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了解帕金森病的临床前期阶段:我们在临床和研究方面进展如何?

Understanding the Pre-Clinical Stages of Parkinson's Disease: Where Are We in Clinical and Research Settings?

作者信息

Dalla Verde Camilla, Jayanti Sri, El Khobar Korri, Stanford John A, Tiribelli Claudio, Gazzin Silvia

机构信息

Liver Brain Unit "Rita Moretti", Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy.

Department of Life Sciences, University of Trieste, 34139 Trieste, Italy.

出版信息

Int J Mol Sci. 2025 Jul 17;26(14):6881. doi: 10.3390/ijms26146881.


DOI:10.3390/ijms26146881
PMID:40725128
Abstract

Parkinson's disease (PD) is the second most common neurodegenerative disorder in the world. PD is characterized by motor and non-motor symptoms, but the diagnosis primarily relies on the clinical assessment of postural and movement abnormalities, supported by imaging and genetic testing. It is widely accepted that the disease process begins decades before the onset of overt symptoms. Emerging evidence suggests that neuroinflammation plays a central role in the pathogenesis of PD, particularly during the pre-clinical phase. Activated microglia, increased levels of pro-inflammatory cytokines, and persistent oxidative stress have all been associated with the gradual loss of dopaminergic neurons. Although earlier detection and diagnosis remain elusive, achieving these goals is crucial for advancing prevention and disease-modifying strategies. Clinical studies are ongoing. To fill the gap, research models that recapitulate the chronic disease progression of PD are crucial to test preventive and disease-modifying strategies. This review briefly summarizes clinical knowledge on PD as a starting point for improving research models. Furthermore, we will critically evaluate how the existing models have been utilized and highlight opportunities to overcome their limitations and enhance the translational relevance to clinical application.

摘要

帕金森病(PD)是世界上第二常见的神经退行性疾病。PD的特征在于运动和非运动症状,但其诊断主要依赖于对姿势和运动异常的临床评估,并辅以影像学和基因检测。人们普遍认为,该疾病过程在明显症状出现前数十年就已开始。新出现的证据表明,神经炎症在PD的发病机制中起核心作用,尤其是在临床前期。活化的小胶质细胞、促炎细胞因子水平升高以及持续的氧化应激都与多巴胺能神经元的逐渐丧失有关。尽管早期检测和诊断仍然难以实现,但实现这些目标对于推进预防和疾病修饰策略至关重要。临床研究正在进行中。为了填补这一空白,重现PD慢性疾病进展的研究模型对于测试预防和疾病修饰策略至关重要。本综述简要总结了关于PD的临床知识,作为改进研究模型的起点。此外,我们将批判性地评估现有模型的使用方式,并强调克服其局限性以及增强与临床应用的转化相关性的机会。

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本文引用的文献

[1]
Inhibition of NLRP3 inflammasome ameliorates LPS-induced neuroinflammatory injury in mice via PINK1/Parkin pathway.

Neuropharmacology. 2024-10-1

[2]
Rotenone-induced PINK1/Parkin-mediated mitophagy: establishing a silkworm model for Parkinson's disease potential.

Front Mol Neurosci. 2024-4-19

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Role of the Insulin-like Growth Factor System in Neurodegenerative Disease.

Int J Mol Sci. 2024-4-20

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Med Princ Pract. 2024

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Eur J Med Res. 2024-3-27

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Front Cell Neurosci. 2024-2-13

[7]
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Front Neurosci. 2024-1-8

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FASEB J. 2023-12

[10]
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Nat Commun. 2023-11-18

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