Earlier this year, research on Parkinson’s disease (PD) entered a new era when the Michael J. Fox Foundation announced a major scientific breakthrough – the discovery of a biomarker for PD. This has meant that for the first time we can ever identify the earliest known signs of the disease at Parkinson patients.
This long-awaited new procedure is called the “Alpha Synuclein Sow-Amplification Test” (SAA), and it is capable of detecting the wrong folded alpha-synchlein in spinal fluid-the self-ridiculous protein that is clearly linked to Parkinson’s . It separates, with an astonishing 90 percent specificity, those who have evidence of pd pathology in their cells from those who do not have it. This does this even before the rise of symptoms, much like the way high blood pressure or cholesterol levels are used to detect cardiovascular risk long before a heart attack lands someone in the ER.
It will be difficult to over-emphasize the implications of this development for people living with dysfunction in their Alpha Synuclein. For one thing, we have never had a way of knowing who these people are – it is until the moment of diagnosis, at what point continuous damage to brain cells is already well underway. As for the diagnosis itself, which comes out of the blue for most people, it has always been frustratingly subjective and essentially based on a doctor’s opinion after a short time in the doctor’s office – not very useful For medical care, let biomedical drug development.
The new SAA test is already integrated into drug trials as the first measure that people can objectively identify with the biology we target-which offers drug manufacturers greater assurance that they test experimental treatments in the right populations. For biofarma businesses weighing a decision to enter or stay the high-risk neurological disease space, it changes the value offering of investment on his face. In 2024 we will see an increase in potential new medicines entering the pipeline and progressing on their way to pharmacy shelves.
What is just as remarkable is how to the SAA breakthrough. The search for the biomarker required to find and study “needles in a haystack”: people without any traditional symptoms of PD and who unconsciously live with an increased risk of the disease. It was critical to find out what biology they distinguish from those who do not get Parkinson’s. But how do you find someone who doesn’t know they are being sought?
As it turns out, your sense of smell is a surprisingly good predictor of brain disease. (We are not talking here about the short-term odor loss associated with Covid-19, but significant and lasting odor loss that continues over years.) Researchers have known for a while about the connection between odor loss and neurodegeneration, especially in the presence of certain Other risk factors, such as a diagnosis with REM behavioral disorder (RBD), a sleep disorder. Research shows that half of those over 60 live with some loss of smell, but the majority do not realize it until they have been tested. If you connect it to the fact that all major brain diseases – Alzheimer’s, Parkinson’s, ALS, Huntington’s – are associated with a degree of odor loss, it is astounding.
The Michael J. Fox Foundation’s large-scale observation study of Parkinson’s aimed to use poor odor as one of his criteria to find and enter individuals. (We should note that this is still unclear for this risk group as or when The disease can eventually arise.) The highly sophisticated screening device used? A humble scratch-and-sniff test, albeit the scientifically ratified variety.
Until the SAL biom marker was ratified, a reduced sense of smell could not be objectively linked to the presence of the underlying Parkinson disease biology. But now we can report that the test has accurately diagnosed the disease in 99 percent of people with poor odor and so -called Sporadic Parkinson’s (in other words, those with no genetic mutation).
In 2024 we will begin to see a sea change in the possibilities of screening for and predicting PD and, quite possibly, other diseases of aging. An annual crab-and-sniff test can soon become as commonplace as your mammogram or colonoscopy. In 2024, with widespread acceptance, this simple, cheap and accessible mechanism will radically change landscape of what is possible in Parkinson’s research and care.