Gout is a well-known disease, often referred to in a comedic way, despite causing an incredible level of pain to sufferers. It occurs in about 1-2% of the Western population, primarily thought to be because of the diet, although the cause is a combination of diet and genetic factors.
It occurs more commonly in those who eat a lot of meat, drink a lot of beer, or are overweight. The underlying mechanism involves elevated levels of uric acid in the blood. At high levels, the uric acid crystallizes and the crystals deposit in joints and tendons, leading to painful inflammation and disability in the acute phase.
It has been around for a very long time – evidence of uric acid deposition in joints has been found in mummified Egyptian remains in Philae dating from approximately 4000 years ago. However, Hippocrates was thought to be the first person to accurately describe it around 400 BC.
So why an article about gout on a Parky page? High levels of urate occur in some individuals, thought to give them a predisposition to gout. However, there is also a lower incidence of Parkinson’s in this group. It has also been observed that those with Parkinson’s who have a high urate level show slower progression of the disease. Sometimes, observations such as this can be a chance occurrence (incidental) or be having an actual effect (causative) – so which is it and could this help Parky people?
High urate levels can be created artificially by taking a dietary supplement called inosine, which the body converts to create urate. Having made the observations that there may be a potential link between urate levels and PD progression, scientists were funded by the Michael J Fox Foundation (MJFF) to run a study dosing Parky people with inosine. This study showed that taking inosine increases urate levels in the blood and brain and is both safe and tolerable.
There is now an ongoing study to see if the high levels of urate are actually having an effect on Parkinson’s. This is being run in the United States, funded by the National Institutes of Health and led by the Parkinson’s Study Group. Known as SURE-PD3, the study aims to enroll 270 people across 60 U.S. clinics and will run for two-years. Parky people who have been diagnosed in the last three years will be invited to take part.
In the background, the MJFF is also funding studies to look into any potential interactions to ensure that inosine does not cause any interactions with current Parkinson’s treatments or cause them to be less effective. This is a Phase III study, which means it is in the last stage of clinical testing so if all of these study results are positive, this could mean that inosine may be used as the first ‘disease-modifying’ treatment given to Parky people to slow the progression of the disease.
All studies are designed to minimise bias to the outcome, so although the team managing the study is optimistic that their hunch is correct, they will not know the outcome until the results are final and there is always the possibility that no effect may be seen when tested in a large group of patients. However, if the results are positive, inosine could be approved for use to modify Parkinson’s disease progression within the next few years.
Further information can be found HERE
One very important note from the research team: Inosine is available commercially as a dietary supplement, but patients should act with caution. Inosine has not been proven as a therapy for Parkinson’s, and in the absence of medical supervision, it can cause serious side effects such as gout, kidney stones and possibly high blood pressure. As with all early-stage research, it’s critical to discuss any medications or natural supplements with your physician before taking them.