Alshehri Ghadah H, Al-Kuraishy Hayder M, Albuhadily Ali K, Al-Gareeb Ali I, Aboutaleb Amany S, Alexiou Athanasios, Papadakis Marios, Batiha Gaber El-Saber
Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq.
Brain Behav. 2025 Aug;15(8):e70721. doi: 10.1002/brb3.70721.
Parkinson's disease (PD) is a neurodegenerative disease characterized by progressive neurodegeneration of dopaminergic neurons (DNs) in the substantia nigra (SN). PD neuropathology is mainly related to inflammation, mitochondrial dysfunction, oxidative stress, and endoplasmic reticulum (ER) stress. The underlying causes for the progression of PD are linked to the uncontrolled activation of different signaling pathways, such as the renin-angiotensin system (RAS), which is highly expressed in the nigrostriatal pathway. RAS has two main pathways: the classical pathway, which includes angiotensin I (AngI), AngII, angiotensin-converting enzyme (ACE), Ang type 1 receptor (AT1R), and Ang type 2 receptor (AT2R), that has a neuro-detrimental effect on PD neuropathology, and the nonclassical pathway, which includes angiotensin-converting enzyme 2 (ACE2)/Angiotensin 1-7 (Ang1-7), that has a neuroprotective effect against different neurological disorders, including PD. The nonclassical pathway is activated to overcome the harmful impact of the classical pathway on the brain, thereby converting AngII to angiotensin A (Ang-A) via mononuclear leukocyte-derived aspartate decarboxylase (MILDAD). Ang-A is further converted to the neuroprotective alamandine, which acts on the mass-related G-protein coupled receptor member D (MrgD). In PD, overactivation of the classical pathway is associated with neurodegeneration of the DNs in the SN. However, the nonclassical pathway, mainly Ang1-7/alamandine, is deregulated in PD. The objective of the review: This review aims to explore and discuss the potential role of the nonclassical RAS pathway in the pathogenesis and progression of PD and its implications for future therapeutic strategies.
帕金森病(PD)是一种神经退行性疾病,其特征是黑质(SN)中多巴胺能神经元(DNs)进行性神经退行性变。PD神经病理学主要与炎症、线粒体功能障碍、氧化应激和内质网(ER)应激有关。PD进展的潜在原因与不同信号通路的失控激活有关,如肾素-血管紧张素系统(RAS),其在黑质纹状体通路中高度表达。RAS有两条主要途径:经典途径,包括血管紧张素I(AngI)、血管紧张素II(AngII)、血管紧张素转换酶(ACE)、血管紧张素1型受体(AT1R)和血管紧张素2型受体(AT2R),对PD神经病理学具有神经损害作用;非经典途径,包括血管紧张素转换酶2(ACE2)/血管紧张素1-7(Ang1-7),对包括PD在内的不同神经系统疾病具有神经保护作用。非经典途径被激活以克服经典途径对大脑的有害影响,从而通过单核白细胞衍生的天冬氨酸脱羧酶(MILDAD)将AngII转化为血管紧张素A(Ang-A)。Ang-A进一步转化为具有神经保护作用的 alamandine,其作用于与质量相关的G蛋白偶联受体成员D(MrgD)。在PD中,经典途径的过度激活与SN中DNs的神经退行性变有关。然而,非经典途径,主要是Ang1-7/alamandine,在PD中失调。综述目的:本综述旨在探讨和讨论非经典RAS途径在PD发病机制和进展中的潜在作用及其对未来治疗策略的意义。
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