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Will targeted therapy help in Pick’s disease??

Pick's disease (PD) is a form of dementia that resembles Alzheimer's but it is much less prevalent. It has an impact on the brain regions that control emotions, behavior, personality and speech. Frontotemporal dementia (FTD) or frontotemporal lobar degeneration (FTLD) are the additional names for this particular disorder. Several drugs have been proposed for the treatment of Pick’s disease but none of them are e properly effective till now. So, recent studies are said to be focused on targeted therapy to reduce pick’s disease.


What is the treatment for pick’s disease?


Pick’s disease

Unfortunately, there is no properly approved treatment for Pick’s disease. The medications that are commonly used in the frontotemporal dementia group of disorders can be tried in Pick’s disease to get relief from the cognitive and behavioral symptoms. The medications include selective serotonin reuptake inhibitors (SSRI) like fluoxetine, sertraline, paroxetine, fluvoxamine and citalopram. In severe cases where this group of drugs are ineffective, antipsychotic medications, preferably quetiapine or olanzapine can be considered. But they should be avoided as far as possible because of their extrapyramidal side effects. These pharmacological interventions should be combined with non- pharmacological measures like cognitive and behavioral therapy to get relief from the symptoms of Pick’s disease.


According to the systematic reviews, these medications are somewhat effective in relieving symptoms of Pick’s disease, but the cost effectiveness is debatable. Numerous research and development studies are underway to develop disease-modifying therapies for the treatment of Pick’s disease. Targeted therapy is one of them [1].


What is targeted therapy?

  • In general, targeted therapy is a type of treatment commonly used in cancers. Drugs are used to specifically target the genes and proteins that support the growth and survival of cancer cells.

  • The cancer cells create one environment for their favorable growth. The targeted therapy will alter this environment. It can also modify blood vessels that support the growth of these cancer cells.

  • Many different types of cancers can be treated with this targeted therapy. This therapy is always used in addition to other cancer treatments like chemotherapy for better results.

  • Although not all cancers can currently be treated with targeted therapies, but definitely this is a field of study that is expanding quickly. These new targeted therapies are also being tested in clinical trials for other conditions like age-related diseases, neurodegenerative diseases, heart diseases, etc; [2].


Will this therapy help in pick’s disease?

  • The underlying pathology in Pick’s disease is the excessive deposition of Pick bodies, a type of tau protein.

  • Tau proteins are the proteins that are normally present in the nervous system. They help to stabilize the microtubules, a component that determines the shape of the nerve cells.

  • The genes that contribute to the secretion of these Pick bodies are microtubule-associated protein tau (MAPT), and progranulin (GRN).

  • Defects in any of these genes will lead to abnormalities or over-accumulation of Pick bodies, leading to the development of pathologies in the nervous system [3].

  • Numerous targeting therapies have evolved targeting these tau proteins and are currently under clinical trials.

  • These therapies act by reducing the over-expression of genes, thereby preventing excessive tau aggregation, or they may directly act on microtubules by stabilizing them.

  • Several clinical trials of therapeutic strategies involving these targeted therapies are currently being under research to test the hypothesis [4].


A ray of hope in future!


As Pick’s disease does not have a standard treatment regime till now, targeted therapy undoubtedly will become the new hope of treatment for this disease in the future. But further research is required in knowing the efficacy of this targeted therapy against the genes that cause abnormal deposition of Pick bodies (tau protein) in Pick’s disease.


References


1. D. Coughlin and D. J. Irwin, “Emerging Diagnostic and Therapeutic Strategies for Tauopathies,” Curr Neurol Neurosci Rep, vol. 17, no. 9, p. 72, Sep. 2017, doi: 10.1007/s11910-017-0779-1.

2. “Frontiers| New Insights into Drug Discovery Targeting Tau Protein.” https://www.frontiersin.org/articles/10.3389/fnmol.2020.590896/full (accessed Jan. 14, 2023).

3. W. K. Martins et al., Autophagy-targeted therapy to modulate age-related diseases: Success, pitfalls, and new directions,” Current Research in Pharmacology and Drug Discovery, vol. 2, p. 100033, Jan. 2021, doi: 10.1016/j.crphar.2021.100033.

4. F. Panza et al., “Development of disease-modifying drugs for frontotemporal dementia spectrum disorders,” Nat Rev Neurol, vol. 16, no. 4, pp. 213–228, Apr. 2020, doi: 10.1038/s41582-020-0330-x.

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Collaborators

IIT Guwahati
University of Manchester
Rhenix Lifesciences
American university of Sharjah
IIT Delhi
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