Prof. Nir Giladi
The Israeli population has great appeal for the world of medical research. Mass immigration to Israel has translated into a multitude of unique genetic backgrounds and ways of life. These populations enable the research community to identify causes of diseases. As such, they serve as a source for drug development, for new therapeutic interventions, for technological development to characterize diseases in early, preclinical stages, and for understanding processes in disease development, leading to drug development for health maintenance.
Building on this uniqueness, the largest clinical-biological-genetic database of Ashkenazi Parkinson’s patients in the world was established in Israel, at the Tel Aviv Sourasky Medical Center – Ichilov Hospital. The database was created thirteen years ago, and was reported by many widely distributed scientific publications. Within a few short years since its inception, research based on database revealed that a third of Ashkenazi Parkinson’s patients carry a genetic mutation that contributes to the eruption of the disease. They also discovered that mutations of two genes, GBA and LRRK2, are prevalent among roughly 8.3% of the Ashkenazi population, and are associated with a significantly higher risk for developing Parkinson’s disease.
The creation of the database and the scientific publications reporting on it spurred international collaborations, and attracted investments by key players in the research of Parkinson’s disease. For example, the Michael J. Fox Foundation, which is based in the US and invests over $100 million a year in advocating research for the prevention of Parkinson’s, began to support the expansion of the database by investing millions of dollars, and by collaborating with Columbia University and Mount Sinai Beth Israel Hospital in new York.
One promising research angle in battling degenerative brain diseases is a study being conducted on patients’ disease-free relatives (carriers of the mutated genes), who are at high risk for developing the disease, and a study on healthy carriers of the genetic mutation who become sick during the course of the study. The database built at the Tel Aviv Sourasky Medical Center – Ichilov Hospital creates exclusive knowledge about these two population groups. At the conclusion of ten years of research at the center, the US company Biogene discovered that the knowledge accumulated on the progression of Parkinson’s disease in Jewish Ashkenazi patients could also apply to the ten million Parkinson’s patients around the world, and to the tens of millions of people at risk of developing the disease. This knowledge could lead to the development of innovative therapies to prevent the disease.
Biogene initiated a collaboration with the hospital, and is investing tens of millions of shekels to advance and upgrade the clinical-biological database, while preserving Israeli researchers’ academic rights and sharing the fruits of research. This type of partnership serves as a basis for extending collaborations to additional fronts, such as technological development for characterizing the progression of Parkinson’s by use of miniature technology for monitoring movement at home, new imaging methods for diagnosing Parkinson’s disease with MRI or PET scans, technology for quantifying cognitive function and sleep characteristics, and identifying genetic traits that protect at-risk populations from developing Parkinson’s disease. Moreover, first and second phase studies and new drugs for preventing Parkinson’s disease being developed by Biogene are currently being tested in Israel in groundbreaking clinical trials.
Investments by multinational companies, such as the outlined collaboration with Biogene, would not have taken place if not for the identification of the inherent potential of studying the Ashkenazi population to crack the code of Parkinson’s disease. Similar potential lies in the research of additional degenerative nerve diseases, which are prevalent among other ethnic populations in Israel.
Written by Prof. Nir Giladi, director of the Neurology Division at the Tel Aviv Medical Center (Ichilov), responsible for the cathedral named after Shiratzki for neurology, Tel Aviv University; and Prof. Avi Or, director of the genetics center and director of the genome research laboratory, the Tel Aviv Medical Center (Ichilov), and a full professor from the pediatrics department and the department for molecular genetics and biochemistry, Tel Aviv University