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Slowing Parkinson’s Disease Progression with Vaccination and Other Immunotherapies

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Abstract

Parkinson’s disease (PD) is the second most common neurodegenerative disorder. There are several recognized pathways leading up to dopaminergic neuron loss in the substantia nigra pars compacta and other cells in the brain as a result of age-related, genetic, environmental, and other processes. Of these, the most prominent is the role played by the protein α-synuclein, which aggregates and is the primary component of Lewy bodies, the histopathological hallmark of PD. The latest disease-modifying treatment options being investigated in PD are active and passive immunization against α-synuclein. There are currently five different monoclonal antibodies investigated as passive immunization and three drugs being studied as active immunization modalities in PD. These work through different mechanisms but with a common goal—to minimize or prevent α-synuclein-driven neurotoxicity by reducing α-synuclein synthesis, increasing α-synuclein degradation, and preventing aggregation and propagation from cell to cell. These promising strategies, along with other potential therapies, may favorably alter disease progression in PD.

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  1. Department of Medicine, Prisma Health Upstate, The University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA

    Dhanya Vijayakumar

  2. Distinguished Chair in Movement Disorders, Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Baylor St. Luke’s Medical Center at the McNair Campus, 7200 Cambridge, 9th Floor, Suite 9A, Houston, TX, 77030-4202, USA

    Joseph Jankovic

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Dhanya Vijayakumar, MD declares no conflict of interest. Joseph Jankovic, MD has received grants from AbbVie Inc; Acadia Pharmaceuticals; Cerevel Therapeutics; CHDI Foundation; Dystonia Coalition; Emalex Biosciences, Inc; F. Hoffmann-La Roche Ltd; Huntington Study Group; Medtronic Neuromodulation; Merz Pharmaceuticals; Michael J Fox Foundation for Parkinson Research; National Institutes of Health; Neuraly, Inc.; Neurocrine Biosciences; Parkinson’s Foundation; Parkinson Study Group; Prilenia Therapeutics; Revance Therapeutics, Inc; and Teva Pharmaceutical Industries Ltd. He also receives consulting fees from Aeon BioPharma; Allergan, Inc; Merck & Co, Inc; Revance Therapeutics; Teva Pharmaceutical Industries Ltd. and receives royalties from Cambridge; Elsevier; Medlink: Neurology; Lippincott Williams and Wilkins; UpToDate; Wiley-Blackwell. The authors have no other relevant affiliations or financial conflict of interest with the subject discussed in the manuscript apart from those disclosed.

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Vijayakumar, D., Jankovic, J. Slowing Parkinson’s Disease Progression with Vaccination and Other Immunotherapies. CNS Drugs 36, 327–343 (2022). https://doi.org/10.1007/s40263-022-00903-7

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