Department of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq.
Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
Cell Mol Neurobiol. 2023 Aug;43(6):2743-2759. doi: 10.1007/s10571-023-01350-8. Epub 2023 Apr 19.
Parkinson's disease (PD) is one of the most common degenerative brain disorders caused by the loss of dopaminergic neurons in the substantia nigra (SN). Lewy bodies and -synuclein accumulation in the SN are hallmarks of the neuropathology of PD. Due to lifestyle changes and prolonged L-dopa administration, patients with PD frequently have vitamin deficiencies, especially folate, vitamin B6, and vitamin B12. These disorders augment circulating levels of Homocysteine with the development of hyperhomocysteinemia, which may contribute to the pathogenesis of PD. Therefore, this review aimed to ascertain if hyperhomocysteinemia may play a part in oxidative and inflammatory signaling pathways that contribute to PD development. Hyperhomocysteinemia is implicated in the pathogenesis of neurodegenerative disorders, including PD. Hyperhomocysteinemia triggers the development and progression of PD by different mechanisms, including oxidative stress, mitochondrial dysfunction, apoptosis, and endothelial dysfunction. Particularly, the progression of PD is linked with high inflammatory changes and systemic inflammatory disorders. Hyperhomocysteinemia induces immune activation and oxidative stress. In turn, activated immune response promotes the development and progression of hyperhomocysteinemia. Therefore, hyperhomocysteinemia-induced immunoinflammatory disorders and abnormal immune response may aggravate abnormal immunoinflammatory in PD, leading to more progression of PD severity. Also, inflammatory signaling pathways like nuclear factor kappa B (NF-κB) and nod-like receptor pyrin 3 (NLRP3) inflammasome and other signaling pathways are intricate in the pathogenesis of PD. In conclusion, hyperhomocysteinemia is involved in the development and progression of PD neuropathology either directly via induction degeneration of dopaminergic neurons or indirectly via activation of inflammatory signaling pathways.
帕金森病(PD)是由黑质(SN)中多巴胺能神经元丧失引起的最常见的退行性脑疾病之一。路易体和α-突触核蛋白在 SN 中的积累是 PD 神经病理学的标志。由于生活方式的改变和长期左旋多巴的给药,PD 患者经常出现维生素缺乏,特别是叶酸、维生素 B6 和维生素 B12。这些疾病会增加同型半胱氨酸的循环水平,导致高同型半胱氨酸血症的发生,这可能有助于 PD 的发病机制。因此,本综述旨在确定高同型半胱氨酸血症是否可能在导致 PD 发展的氧化和炎症信号通路中发挥作用。高同型半胱氨酸血症与包括 PD 在内的神经退行性疾病的发病机制有关。高同型半胱氨酸血症通过不同的机制触发 PD 的发展和进展,包括氧化应激、线粒体功能障碍、细胞凋亡和血管内皮功能障碍。特别是,PD 的进展与高炎症变化和全身炎症性疾病有关。高同型半胱氨酸血症诱导免疫激活和氧化应激。反过来,激活的免疫反应促进高同型半胱氨酸血症的发展和进展。因此,高同型半胱氨酸血症诱导的免疫炎症紊乱和异常免疫反应可能加重 PD 中的异常免疫炎症,导致 PD 严重程度的进一步发展。此外,核因子 kappa B(NF-κB)和核苷酸结合寡聚化结构域样受体 3(NLRP3)炎性小体等炎症信号通路以及其他信号通路在 PD 的发病机制中错综复杂。总之,高同型半胱氨酸血症通过直接诱导多巴胺能神经元变性或间接通过激活炎症信号通路参与 PD 神经病理学的发展和进展。