Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy.
Department of Neurology, School of Medicine, University of São Paulo, São Paulo 05403-000, Brazil.
Cells. 2023 Feb 27;12(5):764. doi: 10.3390/cells12050764.
Parkinson's disease (PD) is a multifarious neurodegenerative disease. Its pathology is characterized by a prominent early death of dopaminergic neurons in the pars compacta of the substantia nigra and the presence of Lewy bodies with aggregated α-synuclein. Although the α-synuclein pathological aggregation and propagation, induced by several factors, is considered one of the most relevant hypotheses, PD pathogenesis is still a matter of debate. Indeed, environmental factors and genetic predisposition play an important role in PD. Mutations associated with a high risk for PD, usually called monogenic PD, underlie 5% to 10% of all PD cases. However, this percentage tends to increase over time because of the continuous identification of new genes associated with PD. The identification of genetic variants that can cause or increase the risk of PD has also given researchers the possibility to explore new personalized therapies. In this narrative review, we discuss the recent advances in the treatment of genetic forms of PD, focusing on different pathophysiologic aspects and ongoing clinical trials.
帕金森病(PD)是一种多因素的神经退行性疾病。其病理学特征是黑质致密部多巴胺能神经元的明显早期死亡和存在聚集的α-突触核蛋白的路易体。尽管由多种因素引起的α-突触核蛋白病理性聚集和传播被认为是最相关的假说之一,但 PD 的发病机制仍存在争议。事实上,环境因素和遗传易感性在 PD 中起着重要作用。与 PD 高风险相关的突变,通常称为单基因 PD,占所有 PD 病例的 5%至 10%。然而,由于不断发现与 PD 相关的新基因,这一比例随着时间的推移呈上升趋势。鉴定可导致或增加 PD 风险的遗传变异也使研究人员有可能探索新的个性化治疗方法。在这篇叙述性综述中,我们讨论了遗传形式 PD 的治疗的最新进展,重点讨论了不同的病理生理方面和正在进行的临床试验。