Feasibility of repeat and bilateral submandibular gland needle biopsies in Parkinson's disease

Charles H. Adler, Geidy E. Serrano, Nan Zhang, Michael L. Hinni, David G. Lott, Shyamal H. Mehta, Lucia I. Sue, Anthony Intorcia, Thomas G. Beach

Research output: Contribution to journalArticle

Abstract

Introduction: Submandibular gland (SMG) biopsies detect pathological alpha-synuclein (aSyn) in patients with Parkinson's disease (PD). The objectives of this study were to determine 1) the feasibility of performing a second SMG biopsy in previously biopsied patients, 2) the feasibility of doing bilateral SMG biopsies, 3) laterality of aSyn density, 4) whether aSyn density changes over time. Methods: Seven PD patients (6 males) previously having positive unilateral SMG biopsies underwent bilateral needle biopsies. Staining with a validated antibody to pathologic p-serine 129 aSyn was performed. Results: Mean age at time of second biopsy was 76 years and mean time between biopsies was 4.1 years. Five subjects had sufficient SMG tissue bilaterally and two only unilaterally for a total of 12/14 glands biopsied having sufficient tissue, all 7 subjects having sufficient tissue on at least one side, and all 12 glands being aSyn positive. There was a 4x increase in aSyn density on average in the repeat biopsy, with 5 subjects having an increase, one no change, and one a decrease in density. Side effects were similar to previous reports; mainly bruising, swelling, slight bleeding. Conclusions: This is the first published study of bilateral transcutaneous needle biopsies of the SMG in living patients with PD which showed better tissue acquisition and a change in aSyn density over time. While further study is needed, there is potential for SMG biopsies to serve as a tissue biomarker for PD disease progression and potentially as a peripheral outcome measure for anti-aSyn treatment.

Original languageEnglish (US)
Pages (from-to)69-72
Number of pages4
JournalParkinsonism and Related Disorders
Volume68
DOIs
StatePublished - Nov 2019

Fingerprint

alpha-Synuclein
Submandibular Gland
Needle Biopsy
Parkinson Disease
Biopsy
Serine
Disease Progression
Biomarkers
Outcome Assessment (Health Care)
Staining and Labeling
Hemorrhage
Antibodies

Keywords

  • Biopsy
  • Parkinson's disease
  • Submandibular gland
  • Synuclein

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Feasibility of repeat and bilateral submandibular gland needle biopsies in Parkinson's disease. / Adler, Charles H.; Serrano, Geidy E.; Zhang, Nan; Hinni, Michael L.; Lott, David G.; Mehta, Shyamal H.; Sue, Lucia I.; Intorcia, Anthony; Beach, Thomas G.

In: Parkinsonism and Related Disorders, Vol. 68, 11.2019, p. 69-72.

Research output: Contribution to journalArticle

Adler, Charles H. ; Serrano, Geidy E. ; Zhang, Nan ; Hinni, Michael L. ; Lott, David G. ; Mehta, Shyamal H. ; Sue, Lucia I. ; Intorcia, Anthony ; Beach, Thomas G. / Feasibility of repeat and bilateral submandibular gland needle biopsies in Parkinson's disease. In: Parkinsonism and Related Disorders. 2019 ; Vol. 68. pp. 69-72.
@article{83991fea774e464d954bd1eda426584d,
title = "Feasibility of repeat and bilateral submandibular gland needle biopsies in Parkinson's disease",
abstract = "Introduction: Submandibular gland (SMG) biopsies detect pathological alpha-synuclein (aSyn) in patients with Parkinson's disease (PD). The objectives of this study were to determine 1) the feasibility of performing a second SMG biopsy in previously biopsied patients, 2) the feasibility of doing bilateral SMG biopsies, 3) laterality of aSyn density, 4) whether aSyn density changes over time. Methods: Seven PD patients (6 males) previously having positive unilateral SMG biopsies underwent bilateral needle biopsies. Staining with a validated antibody to pathologic p-serine 129 aSyn was performed. Results: Mean age at time of second biopsy was 76 years and mean time between biopsies was 4.1 years. Five subjects had sufficient SMG tissue bilaterally and two only unilaterally for a total of 12/14 glands biopsied having sufficient tissue, all 7 subjects having sufficient tissue on at least one side, and all 12 glands being aSyn positive. There was a 4x increase in aSyn density on average in the repeat biopsy, with 5 subjects having an increase, one no change, and one a decrease in density. Side effects were similar to previous reports; mainly bruising, swelling, slight bleeding. Conclusions: This is the first published study of bilateral transcutaneous needle biopsies of the SMG in living patients with PD which showed better tissue acquisition and a change in aSyn density over time. While further study is needed, there is potential for SMG biopsies to serve as a tissue biomarker for PD disease progression and potentially as a peripheral outcome measure for anti-aSyn treatment.",
keywords = "Biopsy, Parkinson's disease, Submandibular gland, Synuclein",
author = "Adler, {Charles H.} and Serrano, {Geidy E.} and Nan Zhang and Hinni, {Michael L.} and Lott, {David G.} and Mehta, {Shyamal H.} and Sue, {Lucia I.} and Anthony Intorcia and Beach, {Thomas G.}",
year = "2019",
month = "11",
doi = "10.1016/j.parkreldis.2019.10.006",
language = "English (US)",
volume = "68",
pages = "69--72",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Feasibility of repeat and bilateral submandibular gland needle biopsies in Parkinson's disease

AU - Adler, Charles H.

AU - Serrano, Geidy E.

AU - Zhang, Nan

AU - Hinni, Michael L.

AU - Lott, David G.

AU - Mehta, Shyamal H.

AU - Sue, Lucia I.

AU - Intorcia, Anthony

AU - Beach, Thomas G.

PY - 2019/11

Y1 - 2019/11

N2 - Introduction: Submandibular gland (SMG) biopsies detect pathological alpha-synuclein (aSyn) in patients with Parkinson's disease (PD). The objectives of this study were to determine 1) the feasibility of performing a second SMG biopsy in previously biopsied patients, 2) the feasibility of doing bilateral SMG biopsies, 3) laterality of aSyn density, 4) whether aSyn density changes over time. Methods: Seven PD patients (6 males) previously having positive unilateral SMG biopsies underwent bilateral needle biopsies. Staining with a validated antibody to pathologic p-serine 129 aSyn was performed. Results: Mean age at time of second biopsy was 76 years and mean time between biopsies was 4.1 years. Five subjects had sufficient SMG tissue bilaterally and two only unilaterally for a total of 12/14 glands biopsied having sufficient tissue, all 7 subjects having sufficient tissue on at least one side, and all 12 glands being aSyn positive. There was a 4x increase in aSyn density on average in the repeat biopsy, with 5 subjects having an increase, one no change, and one a decrease in density. Side effects were similar to previous reports; mainly bruising, swelling, slight bleeding. Conclusions: This is the first published study of bilateral transcutaneous needle biopsies of the SMG in living patients with PD which showed better tissue acquisition and a change in aSyn density over time. While further study is needed, there is potential for SMG biopsies to serve as a tissue biomarker for PD disease progression and potentially as a peripheral outcome measure for anti-aSyn treatment.

AB - Introduction: Submandibular gland (SMG) biopsies detect pathological alpha-synuclein (aSyn) in patients with Parkinson's disease (PD). The objectives of this study were to determine 1) the feasibility of performing a second SMG biopsy in previously biopsied patients, 2) the feasibility of doing bilateral SMG biopsies, 3) laterality of aSyn density, 4) whether aSyn density changes over time. Methods: Seven PD patients (6 males) previously having positive unilateral SMG biopsies underwent bilateral needle biopsies. Staining with a validated antibody to pathologic p-serine 129 aSyn was performed. Results: Mean age at time of second biopsy was 76 years and mean time between biopsies was 4.1 years. Five subjects had sufficient SMG tissue bilaterally and two only unilaterally for a total of 12/14 glands biopsied having sufficient tissue, all 7 subjects having sufficient tissue on at least one side, and all 12 glands being aSyn positive. There was a 4x increase in aSyn density on average in the repeat biopsy, with 5 subjects having an increase, one no change, and one a decrease in density. Side effects were similar to previous reports; mainly bruising, swelling, slight bleeding. Conclusions: This is the first published study of bilateral transcutaneous needle biopsies of the SMG in living patients with PD which showed better tissue acquisition and a change in aSyn density over time. While further study is needed, there is potential for SMG biopsies to serve as a tissue biomarker for PD disease progression and potentially as a peripheral outcome measure for anti-aSyn treatment.

KW - Biopsy

KW - Parkinson's disease

KW - Submandibular gland

KW - Synuclein

UR - http://www.scopus.com/inward/record.url?scp=85072984247&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072984247&partnerID=8YFLogxK

U2 - 10.1016/j.parkreldis.2019.10.006

DO - 10.1016/j.parkreldis.2019.10.006

M3 - Article

C2 - 31621624

AN - SCOPUS:85072984247

VL - 68

SP - 69

EP - 72

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

ER -