Can Angiogenesis Treat Parkinson's?

Angiogenesis is the new growth of blood vessels from existing arteries, veins, and capillaries (vasculature). These new blood vessels supply oxygen through the blood to the oxygen-starved areas of the body. Current research into how angiogenesis can be controlled has the potential to impact cancers, heart disease, wounds, and many other diseases, including Parkinson’s disease (PD).

Vascular system explained

A general understanding of the vascular system inside the body is necessary to understand angiogenesis. The vascular system is the body’s network of blood vessels:

• Arteries carry oxygen-rich blood from the heart to the tissues and organs.
• Veins carry blood and waste products back to the heart.
• Capillaries are tiny blood vessels connecting small arteries to small veins.

The thin capillary walls exchange materials, including oxygen, between tissues and blood.

What is angiogenesis?

Angiogenesis is the new growth of blood vessels from the existing arteries, veins, and capillaries (vasculature). The body often needs new blood vessels to ensure that tissues and organs receive enough oxygen. Current research into how angiogenesis can be controlled has the potential to impact cancers, heart disease, wounds, and many other diseases, including PD.

According to the Angiogenesis Foundation, angiogenesis is an essential and natural process for healing and reproduction. The body controls angiogenesis and keeps body tissue in balance. As a result, when an imbalance occurs, there is either too much or not enough angiogenesis.

How does angiogenesis support life?

All parts of the body require oxygen to burn (metabolize) the parts of cells that create energy and growth. Capillaries carry oxygenated blood to all tissues in the body. The more capillaries, the more oxygen, which leads to better metabolism (the chemical process of life). Therefore, increasing angiogenesis to parts of the body that are starved for oxygen means new growth in areas that were formally dying.

On the other hand, for unwanted growth, such as a cancerous tumor, we want fewer capillaries delivering oxygen that ultimately gives the tumor life. Therefore, decreasing angiogenesis in unwanted growth areas will cause tumor death and could eliminate cancer.

The ability to control angiogenesis by creating more or less blood supply to a targeted area could mean healing those diseases with the common denominator of abnormal blood vessel growth — either too much or too little angiogenesis.

Two types of angiogenesis are currently being investigated for treating PD:

1. Angiogenesis-based medicine. These attempt to restore the body’s natural control of angiogenesis through medication.
2. Therapeutic angiogenesis. This stimulates angiogenesis where it is lacking.

Angiogenesis-based medicine and PD

To date, no angiogenesis-based medication is available for treating PD. However, there is research into angiogenesis-based medicine for PD.

One medication under investigation for PD is nilotinib, an angiogenesis-based medication that is already approved for treating chronic myelogenous leukemia (CML). In CML, nilotinib targets and kills the cells that cause cancerous growth. Death of the CML cells can slow or stop cancer. Nilotinib works at the same level in the brain where PD damage occurs, thus being of interest as a possible treatment for PD.

To date, PD research on nilotinib has been shown to increase angiogenesis in the brain where PD damage occurs but demonstrates no improvement in PD motor symptoms. Therefore, researchers recommend more extensive research trials to understand if nilotinib can improve PD symptoms. While nilotinib may not be the answer, the second type of angiogenesis may have more potential in treating PD.

Therapeutic angiogenesis and PD

Therapeutic angiogenesis products are already available for chronic wounds, peripheral artery disease, and ischemic heart disease to restore form and function to the affected tissue. Unfortunately, at this time, no therapeutic angiogenesis is available for treating PD. However, at least one treatment in the research phase holds promise.

The new treatment is based on fibroblast growth factors (FGFs). These protein molecules exist naturally in the body and promote tissue repair and regeneration. There are 23 FGFs identified through research. Specifically, FGF-1 and FGF-2 have been proven to promote angiogenesis.

One company, Zhittya Genesis Medicine (Zhittya), believes that FGF-1 promotes angiogenesis in PD patients, improves PD motor symptoms, and possibly a cure. To date, medical trials are being conducted outside the U.S. due to FDA denial. However, the information provided by Zhittya states that they are now conducting the animal toxicity studies required by the FDA and will reapply in January 2024.

Angiogenesis trial patients

The product developed by Zhittya, FG-1, targets the area in the brain damaged by PD that needs more oxygen supplied by blood vessels. Zhittya is in the process of research trials of intranasal FG-1. So far, there have been 28 patients treated with very early results showing improvement in PD symptoms.

News coverage about Bobby Hill, one of the first FG-1 trial patients, tells an encouraging story.

"For me, I’m able to shave again with my right hand. I’m able to brush my teeth with my right hand. I’m able to eat with my right hand, so it may not mean much to you, but for somebody who hasn’t been able to do it for 16 years, it’s wonderful, you know."

Bobby Hill, the first FG-1 trial patient

The results for intranasal FG-1 are promising, but there are many more steps before Zhittya can conduct human trials in the U.S. According to information from Zhittya, it could be 2033 or later before all the trials are complete and the drug passes the FDA Drug Development Process. Then, according to Zhittya, it will take 12-36 more months for approval from Medicare and other insurers, which will be the year 2035 for patients to have access to FG-1.

A more promising approach is described by Zhittya is to achieve an FDA Breakthrough Therapy designation which, if everything goes to plan, would have FG-1 available for PD patients in 2027.

In the meantime, Zhittya will continue to recruit people with PD into their human medical trials to obtain more proof that FG-1 improves PD symptoms and does not cause harm to the people that use it.

Will angiogenesis treat PD in the future?

Based on existing research, both angiogenesis types can potentially treat PD. However, more research is needed before any angiogenesis treatments reach PD patients. According to the Angiogenesis Foundation, angiogenesis treatments are available for cancer, blinding diseases, wounds, peripheral artery disease, and ischemic heart disease.

With continued PD research in the field of angiogenesis, there is reason to be hopeful that researchers will find a safe and effective application for PD.