Baylor talks PPMI, biomarkers, and finding a cure

Baylor College of Medicine teams up with Michael J. Fox to unravel the deadly mysteries of Parkinson’s

By Caroline Gallay, Houston Culture Map

One of Houston’s major medical claims to fame is that it’s home to the nation’s single most respected cancer center.

While certainly a point of pride, this designation can sometimes overshadow the myriad other breakthroughs occurring across the massive Texas Medical Center system.

Take, for instance, the advances at Baylor College of Medicine in understanding Parkinson’s disease ? a neurological disorder that is diagnosed in more than 50,000 new cases each year. One of Parkinson’s most prominent patients is actor Michael J. Fox, who is leading the charge toward a cure.

Today, treatment remains centered around treating symptoms of the disease as researchers struggle to discern its cause.

The Parkinson’s Progression Markers Initiative (PPMI) is an observational clinical study sponsored by the Michael J. Fox Foundation that aims to use advanced imaging techniques, biologics sampling and behavioral assessment to better identify the biomarkers of the disease’s progression; Baylor College of Medicine is one of the initiative’s 18 official study sites.

Joseph Jankovic, BCM neurology professor and principal investigator at PPMI, tells CultureMap that Baylor has been involved in movement disorder research for more than 35 years, since he helped establish the Huntington’s Disease Center at the college. Jankovic also sits on the scientific advisory board of the Michael J. Fox Foundation for Parkinson’s Research, through which he was involved in the early development of PPMI.

“We have 10,000 visits here per year, so we were in a good position to be able to recruit the subjects that we needed,” Jankovic says of Baylor’s selection in 2010. Enrollment of PPMI participants is slated to continue for the next two years. “We are trying to recruit patients in very early stages of Parkinson’s ? 400 total, and 200 healthy controls. The study is designed to look at just about every imaginable biomarker.”

What is a biomarker, exactly?

“A biomarker is a clinical test that allows people to track their progression of the disease, but more importantly identify individuals who are at risk for developing the disease even before they exhibit any clinical symptoms,” Jankovic explains.

PPMI, which will follow participants for a minimum of three years and, Jankovic hopes, eventually be extended to follow patients for more than five years, is the largest biomarker study ever designed. Jankovic says it holds great promise both for those living with Parkinson’s disease and for those who’ve yet to be diagnosed.

“It provides hope that individuals who are at-risk can be identified through these biomarkers and eventually targeted for disease modifying therapy. For those that are living with the disease now, hopefully the study will identify tools we can use to track the progression of the disease, so when they are involved in the study that explores these modifying therapies, we can accurately track the response.”

Jankovic calls disease modifying strategies “the holy grail” of Parkinson’s treatment because they go beyond symptomatic treatments ? and he hopes PPMI helps him get there.

“I hope the study will identify biomarkers that are sensitive and specific,” Jankovic says. “Sensitive meaning they can detect very early manifestations of the disease or even individuals who do not yet manifest; specific meaning they differentiate this disease from other neurodegenerative diseases.”

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