Page 19 - PULSE@UM 2nd Issue 2019

research spotlight research spotlight

Although this review was a collaborative effort point to important differences, e.g., in
LANDMARK LANCET NEUROLOGY PUBLICATION ON PARKINSON’S involving many key leaders in the Asia-Pacific environmental risk factors.
DISEASE IN THE ASIA-PACIFIC REGION region and beyond, the paper was initiated and
led by University of Malaya (UM) with Prof. • There is likely to be a different weightage
Lim Shen Yang, Assoc. Prof. Tan Ai Huey and for PD environmental risk and protective
Dr. Azlina Ahmad Annuar being the first three factors in the WPR, relating to pesticide
authors, and Prof. CT Tan providing guidance use, smoking, consumption of tea and
especially in the nascent stage of manuscript dairy products, exercise, diabetes, and
preparation. For Prof. Lim, getting this review infections such as hepatitis C. Many
published was a fitting culmination to serving of these require further study and, if
in various roles in the International Parkinson confirmed, will have important public health
and Movement Disorder Society - Asian implications as discussed in the Review.
Oceanian Section (MDS-AOS) including Chair
of the Education Committee, and Honorary • Some genetic factors underlying PD are
Secretary over the past decade, as well as distinctly different in WPR populations.
lecturing and gaining firsthand experience in Taking the LRRK2 gene as the prototypical
many countries in the AOS and beyond under example, G2385R and R1628P (known as
the auspices of the MDS. Prof. Anthony Lang “Asian variants”) are seen in Asians and
from the University of Toronto, a long-standing not Caucasians with PD, whereas the
collaborator and UM Academic Icon (with an converse is true for the G2019S mutation.
h-index >150!) (Figure 2), was a senior author In turn, these genetic differences may
of the paper. have important implications in the basic

Panel of Plenary Speakers and Chairs (left to right): pathogenetic mechanisms (G2019S
Prof. Shen-Yang Lim, Prof. Roger Barker (Chair; University of Cambridge, UK), Prof. Jeffrey Kordower (Rush University, USA), Prof. Per The review has already been hailed as resulting in increased kinase activity,
Borghammer (Aarhus University, Denmark), Ms. Heather Kennedy (USA) and Prof. Hideki Mochizuki (Co-Chair; Osaka University).
an “important landmark” and “standard whereas other mechanisms may be at
reference” by other leading figures in the PD play with the Asian variants). Recognition
PROF DR LIM SHEN-YANG
DEPARTMENT OF MEDICINE within the next couple of decades. In addition, field, providing a valuable resource to readers and understanding of these inter-ethnic
disease heterogeneity has been increasingly and offering numerous critical insights that differences are vitally important as the
here is a huge and increasing burden of recognised to be a crucial aspect of the will help to move the field forwards. PD field enters the era of genetics-based
Tdegenerative disorders worldwide. In fact, disease. In the past decade, several Asian targeted therapies.
the prevalence of Parkinson’s disease (PD) countries have emerged among the global top Among some major highlights of the paper:
was the fastest-growing of all neurological 10 in terms of PD-related publications. Thus, a • There are differences in pharmacological
disorders from 1990-2017, according to review on PD in this region is extremely timely. • Overall, a lower prevalence of PD has management in the WPR which may
the Global Burden of Disease, Injuries and A state-of-the-art discussion on “Parkinson’s been observed in some Western Pacific partly account for substantial differences
Risk Factors Study (GBD), a very extensive disease in the Western Pacific Region” was Region (WPR) countries such as Japan in clinical features such as motor
epidemiological survey funded by the Bill and published in the Lancet Neurology (Lim, and Singapore, despite the relatively high complications and non-motor symptoms.
Melinda Gates Foundation (Dorsey, 2018). 2019) in conjunction with the recent World proportion of aged individuals and the These factors could potentially be
Parkinson’s Congress (WPC) in Kyoto, Japan. long-life expectancies in these countries. exploited or addressed to improve patient
The Asia-Pacific region is poised to face the Prof. Lim was able to highlight some aspects A reversal of the usual male predominance symptomatology.
brunt of this disease burden, with China alone of the Review in his Plenary lecture at the WPC of the disease has also been observed
projected to have the majority of PD patients (Figure 1). in Japan and South Korea and may • Comorbidities such as diabetes, cerebral

18 19