This is another interesting study borne out of large USA health
insurance databases (Medicare database). The team from Washington noticed, whilst
using the same data to see if they could identify people at high risk of
Parkinson’s, that people with Parkinson’s were less likely to have received an
organ transplant than someone without Parkinson’s. This implies that people who
have had organ transplants have a reduced risk of Parkinson’s. They decided to
investigate this further because it could important implications in developing
a medication to prevent Parkinson’s.
They identified 94,155 people with Parkinson’s and then they
randomly selected 118,295 people without Parkinson’s in a similar age group.
Overall 278 people with Parkinson’s had also had a tissue transplant and 302 of
the people without Parkinson’s had a tissue transplant. They found that the
odds of having Parkinson’s after a tissue transplant were reduced.
It’s unclear what is causing this effect but one of the
possibilities is the medication that transplant patients are on. People who
have received transplants are usually started on medication that lowers the
body’s immune system to prevent the body rejecting the transplant. It is
possible that these medications could be protecting the brain in some way from
Parkinson’s. Unfortunately we cannot be sure at the moment and more research is
needed to understand the science underlying this!
Parkinsonism Relat Disord. 2019 Feb 14. pii:
S1353-8020(19)30059-8. doi: 10.1016/j.parkreldis.2019.02.013. [Epub ahead of
print]
Transplant and risk of Parkinson disease.
Fan J1, Searles Nielsen S2, Faust IM3, Racette BA4.
Author information
Abstract
INTRODUCTION:
The pathophysiology
of Parkinson's disease (PD) remains unclear, but growing
evidence supports a role of neuroinflammation. The purpose of this study was to
investigate the association between tissue transplantation and PD risk, given
the importance of immunosuppressants in post-transplant management.
METHODS:
We performed a
case-control study among Medicare beneficiaries age 66-90 using claims from
2004 to 2009. We used International Classification of Diseases, Ninth Edition
(ICD-9) and Current Procedural Terminology (CPT) codes to identify PD (89,790
incident cases, 118,095 population-based controls) and history of tissue
transplant (kidney, heart, liver, lung, and bone marrow). We investigated risk
of PD in relation to tissue transplant in logistic regression models, adjusting
for age, sex, race, smoking, and overall use of medical care.
RESULTS:
Beneficiaries who had
received a tissue transplant at least five years prior to PD diagnosis or
reference had a lower risk of PD (odds ratio [OR] 0.63, 95% confidence interval
[CI] 0.53, 0.75) than those without tissue transplant. This inverse association
was observed for kidney (OR 0.63, 95% CI 0.47, 0.84), heart (OR 0.58, 95% CI
0.40, 0.83), lung (OR 0.41, 95% CI 0.21, 0.77), and bone marrow (OR 0.57, 95%
0.38, 0.85) transplants. Associations were attenuated, but remained, following
adjustment for indications for the respective type of transplant. Liver
transplant was not associated with PD risk.
CONCLUSIONS:
Patients undergoing
tissue transplant may have a lower risk of developing PD than the general population.
Further studies are needed to determine if this association is causal and if
immunosuppressants mediate this association.
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