MRC Laboratory of Molecular Biology, Hills Road, Cambridge CB2 0QH, UK.
Nat Rev Neurol. 2013 Jan;9(1):13-24. doi: 10.1038/nrneurol.2012.242. Epub 2012 Nov 27.
In 1817, James Parkinson described the symptoms of the shaking palsy, a disease that was subsequently defined in greater detail, and named after Parkinson, by Jean-Martin Charcot. Parkinson expected that the publication of his monograph would lead to a rapid elucidation of the anatomical substrate of the shaking palsy; in the event, this process took almost a century. In 1912, Fritz Heinrich Lewy identified the protein aggregates that define Parkinson disease (PD) in some brain regions outside the substantia nigra. In 1919, Konstantin Nikolaevich Tretiakoff found similar aggregates in the substantia nigra and named them after Lewy. In the 1990s, α-synuclein was identified as the main constituent of the Lewy pathology, and its aggregation was shown to be central to PD, dementia with Lewy bodies, and multiple system atrophy. In 2003, a staging scheme for idiopathic PD was introduced, according to which α-synuclein pathology originates in the dorsal motor nucleus of the vagal nerve and progresses from there to other brain regions, including the substantia nigra. In this article, we review the relevance of Lewy's discovery 100 years ago for the current understanding of PD and related disorders.
1817 年,詹姆斯·帕金森描述了震颤性麻痹的症状,这种疾病随后被让-马丁·夏科特(Jean-Martin Charcot)更详细地定义,并以帕金森的名字命名。帕金森预计他的专题论文的发表将迅速阐明震颤性麻痹的解剖学基础;实际上,这一过程花了将近一个世纪的时间。1912 年,弗里茨·海因里希·莱维(Fritz Heinrich Lewy)在一些黑质以外的脑区识别出了定义帕金森病(PD)的蛋白聚集体。1919 年,康斯坦丁·尼古拉耶维奇·特雷蒂亚科夫(Konstantin Nikolaevich Tretiakoff)在黑质中发现了类似的聚集体,并以莱维的名字命名。在 20 世纪 90 年代,α-突触核蛋白被确定为路易体病理的主要成分,其聚集被证明是 PD、路易体痴呆和多系统萎缩的核心。2003 年,引入了特发性 PD 的分期方案,根据该方案,α-突触核蛋白病理起源于迷走神经背核,并由此向包括黑质在内的其他脑区进展。在本文中,我们回顾了 100 年前莱维的发现对当前 PD 及相关疾病认识的相关性。