Parkinson’s Disease (PD) is the second most common neurodegenerative disease worldwide, affecting about 1 million people in the US, another 1 million in the EU, 2.5 million in China, and about 10 million people worldwide. In the coming year, 25,000 patients in the US will die as a direct result of PD and another 60,000 people will learn that they have it. In the US, the cost of PD exceeds $15 billion per year.
PD is best known for the motor symptoms of the disease, that is altered posture, rigidity, shuffling gait and tremor. These symptoms occur because the substantia nigra gets clogged up with a protein called alpha synuclein (αS) and stops sending dopaminergic signals to the basal ganglia. Most patients manage their motor symptoms by taking dopamine and drugs that mimic dopamine or help raise its levels in the brain. However, there is no cure for the motor symptoms of PD, and these therapies improve symptoms without slowing or halting the disease progression.
We have known for many years that people who develop PD often have a history of bowel issues, primarily constipation, a problem that is often present for many years before the motor-related symptoms of PD appear. In fact, at least 60% to 80% of PD patients suffer from such constipation. Soon thereafter, a series of other symptoms develop; these include loss of smell, sleep disturbance, depression, anxiety, fatigue, and progressive cognitive deterioration. Motor symptoms occur late in the course of the disease, as do psychosis and dementia.
People with PD are often more impacted by their non-motor symptoms than motor symptoms. The non-motor symptoms of PD are responsible for much of the economic burden and reduced quality-of-life for PD patients. There is currently only one treatment specifically approved for a non-motor symptom of PD (Nuplazid® for hallucinations and delusions associated with PD psychosis). Nevertheless, significant unmet need remains to address both hallucinations and the many other non-motor symptoms of PD. Enterin is now developing ENT-01 to address these unmet needs.
Other Neurodegenerative Diseases
Not surprisingly, there has been a growing body of research showing the influence of the gut-brain axis on a number of neurodegenerative diseases, not only PD. In fact, as with PD, constipation, sleep and mood disturbance affect a majority of patients with Alzheimer’s Disease, Multiple Sclerosis, Multiple System Atrophy, and even children with Autism Spectrum Disorder. In addition to our clinical assessment of ENT-01 in Parkinson’s Disease, Enterin is also evaluating ENT-01 and related compounds for the treatment of other conditions, including Autism Spectrum Disorder.