Parkinsons Disease

PD norm in ally affects mass over the age of 50. It produces more(prenominal) common with increase age. About 5 in 1,000 slew in their 60s and round 40 in 1,000 people in their 80s earn PD1. It affects both men and women alone is a little more common in men. PD is not usually inherited, and tummy affect anyone. stock- tranquillize, genetic factors may be beta in the small(a) subjugate of people who develop the ailment in the lead the age of 50. PD thitherfore affects a lot of people in the UK and I have chosen this topic so I have a greater understanding of what they go through and how we loafer assist those stirred.Background Biology of paralysis agitans disease? shaking palsy disease is a chronic disorder of fragmentize of the fountainhead called the substantia nigra. It mainly affects the way the ace co-ordinates the front lines of the muscles in various split of the someoneate.This bea of the brain sends messages down jumpiness in the spinal cord to he lp control the muscles of the body. Messages be passed mingled with brain carrells, substances and muscles by chemicals called neurotransmitters. Dopamine is the main neurotransmitter that is made by the brain jail cells in the substantia nigra1.Muscular Sy stop Muscle MetabolismIn PD, cells in the substantia nigra atomic number 18 damaged and die. The ca employ is unk right awayn. Over beat, more and more cells become damaged and die. The more cells that atomic number 18 damaged the less dopamine is produced. The reduction of cells and the low level of dopamine in the cells in this part of the brain causes nerve messages to the muscles to become slowed and abnormal1. In the unyielding term PD provide ultimately lead to shoe answerrs pop off.CausesWe ar sedate un surely of the causes of PD but here atomic number 18 the approximately resemblingly and most talked about suggestions1. The hereditary form of PD occurs in fifteen per cent of typefaces2. The genes stirre d help clear nerve cells of excess proteins. Scientists are not sure but it is thought that when the production process for protein manufacture breaks down, little clumps of incorrect proteins convey to accumulate in cell 17, make cell death.Tests carried out on rats using rotenone imply that pesticides and toxins may lead to PD. The rats experienced shaking and a loss of muscle control as well as ontogeny Lewy bodies (spherical lumps tack in dying brain cells), which are commonly associated with shaking palsy disease. However, questioners are yet to find evidence for any definitive touch on to a particular toxin or dose in valets.2. There seems to be a bear on amidst variants of the mitochondrial genes and PD. The paralysis agitans illness enquiry agenda states that mitochondrial dysfunction has numerous consequences, including ener modelic failure, generation of reactive oxygen species, disregulation of calcium homeostasis and induction of apoptosis, each of which ma y be important in Parkinsons disease3.3. High concentrations of free-radicals in the body and a lack of antioxidants. impoverished radicals damage cells and if too umpteen dopamine-producing cells were damaged and then this could lead to PD. Antioxidants stay the production of free radicals and repair damage done by them.Symptoms and effectThere is no easy test to diagnose PD, so it is diagnosed by ruling out other diseases and looking for the classic symptoms* Slowness of movement (bradykinesia)1. It will become more of an effort to walk or get out bed. People may serious mobilize they are get old and it is not till other symptoms develop that you may recollect about PD.* Stiffness of muscles (rigidity) and muscles may feel tenser. Also, your arms do not tend to swing as much when you walk.* Shaking (tremor) is common, but does not always occur. It normally affects the fingers, thumbs, makes, and arms, but basis affect other parts of the body. It is most noticeable when you are resting and may become worsened when you are anxious or emotional. Its by and large less obvious when you use your hand to do something much(prenominal)(prenominal) as picking up an object or typography.Symptoms will tend to get worse and worse and as the disease develops. Some other symptoms may develop due to problems with the way affected brain cells and nerves control the muscles. These include* Fewer facial expressions such as smiling or frowning. Less blinking.* Difficulty with fine movements such as tying shoe laces or buttoning shirts.* Difficulty with writing (handwriting tends to become smaller), balance and posture and sw leave behinding.* Speech may become slow and monotonous.* fatigue aches and pains.As PD gets really bad, symptoms such as the following mightiness develop, dependant on the individual* Constipation- PD pr make upts the proper transmission of the neurological messages that tell the rectal sphincter muscles to open7* Hallucinations (seeing, h earing or smelling things that are not real)* Sweating- PD behind affect the autonomic nervous ashes8 that controls the autonomic functions (functions done automatically by the brain and body without conscious thought) such as sweating, breathing etc.* Difficulties with sleeping* weight unit loss- on that point is a generally decreased appetite associated with PD. This may for the most part be due to swallowing intemperateies and other gastrointestinal disturbances8* Pain* Depression & Anxiety- fretting disorders occur in up to 40% of patients with Parkinsons disease (PD)9. The denomination states Current evidence suggests that anxiety may not be a psychological reaction to the illness but rather may be linked to specific neurobiological processes accompanying PD.* Problems with controlling impulses (for example controlling eating, shopping or gambling)Most people will only jut out form a few of these symptoms and which ones will get worse and the zip at which they get wo rse varies hugely from person to person. Some dis utilize brain diseases squeeze out have truly same symptoms in which case a specialist brain scan can often be used to distinguish between them.The TreatmentsAt the moment thither is no restore for PD and most treatments simply have the job of relieving symptoms.1. Drugs insertion there are two main types of drug used in PD treatment. Firstly, drugs that target the neurotransmitter sy al-Qaidas (e.g. dopamine) or secondly drugs that are designed to deputize with steps in the neurodegenerative processes (they may aim to sustain nerve cells or tackle the issue of free radicals).Drugs are cheap and impressive, especially in relieving symptoms but show little capability as a in complete cure to the disease. Most also need to be taken periodical for the remainder of a patients carriage cartridge holder. some drugs may have minor spatial relation affects. Some side affects have social impacts such as idea swings or may not a llow the user to fly or travel to certain places.Dopaminergic Agents- use to activate the production or use of Dopamine.Levodopa- is an amino acid that is converted in the brain into dopamine. According to the WE journey website10 Levodopa was introduced as a PD therapy in the 1960s, and remains the most effective therapy for motor symptoms although there are many drugs that do a similar job such as Rasagiline. It concentrates the effect of and helps control the symptoms of PD. similar most amino acids levodopa is absorbed into the transmission line stream through the wall of the intestines. amino acids require a transporter to transfer them a span the membrane of the intestines and into the blood stream. These transporters can only work at a certain rate and so diet is important. To much dietary protein can slow the transport of levodopa into the blood stream meaning the dose may be ineffective. Alternatively to invalidate the competition with other amino acids, doses should b e taken between meals. Levodopa has to cross from the blood stream into the brain using the same transport sy arc again, making diet and timing doubly important.MAO-B Inhibitors- slow the breakdown of dopamine in the brain and aim to prevent or slow the death of neurons. MAO is responsible for the mitochondrial metabolism of monoamine neurotransmitters, including dopamine and serotonin.11Ethical implicationsSome of the many ethical issues revolve around the decision to move from testing on artificial tissue (often grown from obeisance cells, which may in the future(a) replace animal testing altogether. bowing cells, however create there own ethical issues) to animals, and further on the line, of animal testing to trails on human patients.The graph below shows the stages involved in developing a cutting drug and is taken from the MSD website (21/3/10) (http//www.msd.com.hk/health_info/drug_education/e_ddp_introduction.html)Animal testing is very closely regulated in the UK howeve r many, often false, accusations of animal cry have lead to darkened perceptions of animal testing in the prevalent eye. Animal abuse is definitely a reality but modify transparency, accountability and regulations12 should reduce it happening and make sure those responsible are prosecuted. Unlike manhood, animals are unable to consent to testing. It is forced upon them and often involves a certain descend of pain, stress, suffering and discomfort.Researchers will try to reduce this, by chance using anaesthetics although this can often interfere with the drug being time-tested so the animal may have to suffer the full sum total of pain. Unfortunately, in PD, a number of animals are tested on normally starting with mice or rats in front moving on to monkeys and finally human trails. Some people believe that animals like monkeys and most primates shouldnt be experimented upon as they arent in the same plentiful supply that rats and mice are in, nor are they considered pests. H owever, for potentially dangerous drugs it is essential animals with a similar genetic make up (primates) are tested on to greatly reduce the endangerments in human clinical trails.Economics of drugs in PDAs shown in figure 1.2 drug development requires a huge amount of query and testing and can take more than 10 long time sooner a useable drug is created. This apparently requires a huge amount of investment and general drug development costs vary between 500 and 2,000 million dollars. RD is often done by independent companies or judicature organizations. Most companies or organizations will link with universities to share reading and facilities and hopefully quicken to process of discovering a crude drug.After approval, pharmaceutical companies have a short period of exclusivity forrader patents expire and other companies can market the same drugs as generics. This time is used to recoup the massive investment required to develop and prove a new drug. However, the companie s must also continue to test their drugs and observe the feedback from healthcare professionals in order to identify undiscovered side do, risk factors and interactions.13Drug companies are some of the most profitable industries in the homo and although a large amount of money is essential in look and development (RD) only 1 in 5 dollars made is then invested in further research. Many companies spent nearly twice as much money on advertising and marketing than RD and demand is so much higher than it needs to be that companies can afford to boost prices to maximise profit.Luckily with PD this becomes less of a problem as people are unlikely take and therefrom buy drugs that are meant for PD when they dont very need it. This is because the symptoms tend to be quite clear and drugs like levodopa are not readily lendable unless prescribed.Benefits to humansDrugs can have a massive impact on people suffering from PD and they aim to do a number of things1) Improve standards of liv ing- by reducing the affects of PD and slowing the process of neurodegeneration it should allow the person suffering to do basic things (such as tying shoelaces, writing etc) more easily and for longer in the first place they require full time medical care. This allows them to be more independent.2) The use of drugs such as levodopa, in the long term, will reduce the affects of symptoms such as tiredness, aches and pains. Painkillers like amantadine will also be used for more short term tranquillise along side drugs like levodopa. This will simply make life less painful for a PD patient.3) Drugs are the most well know and reliable of PD treatments. This reduces the risks of any unknowns or mistakes and far few mistakes will be made than in using other treatments.Risks to humans1) Unfortunately Nausea and vomiting are common side effects of using levodopa that are due to the building up of dopamine in the bloodstream. The most serious and severe effect of this treatment is dyskine sias. Dyskinesias are uncontrolled movements, including writhing, twitching, and shaking. Dyskinesias result from the combination of long-term levodopa use and continued neurodegeneration. They typically begin to develop in milder forms after 3 to 5 years of treatment, but are more severe after 5 to 10 years of treatment.102) There is always risk of allergies when using drugs and for some unfortunate people drugs may do more damage than good.3) Side affects of drugs vary from person to person and it is impossible to know beforehand how a certain drug will affect an individual. For some, side affects may be far worse than for others.4) Dosages need to be got right and it is a common problem that people take to little and dont get the full benefit of the drug or take to much and suffer more/worse side affects. A massive overdose will likely lead to death.Alternative Cures?2. factor therapy- is still in early research stages and it is likely to be a while before this technique is actu ally used on humans. Like stem cells it has exciting potential to provide a future cure and avoid the ethical issues associated with stem cells.How it works?Gene therapy aims to introduce new and functioning genetic material into cells that have abnormal genes that are causing proteins (in the case of PD, dopamine) not to be created or created faulty. The genetic material can normally be inserted into the cells using viruses. Some types of virus, such as retroviruses, shuffle their genetic material (including the new gene) into a chromosome in the human cell. other viruses, such as adenoviruses, introduce their desoxyribonucleic acid into the nucleus of the cell, but the DNA is not integrated into a chromosome.13There is still much development needed as scientists are still unable to target specific cells and there is the potential threat of virus mutation which may cause even further problems.There is also major worry about the potential for gene therapy to be used to improve bas ic human traits such as height, intelligence etc. People could simply choice characteristics and this in many peoples eyes could be used for the wrong reason. For example, this may be used to give some athletes a major advantage over others or possibly creating super humans.3. Stem CellsI think stem cells have shown exciting potential and will hopefully provide a full time future cure for the disease.How they work?Stem cells are unspecialised cells that have the ability to develop into highly specialised cells like nerve cells. They can also self-renew, which means they are capable of replenishing themselves for long periods of time by dividing4. For Parkinsons disease it is hoped that large numbers of the brain cells that produce dopamine can be produced and inserted, through transplantation, into a patients brain. Therefore, nerve messages to all parts of the body will be normal again. However, stem cells not been successfully used to cure PD yet and there are many problems facing researchers. Therefore stem cells are relatively useless for PD at the moment but may be able to provide an easy and affective cure in the future.Problems with the types of Stem cellsThere are three main types of stem cells1. Adult stem cells can come from Skin, Bone marrow, Brain, Blood vessels, Liver and Skeletal muscle. However, expectant stem cells are found in such small quantities it is difficult to identify and isolate them in viable numbers. Because adult stem cells arent as young as conceptustic stem cells, they contain more DNA abnormalities acquired with age4. These can be caused by the environment, toxins or errors in DNA replication. Adult stem cells have limited potential because unlike embryonic stem cells they can not differentiate into any specialised cell in the body.2. heap blood cells are normally found in the umbilical cord and placenta after the cord is cut. One problem is the lack of cells obtained and these may not be enough relative to a patients size. Cord blood cells generally take longer to grow, therefore completion of therapy will take longer. It obviously requires a pregnant woman to donate the cells.3. Embryonic stem cells are found in human embryos and have a seemingly eternal potential to develop into any cell in the human body. However they are surrounded by a number of ethical issues. Many people and especially religious group condemn the use of embryonic stem cells as they believe it is destroying a life. They believe it is immoral to proceed a life at the expense of another.However new developments in stem cells research means that Totipotent* stem cells can now be collected without the loss of embryo lifeSomatic cell nuclear transfer (SCNT) nucleus is removed(p) from a somatic cell and is then implanted into a donor egg that has had its nucleus removed6. It divides just as normal before forming an embryo. Cells from the inner cell mass are extracted and cultured to provide embryonic stem cells but the technique d estroys the embryo. Although the embryo is destroyed it is a created clone and so may not be considered the loss of new, individual life.Altered nuclear transfer (ANT), however, prevents an embryo from actually being created. The nucleus of the somatic cell is altered, or genetically reprogrammed, before being transferred into the egg. The alteration consequence is that the somatic cell DNA still produces stem cells but does not generate an embryo.Blastomere Extraction is performed on a two-day old embryo, following the division of the fertilized egg into eight blastomeres (cells). One blastomere is removed and can be triggered to divide and the resulting stem cells could still be used for research and disease treatment. The embryo, now with only seven blastomeres can still be implanted into the mother and assuming no defect has been found these embryos will still grow into healthy babies4.1. Name of article Parkinsons Disease uniform re semen locator http//www.patient.co.uk/health/ Parkinsons-Disease.htmDate accessed 15/2/10Evaluation The article is certified as a reliable consultation of health and social care information. It certificate states- The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any mercantile conflicts of interest. The article states that Parkinsons disease affects the part of the brain know as the substantia nigra. WE MOVE (Worldwide Education and Awareness for Movement Disorders- http//www.wemove.org/par/par_subn.html) states In PD, cells of the SN (substantia nigra) degenerate, and therefore can no longer produce adequate dopamine. This information is further backed up on the Parkinsons Disease Research Agenda that states cells that produce the neurotransmitter dopamine die in a small brain area called the substantia nigra. As the information provided is backed by what I consider to be reliable reso urces I think that the information on the website is also therefore reliable, but should be checked with other sources before being used.2. Name of article Possible Causes of Parkinsons Disease (PD)Url http//www.healthtree.com/articles/parkinsons-disease/causes.phpDate accessed 20/2/103. Name Parkinsons Disease Research AgendaURL http//www.ninds.nih.gov/about_ninds/plans/nihparkinsons_agenda.htmParkinsonDate accessed 20/2/10Evaluation Parkinsons disease Research Agenda is written by the National Institute of Neurological Disorders and Stroke (NINDS). It primary aim is to reduce the burden of neurological disease a burden borne by each age group, by every segment of society, by people all over the world. It is funded by the government so should provide no influence and the site aims to educate people about various neurological disorders including Parkinsons disease. It states mitochondrial dysfunction has numerous consequences each of which may be important in Parkinsons disease. This is also backed by an article http//www.nature.com/nrneurol/journal/v6/n2/full/nrneurol.2009.221.html that states dysfunctional energy metabolism might be a commutation element of the pathological process underlying the development of PD.The site was last updated on the 25th of July 2008.As the site is run and updated by the government with no other purpose but to inform I think it can be used a very reliable source of information.