Parkinson’s Disease is named after James Parkinson, a British physician who published a paper on what he called The Shaking Palsy
An estimated 400,000 people in Pakistan are suffering from the Parkinson’s (James Parkinson) Disease. Considering a total population of 190 million, 0.21% of Pakistanis are affected compared to a global average of 0.08% (6 million people affected out of total world population of 7.4 billion). Pakistanis suffering from this disease make about 6.7% of the total patients worldwide while Pakistan’s population is about 2.57% of the total. Thus apparently the disease is more prevalent (twice more than on the global level) in Pakistan as compared to the world as a whole. This is an alarming situation and needs to be addressed on a national level. The disease is more prevalent in men than women but knows no social, economic or geographic boundaries.
Parkinson’s disease was first described in 1817 by James Parkinson, a British physician who published a paper on what he called “the shaking palsy.” In this paper, he set forth the major symptoms of the disease that would later bear his name. For the next century and a half, scientists pursued the causes and treatment of the disease. They defined its range of symptoms, distribution among the population, and prospects for cure. The disease may be one of the most baffling and complex of the neurological disorders. Its cause remains a mystery but research in this area is active, with new and intriguing findings constantly being reported. It belongs to a group of conditions called motor system disorders with the symptoms that include i) trembling in hands, arms, jaw, and legs, ii) rigidity or stiffness of the limbs and trunk, iii) slowness of movements, and iv) postural instability of impaired balance and coordination. Luckily the disease is neither contagious not hereditary but keeps the patient relatively immobile and uncommunicative.
In the early 1960s, it was found that the disease results from the loss/death of brain cells or neurons (The cause of death of dopamine producing cells is not known so far) in an area called “Substantia nigra”. These cells are responsible for the production of “Dopamine”, a chemical messenger that is responsible for transmitting signals between “Substantia nigra” and “Corpus striatum”. Lack of communication between the two means an uncontrolled muscle activity and thus a disorder in movement of different body parts. This discovery pointed to the first successful treatment for Parkinson’s disease and suggested ways of devising new and even more effective therapies.
Besides central nervous system, dopamine functions in several parts like i) the peripheral nervous system as a local chemical messenger, ii) blood vessels as inhibitor of norepinephrine also called noradrenaline (NA) or noradrenalin which is an organic chemical functioning as a hormone and neurotransmitter thus acting as a vasodilator (widening of blood vessels) following relaxation of smooth muscle cells within the vessel walls, iii) in the kidneys for increasing sodium excretion and urine output, iv) in the pancreas for reducing insulin production, v) in the digestive system for reduction of gastrointestinal motility and protecting intestinal mucosa, and vi) in the immune system for reducing the activity of lymphocytes. With the exception of the blood vessels, dopamine in each of these peripheral systems is synthesized locally and exerts its effects near the cells that release it.
Biochemically, dopamine results from decarboxylation of L-DOPA (L-3,4-dihydroxy phenylalanine) that is synthesized in brain and kidneys from an amino acid L-tyrosine that serves as a precursor. L-DOPA can also be chemically synthesized and marketed as Levodopa for treatment of disease. Dopamine is synthesized not only in humans but in plants and most multicellular animals as well. When administered through intravenous injection, dopamine cannot reach the brain from the bloodstream but its peripheral effects make it useful in cases of heart failure and or shock especially in newly born. Nevertheless, precursor of dopamine i.e. L-dopa can cross the protective blood-brain barrier thus serving as raw material for dopamine on site.
Many plants, including a variety of food plants like bananas, potatoes, avocados, broccoli, oranges, tomatoes, spinach, beans, and others synthesize dopamine using tyrosine as a precursor like than in animals. Unfortunately, dopamine consumed in food cannot act on the brain, because it cannot cross the blood–brain barrier as mentioned earlier. However, there are also a variety of plants that contain L-DOPA and can thus be consumed as a source to synthesize dopamine. In fact, leaves and pods of Mucuna (especially M. pruriens) have been used as a source for L-DOPA based drug. Some other plants with reasonable levels of L-dopa in different plant parts of legumes like Vicia faba, Cassia and Bauhinia trees. Thus the most important thing one can do to improve upstairs-downstairs communication is to eat a variety of legumes to support healthy gut as a means to meeting challenges by diseases like Parkinson’s.
Besides higher plants some marine algae like Ulvaria obscura contains high concentrations of L-dopa (4.4% of dry weight). Incidentally there are no reports of dopamine production in archaea (unicellular, prokaryotic microbes). However, it has been detected in some species of bacteria and in the protozoan called Tetrahymena. There are also types of bacteria that contain homologs of all the enzymes that animals use to synthesize dopamine. It has been proposed therefore that animals derive their dopamine-synthesizing machinery from bacteria via horizontal gene transfer. This may have occurred relatively late in evolutionary history as a result of the symbiotic incorporation of bacteria into eukaryotic cells that also gave rise to mitochondria.
Although probiotics have not yet been identified to treat the disease, probiotics have indeed been found to reduce constipation in Parkinson’s patients. It has also been observed, that Parkinson’s patients have a noticeable difference in relatively frequency of intestinal bacteria from the Prevotellaceae and Enterobacteriacaea family, being much more from the latter. Interestingly, higher the levels of Enterobacters, more severe are the Parkinson’s symptoms. Thus a change in gut microbiome could lead to reduce/control the disabilities caused by the disease. Quite a few studies suggest that there is a definite linkage between this disease and microbial diversity and relative population of different bacteria. It is becoming a matter of increased understanding now that 80 percent of the immune system is living in the gut. Modern environmental influences such as poor water and food quality, pollution, disease-states and stress can alter gut bacteria function. Hence choosing a multi-strain, non-GMO probiotic will help populate the entire digestive tract with the bacteria essential for a thriving immune system. Studies have shown favourable benefits of probiotics for relief in on arthritis, diabetes, cardiovascular and neurological health.
As an end note, mapping gut microbiome and giving it the attention it deserves could help stave off an entire host of health concerns, like Parkinson’s and beyond. This approach may not necessarily improve dopamine production but could help maintain a healthy system to mitigate the negative impact of Parkinson’s on nervous and muscular functioning. Attention to microbes could ultimately lead to identification of those having the metabolic capacity to synthesize L-DOPA and ultimately dopamine in situ in the human gut and their deployment where needed.
Some famous and important names who suffered from Parkinson’s disease include Adolf Hitler (Chancellor, Germany), Mao Zedong (Chairman/President, China), Muhammad Ali (All time great Boxer, USA), Sultan Bashiruddin Mahmood (Nuclear Scientist/Engineer, Pakistan).