There is a great deal of variability between individuals with Parkinson's in terms of features like symptoms and speed of disease progression.

Given these differences, many researchers believe that we may not be dealing with a single condition, but rather a 'syndrome' - that is, a collection of different diseases that appear very similar. This idea has led to a lot of research focused on attempting to define possible 'subtypes' of Parkinson's, where the disease is categorised into groups according to dominant symptoms. This approach will hopefully lead to more targeted and relevant treatments for people with Parkinson's in the future.

Researchers at Sheffield and Oxford Universities have recently published research exploring this idea. They took skin cells from 100 people with Parkinson's and skin cells from 50 age-matched control people without Parkinson's, and they analysed the health of all the cells according to two functions: energy production within the cell and how well the cells coped with waste products.

Whilst there was little difference between the Parkinson's cell samples and the control cell samples in both sets of experiments, there were a lot of differences between the Parkinson's cells samples themselves - with much greater variability than the control samples - which allowed for distinct subgroups to be identified.

The researchers also treated some of the cells with a drug called ursodeoxycholic acid (or UDCA). This is a medication that is already used for treating gallstones , which has previously demonstrated interesting results in models of Parkinson's. Read more about UDCA in Parkinson's. The researchers reported that UDCA treatment restored the Parkinson's cells to normal levels of energy production.

Read more about this trial.

We are interested in this new study for two reasons: firstly, it proposes a cell culture-based approach that could one day become a routine part of selecting which drugs may benefit particular people with Parkinson's; and secondly, the study provides further support for a clinical study of UDCA led by Professor Oliver Bandmann and funded by The Cure Parkinson's Trust, Van Andel Institute and JP Moulton Charitable Foundation.

This UDCA trial - the UP-Study - is a phase II, placebo controlled, double blind, randomised clinical study assessing the safety and tolerability of UDCA in people with Parkinson’s. This study has recruited 30 individuals who are being blindly treated for 48 weeks with either UDCA or a placebo control. The results of this study are expected in early 2021. Read more about the UP-Study in Parkinson's.