# Repurposing Existing Therapies for Parkinson's Disease Risk and Phenoconversion

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2024 · $163,750

## Abstract

Project summary
Parkinson's disease (PD) is a prevalent and progressive neurological disorder impacting more than 1 million
Americans with a well-known prodromal period in which individuals experience non-specific symptoms before
receiving a diagnosis. Critically, this diagnosis often occurs after widespread, irreversible neurodegeneration has
already occurred. Those with PD then encounter an escalating burden of disability and symptom severity,
resulting in substantial direct medical expenses related to pharmaceutical treatments, hospitalizations, and
skilled nursing care. Despite the significant disease burden associated with PD, there is a scarcity of effective
preventive measures or risk reduction strategies, and limited understanding of factors that influence the rate at
which clinical PD develops or ‘phenoconversion’ for those with prodromal symptoms. Inflammation is an
emerging key disease process contributing to PD risk and may play a key pathogenic role during the prodromal
period. Conditions characterized by chronic inflammation and immune dysfunction, including several
autoimmune disorders, are considered potential risk factors for PD; certain immune agents used to treat these
conditions have also been associated with a lower risk of PD, offering a novel approach to reduce PD risk by
targeting immune processes. However, the results of existing are inconsistent, potentially due to inadequate
control for confounding or bias related to reverse causation; few have also assessed the impact of immune
factors on the rate of phenoconversion to clinical PD. The goals of this proposal are to evaluate whether long-
term exposure to immune therapies is a strategy to reduce PD risk and phenoconversion rates. For this study,
we will leverage genetic and risk factor information and detailed follow-up available as a part of three large-scale
biobanks in which we will consider comprehensive array of therapeutic agents used to treat a range of
autoimmune diseases (AIDs) as they relate to PD. Specifically, we will utilize the well-characterized effects of
genetic variation in influencing the expression or function of individual AID therapeutic targets as instruments to
help to understand the downstream effects of AID treatment on PD risk and phenoconversion. This epidemiologic
framework will be embedded within a comprehensive bioinformatic pipeline in which extensive differential
expression and epigenetic remodeling-based analyses at the single-cell level will further refine and characterize
novel immune-associated therapeutic targets in the context of PD. Our central hypothesis is that inflammatory
mechanisms contribute to both PD and AIDs, and that certain therapies approved to target immune processes
in AIDs may be novel strategies to mitigate PD risk and phenoconversion. The collective results of this project
will (1) help to improve risk stratification; (2) unravel new mechanisms contributing to disease risk and
progression in PD’s early stages; and...

## Key facts

- **NIH application ID:** 10867785
- **Project number:** 1R21NS136978-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Kathryn C. Fitzgerald
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $163,750
- **Award type:** 1
- **Project period:** 2024-02-15 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10867785

## Citation

> US National Institutes of Health, RePORTER application 10867785, Repurposing Existing Therapies for Parkinson's Disease Risk and Phenoconversion (1R21NS136978-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10867785. Licensed CC0.

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