A recent study from researchers at the Icahn School of Medicine at Mount Sinai provides new insights into a link between inflammatory bowel disease (IBD) and Parkinson's disease, and may have significant implications for the treatment and prevention of Parkinson's disease.
The recent study, published in JAMA Neurology, shows that individuals with IBD are at a 28% higher risk of developing Parkinson's disease than those without IBD. However, if they are treated with anti-Tumor Necrosis Factor alpha (anti-TNFα) therapy, a monoclonal antibody that is commonly used to control inflammation in IBD patients, then their risk of developing Parkinson's disease goes down significantly, and becomes even lower than that in the general population.
These new insights will allow for better screening of IBD patients for Parkinson's disease, given that IBD onset usually precedes that of Parkinson's disease by decades, and they also offer evidence to support exploring anti-TNFα therapy to prevent Parkinson's disease in at-risk individuals.
While previous research had shown genetic and functional connections between IBD and Parkinson's disease, clinical evidence linking the two has been scarce. The authors of the study previously identified a number of genetic variants that contributed to either an increased risk of both Parkinson's disease and of Crohn's disease, a type of IBD, or a decreased risk of both diseases, which prompted them to further study the co-occurrence of the two diseases.
"Systemic inflammation is a major component of IBD, and it's also thought to contribute to the neuronal inflammation found in Parkinson's disease," explained Inga Peter, Professor in the Department of Genetics and Genomic Sciences at Mount Sinai and lead investigator in the study. "We wanted to determine if anti-TNFα therapy, could mitigate a patient's risk in developing Parkinson's disease."
The Mount Sinai team found a 78% reduction in the incidence of Parkinson's disease among IBD patients who were treated with anti-TNFα therapy when compared to those who were not.
It was previously thought that anti-TNFα therapies had limited effects on the central nervous system, the site where molecular mechanisms of Parkinson's disease are found, because the large molecules in the anti-TNFα compounds cannot independently pass through the blood brain barrier. The outcomes of this study suggest that it may not be necessary for the drug to pass through the blood brain barrier to treat or prevent inflammation within the central nervous system, or that the blood-brain barrier in patients with IBD may be compromised, allowing the large molecules of the compound to pass through.
Parkinson's disease ranks among the most common late-life neurodegenerative diseases, affecting approximately 1-2% of people 60 years or older. "Current therapies for Parkinson's disease focus on ameliorating symptoms," said Peter, "Our findings provide promising insights that support further investigations into how reducing systemic inflammation could help treat or prevent Parkinson's disease."
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is an international leader in medical and scientific training, biomedical research, and patient care. It is the medical school for the Mount Sinai Health System, which includes seven hospital campuses, and has more than 5,000 faculty and nearly 2,000 students, residents and fellows. The School is made up of 36 multidisciplinary research, educational, and clinical institutes and 33 academic departments. It ranks 13th among U.S. medical schools for NIH funding and 2nd in research dollars per principal investigator among U.S. medical schools by the Association of American Medical Colleges (AAMC)
The School was named 4th among "World's Most Innovative Companies in Data Science" by Fast Company magazine in 2016. For more information, visit http://icahn.mssm.edu
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system encompassing seven hospital campuses, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The System includes approximately 7,100 primary and specialty care physicians; 10 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of 3 medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 13 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in four other specialties in the 2017-2018 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked in six out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology and 50th for Ear, Nose, and Throat, while Mount Sinai Beth Israel, Mount Sinai St. Luke's and Mount Sinai West are ranked regionally. For more information, visit http://www.mountsinai.org/, or find Mount Sinai on Facebook, Twitter and YouTube.