帕金森病:200 年的简史。

Parkinson's disease: a short story of 200 years.

机构信息

Clinical and Experimental Neuroscience Group (NiCE-IMIB), Department of Human Anatomy and Psychobiology, Institute for Aging Research, School of Medicine, University of Murcia, Murcia, Spain.

Biosanitary Research Institute of Murcia (IMIB-Arrixaca), Campus of Health Sciences, University of Murcia, Murcia, Spain.

出版信息

Histol Histopathol. 2019 Jun;34(6):573-591. doi: 10.14670/HH-18-073. Epub 2018 Dec 12.

Abstract

After Alzheimer's disease, Parkinson's disease (PD) is the second most prevalent and incidental neurodegenerative disorder, affecting more than 2% of the population older than 65 years old. Since it was first described 200 years ago by Dr James Parkinson, great steps have been made in the understanding of the pathology. However, the cause(s) that initiates and perpetuates the neurodegenerative process is (are) still not clear. Thus, early diagnosis is not available, nor are there efficient therapies that can stop neurodegeneration. PD clinical features are defined by motor (like bradykinesia, resting tremor, gait impairment) and non-motor symptoms (like constipation, apathy, fathigue, olfactory dysfunction, depression and cognitive decline) that get more severe as the disease advances. Neuropathological hallmarks comprise selective loss of dopaminergic neurons in the Substantia Nigra pars compacta (SNpc) and Lewy bodies (LB) in different nuclei of the nervous system. Numerous studies have shown that these pathological features are aggravated by the confluence of other contributing factors, such as a genetic component, exposure to environmental toxins, mitochondrial dysfunction, increase of oxidative stress, calcium imbalance and chronic neuroinflammation, among others. Here, we provide a summary of the actual state of PD's pathology, the most studied molecular mechanisms, classic and novel therapeutic strategies and diagnosis methods, especially highlighting recent advances in these 200 years.

摘要

阿尔茨海默病之后,帕金森病(PD)是第二常见的偶发性神经退行性疾病,影响着超过 65 岁人群中的 2%以上。自 200 年前詹姆斯·帕金森博士首次描述以来,人们对其病理学已经有了很大的了解。然而,引发和延续神经退行性过程的原因仍不清楚。因此,目前还无法进行早期诊断,也没有有效的治疗方法可以阻止神经退行性病变。PD 的临床特征由运动症状(如运动迟缓、静止性震颤、步态障碍)和非运动症状(如便秘、冷漠、疲劳、嗅觉功能障碍、抑郁和认知能力下降)定义,随着疾病的进展这些症状会变得更加严重。神经病理学的标志包括黑质致密部(SNpc)中的多巴胺能神经元选择性丧失和不同神经核中的路易体(LB)。许多研究表明,这些病理特征会因其他致病因素的共同作用而加剧,如遗传成分、暴露于环境毒素、线粒体功能障碍、氧化应激增加、钙失衡和慢性神经炎症等。在这里,我们总结了 PD 病理学的现状、研究最多的分子机制、经典和新型治疗策略以及诊断方法,特别是强调了这 200 年来的最新进展。

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