A new way to treat Parkinson's disease may be through your nose

Oct 22, 2015, 6:42am EDT

Senior author Dr. Benjamin S. Bleier, of the department of otolaryngology at Mass. Eye…

The findings, published in Neurosurgery, have created a buzz among scientists and researchers who have struggled to deliver necessary drugs to the brain for decades. The brain is equipped with what is known as the blood-brain barrier, a filtering mechanism of the capillaries that carries blood to the brain, but protects the brain from foreign substances.

Yet that protective mechanism creates a barrier for up to 98 percent of promising drugs that could be used to treat neurological conditions and other problems in the central nervous system.

Boston scientists have found a way around the issue through a technique known as nasal mucosal grafting.

“We are developing a platform that may eventually be used to deliver a variety of drugs to the brain,” said senior author Dr. Benjamin Bleier, of the department of otolaryngology at Mass. Eye and Ear and Harvard Medical School, in a release. “Although we are currently looking at neurodegenerative disease, there is potential for the technology to be expanded to psychiatric diseases, chronic pain, seizure disorders and many other conditions affecting the brain and nervous system down the road.”

In research funded by The Michael J. Fox Foundation for Parkinson’s Research, researchers have discovered that they can remove some layers of the blood-brain barrier through endoscopic skull base surgery, a minimally invasive procedure that involves small incisions being made through natural body openings, such as the nose.

  

A nasal mucosal graft, used from nearby nasal lining, is then placed over the

opening to permanently rebuild the hole.

While this technique is normally used by ear, nose and throat specialists for other procedures involving endoscopic skull-based surgery, such as the removal of brain tumors, researchers discovered that the mucosa membrane is 1,000 times more permeable than the blood-brain barrier.

According to the local research team, surgeons can create a “screen door” of sorts that still protects the brain, but allows for drugs to pass into the brain and central nervous system. Using this technique, researchers were able to deliver a therapeutic protein — which has shown to delay and even reverse progression of Parkinson’s in pre-clinical models — into the brains of mice.

Behavioral and histological data showed that the method was just as effective as directly injecting the drug into the brain, minus the obvious trauma and high complication rates.

“Brain diseases are notoriously difficult to treat due to the natural protections the body builds against intrusion,” said Dr. Jamie Eberling, senior associate director of the Michael J. Fox Foundation research programs. “Dr. Bleier’s group has identified a potential avenue to pass that barrier, and we look forward to the next stage of research to further test its utility in people with Parkinson’s disease.”

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