Important scientific news arrives from the Congress of the Italian Society of Neurology underway in Milan. Among the topics under discussion are the possibilities of understanding what it could be the clinical evolution for those suffering from Parkinson’s disease doing a simple saliva test. How? Thanks to a biomarker present in it. Alfredo Berardelli, President of the Italian Society of Neurology, explains the perspectives of this exam and those offered by the analysis.
On the hunt for an abnormal protein
Scholars led by Berardelli have been working on this problem for some time at the Sapienza University of Rome. The effort of the experts was to locate a non-invasive diagnostic biomarker e precocious of Parkinson’s disease by flushing out the anomalous alpha-synuclein protein that characterizes it in easily accessible locations, therefore without having to resort, for example, to intestinal biopsies where it seems the alpha-synuclein begins to develop or of the salivary gland where it seems to collect before spreading to the brain. With various studies, scientists have thus indicated how it is possible to do it through a simple saliva analysis.
Now a further leap in quality has been made, achieving a result never seen before: no longer just the early diagnosis of the disease, but even the possibility of a prognosis. The Roman researchers have in fact discovered that from the analysis of particular salivary components and their relationships with respect to the concentration of alpha-synuclein it is possible to make a highly reliable prediction of the course.
“Oligomeric alpha-synuclein is the marker of excellence which, with a sensitivity of almost 100% and a specificity of 98.39%, can distinguish who is in the initial stage of the disease from who is not affected, with an accuracy overall diagnostics equal to 99% – explains Berardelli. A long-term study has already begun to verify how much the new components detected in saliva can influence, individually or in combination, the oligomeric alpha-synuclein which is the main actor of the disease, so as to identify the different clinical trajectories that characterize the different pathological progression of the various patients”. In this way the salivary markers could come to have a prognostic value but had previously.
Parkinson’s disease, what characterizes it: clichés to dispel
Parkinson’s disease was first fully described by James Parkinson in 1817 in his book entitled “Essay on the Shaking Palsy”. It is also known as “the disease of great men” (Franco, Cassius Clay, Hiltler, Arafat, Mao, Bresniev, Michael J. Fox, John Paul II and many other famous personalities have suffered or are suffering from it). It is a commonplace that the disease only affects the elderly, that the main symptom is tremor and that it does not cause pain.
The reality is quite different as this disease is common among young people, the main symptom is slowness of movements (about 30% of patients have no tremor) and pain are often the first symptom of the disease.
The clinical picture of the disease is classically identified by slowness of movement (bradykinesia), rigidity and tremor, even if the latter is not always present.
Symptoms are caused by cell degeneration and death of a small area of the brain called “black substance” which is the area capable of producing a neurotransmitter, dopamine, involved in the “control” of movement. The symptoms do not always present an equal intensity determining, in relation to the prevalence of one over the other, the manifestation of different clinical forms.
The disability induced by Parkinson’s disease does not correlate only with the “movement disorder” but can also involve other systems such as the cardiovascular, gastrointestinal, urinary systems. There is great variability in the evolution of the disease and in the degree of disability of the patients: the course is generally defined as “chronic-progressive”, but it is possible to recognize protracted phases of stabilization of the picture especially if the patient is carefully treated and monitored