Ask the doctors: Asthma medications may reduce the risk of Parkinson’s

Dear Doctor: Can asthma medications really reduce the risk of Parkinson’s disease? It runs in my family, so should I start taking the medications as a preventive?

Dear Reader: A few years ago, research published in the journal Science revealed a surprising property of several drugs, including those that contain compounds known as beta-2 adrenergic agonists. These are found in drugs like salbutamol, also known as albuterol, a bronchodilator used to help open the airways of people with asthma and other respiratory diseases.

The stated goal of the research was to identify any existing drugs or compounds that could diminish or eliminate the presence of alpha-synuclein, a protein that accumulates in the brains of people with Parkinson’s disease. To that end, the team of researchers cultured human nerve cells in the lab and exposed them to more than 1,100 different medications, dietary supplements and vitamins. In the course of their testing, they identified several compounds that interfered with the production of that protein. These included asthma medications that contain beta-2 adrenergic agonists. This suggested that certain asthma meds may have potential in the management of Parkinson’s disease.

Parkinson’s disease is a progressive neurological disorder that affects the areas of the brain that control movement and balance. An estimated 1 million Americans are currently living with the disease. The disease develops gradually and is most often diagnosed in later years, at around age 60 or older. Symptoms can include tremors, slowed movement, muscle stiffness or rigidity, difficulty standing, poor balance, difficulty walking, changes to speech and vocal expression, changes to handwriting and in some cases, loss of cognitive function.

Although it is known that the symptoms of Parkinson’s are linked to changes in the brain that cause certain cells and tissues to malfunction and die, the reason this happens is not yet known. However, scientists have observed a buildup of protein clumps, known as Lewy bodies, in the brains of Parkinson’s patients. It’s because Lewy bodies consist mainly of alpha-synuclein that the researchers we’re discussing began their search for compounds to interfere with that specific protein.

Once the researchers isolated the drugs that interfere with alpha-synuclein, they needed a way to identify asthma patients and their health outcomes. They found what they needed in a database in Norway, which tracks all prescription medications. The researchers selected a group of 600,000 individuals who had used the asthma drug that we in the United States know as albuterol. When they looked at the incidence of Parkinson’s disease among all individuals in the drug database over the course of an 11-year period, it turned out that people who had used albuterol were 30 percent less likely to develop Parkinson’s than those who had never used the asthma medication. Those who used the highest doses of albuterol had half the incidence of Parkinson’s disease, according to the study.

As to your question about using asthma meds as a preventive, the researchers say – and we wholeheartedly agree – the answer is no. The origins of Parkinson’s disease are unclear, and the findings from the study are not fully understood. However, this new research is promising and is likely headed to clinical trials. We haven’t heard the last of it.