Parkinson Disease Overview

Parkinson Disease Overview

• Affects approximately 1 million people in the United States
• 60,000 new cases occur annually
• Average age at onset: 57 years

Symptoms

• Motor functions:
  • Bradykinesia (extended time to initiate normal movements)
  • Resting tremor (involuntary shaking)
  • Stiff gait
  • Stooped posture
  • Muscle rigidity
• Non-motor components:
  • Sleep disorders
  • Rapid eye movements
  • Tingling of the skin
  • Loss of sense of smell
• Psychiatric disturbances often accompany the disease

Pathophysiology

• Progressive loss of dopamine-releasing neurons
• Affects transmission of signals between brain components
• Results in motor deficiencies

Genetics

• About 85% of patients do not have a mutation in identified Parkinson disease genes
• No specific gene can be used therapeutically

Treatment

• Levodopa therapy:
  • Attempts to compensate for dopamine loss
  • Effective for short periods
  • Eventual development of motor fluctuations, decreased voluntary movements, and increased tremor frequency
• Deep brain stimulation:
  • Implants thin-wire electrodes on both sides of the brain
  • Battery-operated neurostimulator (brain pacemaker) regulates electric pulses to target regions
  • Thought to normalize Parkinson disease-induced signal pathway
  • Reduces motor-related symptoms (walking problems, tremors, rigidity, and slow movements)
  • No significant impact on non-motor aspects of the disease

Vaccines and Public Health

• Traditional vaccines have been successful in preventing human infectious diseases and preserving public health.
• The success of vaccines has led to a new era in the 21st century, driven by increased understanding of human immunity and microbial pathogenesis.

Advances in Vaccine Research

• Vaccine research in the 21st century focuses on developing vaccines to prevent cancer and chronic infectious diseases, including HIV, tuberculosis, and malaria.
• Revolutionary technologies have made vaccines safer and enabled development against infectious agents or diseases that were previously difficult to target.

Innovative Technologies

• Cell-based and recombinant methods have replaced egg-based methods for vaccine manufacturing.
• Recombinant DNA technology enabled the development and large-scale manufacture of the hepatitis B vaccine.
• Glycoconjugation technology enabled the development of vaccines against H. influenzae type b, pneumococci, and meningococci.
• Genome-wide sequencing of viruses and bacteria has allowed for the selection of targets for vaccine development.
• Reverse vaccinology has enabled the discovery of new antigens and the development of vaccines against meningococcus B.

Future Developments

• DNA vaccines and vector vaccines may expedite the development of new vaccines for cancer, HIV, tuberculosis, and malaria.
• Next-generation technologies, such as virus-like particles, may promote the development of effective vaccines against many new pathogens.
• Understanding the human innate immune system may facilitate the production and licensing of novel TLR agonist-based adjuvants.

Vaccine Development and Clinical Trials

• New vaccines should be systematically analyzed for their potential to confer protection against a wide spectrum of diseases in people of all ages.
• Innovative clinical trials, such as parallel testing of multiple vaccines or vaccination regimes, may accelerate vaccine development.
• High-throughput technologies, such as systems biology methodologies, may provide early information about vaccine effectiveness and immune response.