Patient's Life

Exercise, undeniably, plays a pivotal role in the life of those individuals who are affected by Parkinson's disease. It is not only good for their health, but also an essential factor that helps them to maintain body balance and enhance their mobility as Parkinson's is a Neurodegenerative disorder that causes severe mobility issues. 

According to a recent research conducted on Parkinson's disease revealed that daily exercise will help the individuals in mitigating the symptoms of Parkinson's disease at a greater level. Daily exercises reduce the stiffness and improve the mobility, posture and balance.  Here are few of the exercises that benefit the people with Parkinson's disease.

1. Exercises that Focus on Body Balance:
   Losing control over the limbs is one of the major issues Parkinson’s disease patients face. Simple exercises such as walking and stepping over minor obstacles help people in reducing the stiffness of their muscles and limbs. Few physical activities that involve in our regular life, such as climbing staircases will also help.
   
   
2. Strengthening Exercises:
   Strengthening Exercises, also known as 'Resistance exercise', help the individual to improve their muscle mass and rate of metabolism. Include physical activities such as squats, planks (only if your body supports) and jumping jacks on your exercise calendar.
   
   
3. Endurance Exercise:
   Endurance exercises such as jogging, cycling and swimming can benefit at a great level if practiced on a regular basis. These exercises improve the breathing pattern and cardiovascular functionality which indirectly helps in better oxygen reach to the brain.
   
   
4. Flexibility Exercises:
   Flexibility issues in Parkinson’s patients make the day to day life challenging. The elders will find it difficult even to perform simple physical activities such as sitting on or getting up from a chair, with Parkinson’s disease. Practicing yoga and tai chi every day will help in enhancing the body and limb flexibility.

Apart from these exercises, focus on physical activities such as dancing, aerobics and Jazzercise will help you in deriving the results in a faster way. Also, consider joining in yoga and meditation centers as mental Peace is as important as the regular exercises. Defensive arts such as Karate and Kung Fu will not only help you to improve your physical ability, but also motivates you to fight the Parkinson’s disease.

This is the very reason why few Parkinson's Support Agencies in the western countries encourage their patients to practice defensive art such as boxing and taekwondo with an objective to maintain the physical ability that is empowered with strong positive attitude.

Consistency is the key to derive the best results through these exercises. If performed on a regular basis, these exercises will start showing the results only after 3-6 months. Parkinson’s is tough and the only way to manage it effectively is by being tough on it.

The Impact of Parkinson's Disease on Elderly

Parkinson’s disease is a neurodegenerative disorder by which people of various age groups are found to be affected today. The disease is common across both eastern as well as western countries.

But how exactly does the disease affect you? Well, it mainly affects the way you move. Our body movement is basically controlled by a chemical called dopamine that is secreted by the nerve cells. Thanks to dopamine, you can move smoothly, just the way you want to. In case of Parkinson’s disease the nerve cells break down and as a result they stop secreting dopamine. Naturally, you cannot move the way you wish to. The symptoms worsen with time and you are likely to face more difficulties with the passage of time.

Parkinson’s disease and Dementia are somewhat related. About 50-80% of people suffering from Parkinson’s disease are found to develop dementia too. It is featured by lack of proper thinking and reasoning. As a result, people may suffer from problems in memory, judgement and lack of concentration. They might also face difficulties in vision and speech or may go through problems of hallucination, depression and anxiety.  They may also get irritated at the slightest of instances.

The symptoms, however, take time to develop and early detection of the disease can help you to treat it and get cured as seen in most of the cases. The main symptoms of the disease include tremor and stiffness in the legs. However, by the time these symptoms develop, you are already 40-50% affected by the disease. So let us get acquainted with the early sign of PD so that it can be detected and diagnosed at an early stage.

Inability to Sleep: This is one of the early symptoms of Parkinson’s disease which doctors often fail to detect. PD patients often suffer from RBD or Rapid Eye Movement Disorder in the initial stage where they tend to act out their dreams. This even includes attacking their partners in certain instances and showing violent behaviour.

Dysfunction of Facial Muscles: Stoppage of Dopamine synthesis affects the facial muscles and this, in turn, results in lack of expression. This may render the person emotionless to the eyes of another. The extreme form of this condition is known as ‘Parkinson’s Mask’. Frequent blinking of eyes and delay in smiling or frowning are also found in certain cases.

Inability to Smell: Sense of smell is also impaired to a great extent during the early stage of Parkinson’s Disease. The patients are often found to be incapable of recognizing the smell of perfumes and other similar stuffs.

Problem in Urinating and Bowel Movement: PD patients may also be found to face problems in urinating and constipation problems. Gastric trouble is also observed in certain cases. This is because the nerve cells signalling the muscles of bladder and those related to bowel movement die out due to the disease.

Pain in the Neck: During the early stage of PD patients are also observed to have pain in their neck. Stiffness, tingling sensation and discomfort may also be there.

Naturally, due to the above mentioned problems caused due to the dying out of nerve cells, the following side effects of Parkinson’s disease may be observed:

Drowsiness: People suffering from PD are likely to feel sleepy throughout the day as they do not have a good night’s sleep. During night, nightmares can make them restless and their sleep might be disturbed. RBD, as already discussed, may hamper their sleep.

Leakage of Urine: Due to improper functioning of the muscles near the urinary bladder, leakage of urine may be observed.

Apathy: Apathy or anxiety is also common and the patients have the tendency to get irritated or lose their calm at the slightest of instances. Their mood as well as personality changes and they cannot behave normally in changed situations and social withdrawals. They become depressed very easily and execution of important tasks might also be affected.

Cramped Handwriting: As a result of Dementia, the routine jobs of a person gradually become slower. The handwriting also becomes small and cramped than usual.

Excessive Sweating: Along with other parts of the body, the sweat glands also stop functioning properly and as a result there can be sweating as well as other skin problems. It may also lead to oily skin and oily scalp.

Reduced Arm Swing: As already discussed, muscles become stiff due to PD and arms cannot stretch across considerable distances, as a result. In other words, the arms do not go where the brain tells them to go.

Thus a Parkinson’s disease patient has to go through all of these or at least some of these problems. The disease affects them mentally as well as physically and hampers their day to day activities severely.