Department of Geriatrics, The Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, 050000, Hebei, People's Republic of China.
Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Mol Neurobiol. 2023 Jun;60(6):3054-3070. doi: 10.1007/s12035-023-03257-3. Epub 2023 Feb 14.
Parkinson's disease (PD) is a neurodegenerative disease characterized pathologically by α-synuclein (α-syn) aggregation. In PD, the current mainstay of symptomatic treatment is levodopa (L-DOPA)-based dopamine (DA) replacement therapy. However, the development of dyskinesia and/or motor fluctuations which is relevant to levodopa is restricting its long-term utility. Given that the ability of which is to modulate the striato-thalamo-cortical loops and function to modulate basal ganglia output, the adenosinergic pathway (AP) is qualified as a potential promising non-DA target. As an indispensable component of energy production pathways, AP modulates cellular metabolism and gene regulation in both neurons and neuroglia cells through the recognition and degradation of extracellular adenosine. In addition, AP is geared to the initiation, evolution, and resolution of inflammation as well. Besides the above-mentioned crosstalk between the adenosine and dopamine signaling pathways, the functions of adenosine receptors (AR, AR, AR, and AR) and metabolism enzymes in modulating PD pathological process have been extensively investigated in recent decades. Here we reviewed the emerging findings focused on the function of adenosine receptors, adenosine formation, and metabolism in the brain and discussed its potential roles in PD pathological process. We also recapitulated clinical studies and the preclinical evidence for the medical strategies targeting the Ado signaling pathway to improve motor dysfunction and alleviate pathogenic process in PD. We hope that further clinical studies should consider this pathway in their monotherapy and combination therapy, which would open new vistas to more targeted therapeutic approaches.
帕金森病(PD)是一种神经退行性疾病,其病理学特征是α-突触核蛋白(α-syn)聚集。在 PD 中,目前的主要症状治疗方法是基于左旋多巴(L-DOPA)的多巴胺(DA)替代疗法。然而,与左旋多巴相关的运动障碍和/或运动波动的发展限制了其长期应用。鉴于腺苷能途径(AP)能够调节纹状体-丘脑-皮质环路的功能并调节基底神经节的输出,因此它被认为是一种有前途的非 DA 靶点。作为能量产生途径的不可或缺的组成部分,AP 通过识别和降解细胞外腺苷来调节神经元和神经胶质细胞的细胞代谢和基因调控。此外,AP 还与炎症的发生、发展和解决有关。除了上述腺苷和多巴胺信号通路之间的串扰外,近年来,腺苷受体(AR、AR、AR 和 AR)和代谢酶在调节 PD 病理过程中的功能已得到广泛研究。在这里,我们综述了近年来有关大脑中腺苷受体、腺苷形成和代谢的功能及其在 PD 病理过程中的潜在作用的新发现。我们还回顾了针对 Ado 信号通路的医学策略的临床研究和临床前证据,以改善 PD 中的运动功能障碍和减轻致病过程。我们希望进一步的临床研究应在其单药和联合治疗中考虑该途径,这将为更有针对性的治疗方法开辟新的前景。