Genetic Testing and Immunotherapy Research Potentially Practice-Changing for Parkinson’s Disease

Danielle N. Larson, MD, Northwestern University Parkinson’s Disease and Movement Disorders Center, Chicago, IL, highlighted immunotherapy and genetic testing research that could be practice-changing for treatment of Parkinson’s disease in a presentation at Neurology Week.

Dr Larson discussed several areas of research interest for treatment of Parkinson’s disease including alpha-synuclein targeting and immunotherapy, genetic therapies in development, and how genotyping can guide treatment management.

One immunotherapy researchers are investigating is prasinezumab, an anti-body against the alpha-synuclein protein, in the phase II PASADENA and phase IIb PADOVA trials with hopes to prove its effectiveness at slowing motor decline. Alpha-synuclein immunotherapy is showing promise and the thought is this will medication will stop the neurodegenerative cascade.

If the current studies confirm significant reduction of motor decline, prasinezumab would be the first treatment for Parkinson’s disease to modify disease progression.

Referring patients to neurologists and movement disorder specialists early, and establishing biomarkers before motor symptoms onset will become even more important if a disease-modifying agent detecting Parkinson’s disease early is available, noted Dr Larson during the presentation.

Dr Lawson also highlighted the importance of genotyping in Parkinson’s disease. Research is currently underway for gene-targeting therapies. Mutations in the LRRK2 and GBA genes are prevalent in up to 10% of PD cases, respectively. Dr Larson covered a number of therapies in development related to targeting the GBA and LRRK2 risk genes, and what we know about them. These are the main targets of phase I or II clinical trials.

Additionally, the PDGENEration study is a national initiative to identify and map 7 gene variants in Parkinson’s disease. Any patient with Parkinson’s disease can qualify for the study at no cost. Visits can be conducted virtually with a mailed-in swab kit for testing.

“If current studies identify gene-specific therapies that alter disease progression, genotyping in PD will become standard of care, as it would inform disease management,” said Dr Larson.

“…Alpha-synuclein immunotherapy is showing  promise at modifying disease course or progression of disease.….. I also want to highlight genotyping is relevant,” Dr Larson concluded, specifically for GBA and LRRK2 risk genes.

Dr Larson noted once more the PDGeneration study is offering free genetic testing to any patient with Parkinson’s disease. Anyone interested can visit https://www.parkinson.org/PDGENEration for more information.

“We are hopeful in the movement diosrders arena that we are getting closer to a medicine that is a holy grail and can slow or stop the progression of Parkinson’s Disease.” —Kaitlyn Manasterski

Larson, D. Translating Research into Practice in Movement Disorders. Presented at Neurology Week 2021; July 14-18. Virtual.