Posted by Phillipa on March 3, 2011, at 21:02:00
Seems Ibuproben and not other over the counter pain or fever reducers is linked to prevention of Parkinson's disease. As PPARy involve (no idea what that is). Please it's also an inflammtory for brain which might or could explain why I felt great after 24 hours of 600mg of named med. CoulFrom Medscape Medical News > Neurology
Ibuprofen Use Linked to Lower Parkinson's Risk
Susan JeffreyAuthors and Disclosures
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Learn more March 2, 2011 Use of ibuprofen, but not other analgesics, is associated with a lower risk for Parkinson's disease (PD), a new study suggests.
Dr. Xiang GaoThe findings, using data from the large, ongoing, prospective cohorts, the Nurses' Health Study (NHS) and Health Professionals Follow-up Study (HPFS), were published online March 2 ahead of print in the March 8 issue of Neurology.
"Ibuprofen was associated with a 38% lower risk of Parkinson's disease, but we didn't find any significant protective effects for other NSAIDs [nonsteroidal anti-inflammatory drugs], for example, aspirin or acetaminophen," lead study author Xiang Gao, MD, PhD, from the Channing Laboratory at the Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, said in an interview.
Their results were supported by those of a separate meta-analysis of other such trials included in this report. The findings were presented last year at the American Academy of Neurology 62nd Annual Meeting in Toronto, Ontario, Canada, and reported by Medscape Medical News at that time.
Addressing Neuroinflammation?
Neuroinflammation may contribute to the pathology of Parkinson's disease, the study authors note, and use of NSAIDs in general, and ibuprofen in particular, has previously been linked to reduced risk for the disease.
Dr. Gao and colleagues published a previous report in 2003 using data from NHS and HPFS showing a reduced risk for PD with NSAIDs but not aspirin (Arch Neurol. 2003;60:1059-1064). A subsequent article by Dr. Gao's Harvard School of Public Health colleagues, using data from the American Cancer Society's Cancer Prevention Study II Nutrition Cohort, showed that ibuprofen, but not other NSAIDs, was associated with a reduction in PD risk of about 35% (Ann Neurol. 2005;58:963-967).
In the present study, the study authors analyzed data on 136,197 men and women included in the prospective cohorts of the NHS and the HPFS who were free of PD and other diseases at baseline in 1998 for the NHS and 2000 for the HPFS. The use of NSAIDs was assessed by questionnaire. For this analysis, they included only new incident cases since their previous report.
During 6 years of follow-up, there were 291 incident cases of PD. The study authors report that users of ibuprofen had a significantly lower risk of developing PD than nonusers and, further, that there was a dose-response relationship between the number of tablets taken per week and PD risk (P for trend = .01).
Table 1. Risk for Parkinson's Disease for Analgesic Use vs Nonuse
Agent Relative Risk (95% CI) P
Ibuprofen 0.62 (0.42 0.93) .02
Aspirin 0.99 (0.78 1.26) .86
Others NSAIDs 1.26 (0.86 1.84) .24
Acetaminophen 0.86 (0.62 1.18) .39CI = confidence interval; NSAIDs = nonsteroidal anti-inflammatory drugs
Further adjustment for self-reported gout, use of other types of analgesics, sleep duration, bowel movement, and use of antidepressants "did not materially change these results," they write.
They also performed an additional meta-analysis combining 5 published prospective studies, Dr. Gao added. "We found similar results," he said. "The use of ibuprofen is associated with around 30% lower risk of PD in this meta-analysis."
Table 2. Risk for Parkinson's Disease With Ibuprofen Use: Pooled Analysis
Agent Relative Risk (95% CI) P
Ibuprofen 0.73 (0.63 0.85) < .0001CI = confidence interval
The mechanism of an apparent advantage for ibuprofen is not clear, but ibuprofen can activate the PPARγ pathway, Dr. Gao noted. "That's a very important pathway for Parkinson's disease because it inhibits apoptosis, suppresses oxidative damage, and moderates inflammation in the brain," he said. "So we thought that is a potential mechanism why ibuprofen but not other NSAIDs are associated with a lower risk of Parkinson's disease but this is just a hypothesis."
If it's confirmed in a future clinical trial, ibuprofen could be a very useful and inexpensive new treatment for Parkinson's disease.
An important next step is to see whether use of ibuprofen can slow disease progression among PD patients, Dr. Gao said. "I hope in the future we'll have the opportunity to look at this potential effect of ibuprofen. If it's confirmed in a future clinical trial, ibuprofen could be a very useful and inexpensive new treatment for Parkinson's disease."Smoking, Coffee, Ibuprofen
In an editorial accompanying the publication, James H. Bower, MD, MSc, from the Department of Neurology at Mayo Clinic, Rochester, Minnesota, and Beate Ritz, MD, PhD, from the Department of Epidemiology at the University of California, Los Angeles. School of Public Health, are cautious in their assessment of the relationship between ibuprofen use and PD.
Although these observational studies are well-conducted and analyzed and have "excellent" participation rates that would minimize selection bias, short follow-up of 6 years could miss PD cases that can take up to 20 years to manifest, they suggest.
In addition, they ask, "Could gastrointestinal symptoms cause a patient with preclinical PD to be less likely to take ibuprofen regularly, thus explaining the association? The 2-year lag they employed and the long-term 'ibuprofen' use sensitivity analysis would not suffice to refute this alternative hypothesis."
Still, they are intrigued by the possible biological explanation suggested by the study authors that ibuprofen may act as a ligand for PPARγ, an inhibitor of apoptosis and oxidative damage.
"Are we ready to tell our patients with PD that they should start taking ibuprofen? Absolutely not," they conclude. "Nor should we tell them to start smoking, drinking coffee, and eating liver pâté in hopes of developing gout."
However, "just as prior epidemiologic associations have inspired the development of clinical trials for transdermal nicotine (smoking), istradefylline (coffee), and inosine (uric acid), a clinical trial for ibuprofen, or perhaps a safer PPARγ antagonist, may be warranted."
The study was supported by a grant from the National Institutes of Health (NIH)/National Institute of Neurological Disorders and Stroke (NINDS) and in part by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences. Dr. Gao reports he has received research support from NIH/NINDS. Disclosures for other coauthors appear in the article. Dr. Bower reports research support from the NIH. Dr. Ritz reports receiving research support from the NIH, the US Department of Defense, Environmental Protection Agency, Health Resources and Services Administration, and the Foundation for Psychocultural Research.
Could this be the missing link so to speak inflammation of brain psychiatric disorders? Phillipa
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