DEAR PHARMACIST: Ways to help with Parkinson’s and diabetes

• SUZY COHEN For the Herald & Review

• DECEMBER 14, 2016

When you think of Parkinson’s disease, you probably think of it as a progressive disorder affecting movement and causing tremors of the hands, arms, legs, jaw and elsewhere.  The condition causes movements to be slowed, and a sensation of rigidity and stiffness of the limbs and trunk. Balance can be impacted, too. A related condition of Lewy Body Disease may look very similar to Parkinson’s but doesn’t have to show up with tremors. The cognitive fluctuations are hallmark to both disorders. 

The one thing they have in common is the issue with dopamine. There’s some kind of malfunction associated with either the production of dopamine or the transport of this ‘passion hormone’ across the synapse… or maybe suppressed ‘receptor sensitivity’ meaning the dopamine is there but it doesn’t get hugged into the cell. This is known as post-synaptic D2 receptor down-regulation. It can happen to people who do not have Parkinson’s, for example, those afflicted by withdrawal symptoms from hydrocodone, or kids who took methylphenidate. When SPECHT studies were conducted in children on ADHD stimulants, researchers concluded that their D2 (dopamine) receptors were destroyed. They had a maximum of 20 percent functional ability, and this was published in Neuropediatrics in 2003.

I want to keep my article simple today because what I have to tell you is rather exciting. It’s about a diabetes drug that’s in Phase 2 studies (MSDC-0160), it’s not named yet. The emerging research suggests its role in Parkinson’s could be even more profound. It’s not due to balancing blood sugar either, it’s because this diabetes agent improves mitochondrial function. Your mitochondria are the organelles that produce energy for you. They help you make ATP.  So this diabetes drug belongs to the category of “Mitochondrial Target of Thiazolidinediones” modulators or mTOT for short. The mTOT drugs make your body more sensitive to insulin. They are insulin sensitizers. 

Forget insulin for a minute. The novelty of mTOT drugs is really about energy.  If you can improve mitochondrial function in brain cells, you then restore the cells' ability to convert basic nutrients into energy. Consequently, the cells' ability to handle potentially harmful proteins is normalized, which leads to reduced inflammation and reduced death and dysfunction of the neurons. This may help Alzheimer’s, Parkinson’s disease, Lewy body dementia and other types of cognitive decline. When I worked in Florida nursing homes for 7 years, we saw a lot of this and we had very few tools to use. We had levodopa, a drug from the 70’s that’s still used today but ramping up dopamine isn’t the cure. Side effects are disturbing. 

http://herald-review.com/lifestyles/health-med-fit/dear-pharmacist-ways-to-help-with-parkinson-s-and-diabetes/article_53da5da0-7efc-55fe-9108-a900b42ac8b3.html