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Role of Immune System in PD Risk, Therapy

June 05, 2018

The use of immunosuppressant drugs, especially inosine monophosphate dehydrogenase inhibitors (IMDIs) and corticosteroids, may be associated with a lower risk for Parkinson disease (PD), according to new research.

This finding adds to existing evidence suggesting a potential role of the immune system in PD risk, as well as potential therapeutic targets that could modify the risk and/or progression of PD.

The new data emerged from a study of 48,295 incident cases of PD and 52,324 controls. Participants included in the study were aged 60 to 90 years in 2009 and were Medicare beneficiaries with available prescription data.

The researchers specifically assessed the effects of 6 immunosuppressant drug classes on PD risk, including calcineurin inhibitors, IMDIs, dihydrofolate reductase inhibitors, biologics, corticosteroids, and miscellaneous drugs.

Ultimately, results of the study indicated that IMDIs (relative risk [RR], 0.64) and corticosteroids (RR, 0.80) were both associated with a decreased risk of PD.

“While corticosteroids affect both acute and chronic inflammation by multiple mechanisms, the IMDH inhibitor mechanism is much more specific,” the researchers wrote. “…Although it is not clear that these medications cross an intact blood–brain barrier, the potential neuroprotective mechanism could be entirely due to peripheral suppression of T‐cell activity.”

Inverse associations for both drug classes remained after applying a 12-month lag on medication exposure, the researchers noted.

—Christina Vogt

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