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Immune cells key in Parkinson’s disease – study

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The research could help develop new understandings to how the disease progresses

Immune cells in the blood influence the brain during early development of Parkinson’s disease, new research has found.

Until now, Parkinson’s disease has always been considered a brain disorder, but through new research into a sleep disorder, a close link has been established between the disease and certain immune cells in the blood.

Researchers from Aarhus University have taken the first step on a path which could lead to new ways of understanding and, in the long term, possibly treating this widespread disease that affects not only motor functions but also cognition and emotions.

“We know that Parkinson’s disease is characterised by an inflammation in the brain, and that this is crucial for the progression of the disease. But in the study, our interest has been focused on the immune cells found outside the brain,” explains Marina Romero-Ramos, associate professor at the department of biomedicine at Aarhus University.

The researchers have studied a group of patients suffering from REM Sleep Behaviour Disorder (RBD), a condition where the patients physically act vivid dreams with vocalisations and movements.

If, for example, a patient dreams that they are running, their legs will move as if they were actually running. The sleep disorder is often discovered by a spouse as it results in violent movements at night, and the diagnosis is often indicative of something more.

Patients with RBD have a high risk of developing Parkinson’s – statistically approximately ninety per cent of them will be diagnosed with a Parkinsonism related disorder over the course of five to ten years.

In Parkinson’s disease, a protein called alpha-synuclein aggregates in the neurons in the brain, and this kills the cells. The same protein also aggregates in the brain of people with the RBD, and it is therefore regarded as an early form of Parkinson’s disease.

This led the researchers from the Department of Biomedicine at Aarhus University – in collaboration with a group of neurologists and experts in nuclear medicine at Aarhus University Hospital, led by Dr. Nicola Pavese – to carry out scans of the brains of 15 patients with RBD and ten healthy people.

The scan revealed that the patients with the sleep disorder had inflammation and a loss of neuronal activity in the brain. Although they did not present symptoms of Parkinson’s, their neurons were already ill and the brain’s immune cells were activated.

The groundbreaking discovery happened when Dr. Marina Romero-Ramos and her colleagues from Aarhus University analysed blood samples from these patients.

It turned out that the inflammation in the brain, and the associated loss of brain cells, directly related to changes in some immune cells in the blood, the monocytes.

When certain proteins increased on these immune cells, there was in parallel increased inflammation in the brain and a decrease on the neuronal activity.

This is a key finding when it comes to understanding Parkinson’s disease, say the researchers.

“We could see that the blood’s immune system changes very early on – even before Parkinson’s is diagnosed,” says Marina Romero-Ramos.

“This is the first study to show that the body’s immune system continuously communicates with the brain during the development of Parkinson’s disease, and that changes in the body’s immune system influence the condition of the neurons in the brain.

“In connection with Parkinson’s, this presents us with new opportunities for studying the immune cells in the blood and finding new forms of treatment.”

This means that the researchers now hope to find and investigate ways to influence Parkinson’s disease by treating the blood and not the brain.

Previous experiments on mice and rats suggest that this is possible, even though there is still much research to be done, as Dr. Romero-Ramos explains.

“This opens up the possibility of being able to design immunotherapy that modulates cells in the blood, which subsequently would stop or delay the changes in the brain. For the patients, being able to enjoy more years with good quality of life will be very significant,” she says.

“It also opens up opportunities for us to be able to find biomarkers in the blood that can tell us how someone’s brain is doing. Blood tests can be done more often and cheaper than a brain scan.”

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Flu vaccinations to become compulsory for care staff?

Plans to introduce mandatory flu jabs could be “one step too far” for an already under-pressure sector, leaders warn

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The introduction of compulsory flu vaccinations for care home staff could be “one step too far” for a sector already battling a recruitment crisis amidst the ongoing impact of COVID-19, leading professionals in the industry have told NR Times. 

The Government is currently consulting with key bodies in health and social care over whether to introduce a statutory requirement for vaccination against flu as a condition of employment for frontline workers. 

This follows the move to make COVID-19 double vaccination compulsory, which some forecasters predict could see up to 30 per cent of social care workers leave their roles in a sector already struggling to meet the soaring demand for its services, with an existing and growing shortfall of at least 80,000 staff nationally.

The consultation, which concludes next week, is likely to be met with “fury and outrage” by care operators, many of whom have battled to stay afloat over the past 18 months with mounting staffing and financial challenges. 

SAGE has advised that the combination of flu and COVID-19 could make this winter more of a threat than ever before to the most vulnerable people, particularly those in specialist care environments, and that vaccination is a tool in preventing the transmission of both.

In its consultation paper, titled ‘Making vaccination a condition of deployment in the health and wider social care sector’, the Department of Health and Social care says that flu vaccine uptake among social care workers in care homes was around 33 per cent last year – including 48 per cent for those directly employed and 36 per cent for those employed through an agency – which is significantly lower than uptake of the COVID-19 vaccine.

But for operators already under pressure to meet the needs of their residents while losing staff over the COVID-19 vaccination issue, the worry is that more leaving the profession over the compulsory flu jab may tip the balance. 

One senior figure in a care operator, who wished to remain anonymous, told NR Times: “This is one step too far, particularly so soon after we’ve been forced to lose good people because of the COVID vaccination. 

“Smaller operators are struggling to stay afloat. We’re doing all we can but these are very difficult times. People say we’re through the worst, and in some ways that is true, but the staffing situation is getting worse. By forcing more people out of the sector, the future is very worrying.” 

Paul TM Smith – consultant to Renal Health Ltd and a leading name in specialist care, who is also part of the Royal College of Nursing’s older people’s forum – confirmed to NR Times that the RCN was invited to be part of the consultation. 

“The recent report from MPs (Coronavirus: lessons learned to date) highlighted many failures in the Government’s handling of COVID, but also showed the success of the vaccination programme. There is absolute terror at the prospect of a fourth or fifth wave of COVID, particularly as we come into flu season,” he says. 

“So, given that, I can understand where this approach by the Government comes from – but the situation with the COVID vaccinations has been rushed through and care homes now risk being hit again. And I can’t see it being a one-off for this year, as COVID isn’t going away. 

“I think there will be fury when this becomes known, there will be outrage from many. I worry this could be one vaccination too far and I’d be hesitant to say I’m 100 per cent convinced a policy around compulsory flu vaccinations for staff would be a good thing.

“We’ve seen that clinical advice and political action can be poles apart, and the Government aren’t bound to take that advice. The implications for the sector need to be fully considered.”

While many social care workers will qualify for free flu jabs, not all will, and a lack of clarity also exists over who would have to fund compulsory vaccinations. 

“If it starts costing people to be vaccinated, people who are on low pay working in very challenging conditions, then it becomes a levy. And if this falls to operators, up to 85 per cent of whom are very small operations, this will be a very significant expense for them at a time when they can’t afford any more financial pressures,” says Paul. 

The care home operator adds: “For any care staff in our homes who didn’t qualify for a free flu vaccination, I couldn’t possibly allow them to pay; but then that’s yet another outlay for us. I would hope there may be some Government support there, and that they appreciate how under pressure we really are.”

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Long COVID symptoms ‘typically last up to six months’

Research shows more than half of people with COVID-19 will go on to experience long-term Long COVID symptoms

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More than half of the 236million people who have been diagnosed with COVID-19 worldwide since December 2019 will experience Long COVID symptoms up to six months after the initial virus, new research has revealed. 

During their illnesses, many patients with COVID-19 experience symptoms such as tiredness, difficulty breathing, chest pain, sore joints and loss of taste or smell.

But its impacts, both mentally and physically, can extend into a range of further debilitating issues which can last for months – which the research team at Penn State College of Medicine saying their study findings should leave governments, healthcare organisations and public health professionals in no doubt over the scale of COVID-19 survivors who will need care for a variety of psychological and physical symptoms.

Until recently, few studies have evaluated patients’ health after recovering from the Coronavirus. To better understand the short- and long-term health effects of the virus, the researchers examined worldwide studies involving unvaccinated patients who recovered from COVID-19.

According to the findings, adults, as well as children, can experience several adverse health issues for six months or longer after recovering from COVID-19.

The researchers conducted a systematic review of 57 reports that included data from 250,351 unvaccinated adults and children who were diagnosed with COVID-19 from December 2019 through to March 2021. 

The researchers analyzed patients’ health post-COVID during three intervals at one month (short-term), two to five months (intermediate-term) and six or more months (long-term).

According to the findings, survivors experienced an array of residual health issues associated with COVID-19. Generally, these complications affected a patient’s general wellbeing, mobility or organ systems. 

Overall, one in two survivors experienced long-term COVID manifestations and the rates remained largely constant from one month through to six or more months after their initial illness.

Issues with general wellbeing, mobility, neurological impacts and mental health disorders all featured heavily in the long-term symptoms. 

“These findings confirm what many health care workers and COVID-19 survivors have been claiming, namely, that adverse health effects from COVID-19 can linger,” said co-lead investigator Vernon Chinchilli, chair of the Department of Public Health Sciences. 

“Although previous studies have examined the prevalence of Long COVID symptoms among patients, this study examined a larger population, including people in high-, middle- and low-income countries, and examined many more symptoms. Therefore, we believe our findings are quite robust given the available data.”

“The burden of poor health in COVID-19 survivors is overwhelming,” said co-lead investigator Dr. Paddy Ssentongo, assistant professor at the Penn State Center for Neural Engineering. 

“Among these are the mental health disorders. One’s battle with COVID doesn’t end with recovery from the acute infection. Vaccination is our best ally to prevent getting sick from COVID-19 and to reduce the chance of Long COVID even in the presence of a breakthrough infection.”

The mechanisms by which COVID-19 causes lingering symptoms in survivors are not fully understood. These symptoms could result from immune-system overdrive triggered by the virus, lingering infection, reinfection or an increased production of autoantibodies. 

According to the researchers, early intervention will be critical for improving the quality of life for many COVID-19 survivors. They said that in the years ahead, healthcare providers will likely see an influx of patients with psychiatric and cognitive problems, such as depression, anxiety or post-traumatic stress disorder, who were otherwise healthy before their COVID-19 infection. 

Based on these findings, healthcare providers should plan and allocate resources accordingly in order to effectively monitor and treat these conditions, the team said. 

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A Chance for Life extends neurorehab in the North

The move will extend the range of patient services in the area and improves patient journeys

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Neurological physiotherapy provider Neurocare Physiotherapy now falls under the umbrella of complex case management and rehabilitation specialist A Chance for Life. 

The move extends the range of patient services in the North and improves patient journeys, too.

There is an inevitable challenge for any organisation delivering neuro rehab. With such a wide range of conditions to treat, it can be difficult for any organisation to build a pool of expertise large and diverse enough to service them all.

But Louise Chance, founder of A Chance for Life Ltd, the specialist in rehabilitation support work, case management, physiotherapy, occupational therapy and medico-legal reporting, has found a solution to that challenge.

Louise has combined her team’s capabilities with those of Lancashire-based Neurocare Physiotherapy. 

For almost two decades, Neurocare Physiotherapy has treated patients across the North West of England for neurological conditions such as stroke, multiple sclerosis (MS), Parkinson’s, foot drop, head injury and other disorders.

For much of that time, A Chance for Life has worked in a similar space from its base in Penrith, providing support for clients who often have a variety of social, physical, mental and vocational needs.

Louise saw an opportunity to bring the two organisations together: “We saw that what we do and where we do it dovetails nicely.

“Being able to expand the range of care we offer across the North of England and Southern Scotland is so important, because it means our clients can access more of the support they need from a single source.”

Get in touch to find out more on 01768 891709.

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