Slowing of neurodegeneration in Parkinson's disease and Huntington's disease: future therapeutic perspectives.

Abstract

Several important advances have been made in our understanding of the pathways that lead to cell dysfunction and death in Parkinson's disease and Huntington's disease. These advances have been informed by both direct analysis of the post-mortem brain and by study of the biological consequences of the genetic causes of these diseases. Some of the pathways that have been implicated so far include mitochondrial dysfunction, oxidative stress, kinase pathways, calcium dysregulation, inflammation, protein handling, and prion-like processes. Intriguingly, these pathways seem to be important in the pathogenesis of both diseases and have led to the identification of molecular targets for candidate interventions designed to slow or reverse their course. We review some recent advances that underlie putative therapies for neuroprotection in Parkinson's disease and Huntington's disease, and potential targets that might be exploited in the future. Although we will need to overcome important hurdles, especially in terms of clinical trial design, we propose several target pathways that merit further study. In Parkinson's disease, these targets include agents that might improve mitochondrial function or increase degradation of defective mitochondria, kinase inhibitors, calcium channel blockers, and approaches that interfere with the misfolding, templating, and transmission of α-synuclein. In Huntington's disease, strategies might also be directed at mitochondrial bioenergetics and turnover, the prevention of protein dysregulation, disruption of the interaction between huntingtin and p53 or huntingtin-interacting protein 1 to reduce apoptosis, and interference with expression of mutant huntingtin at both the nucleic acid and protein levels.

• Authors: Anthony H V Schapira, C Warren Olanow, J Timothy Greenamyre, Erwan Bezard
• Journal: Lancet (London, England) (Lancet) Vol. 384 Issue 9942 Pg. 545-55 (Aug 09 2014) ISSN: 1474-547X [Electronic] England
• PMID: 24954676 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Neuroprotective Agents
• Receptors, Growth Factor
• Protein Kinases

Topics

• Apoptosis (drug effects)
• Humans
• Huntington Disease (drug therapy, metabolism)
• Mitochondria (drug effects, metabolism)
• Neuroprotective Agents (pharmacology, therapeutic use)
• Oxidative Stress (drug effects)
• Parkinson Disease (drug therapy, metabolism)
• Protein Kinases (drug effects, metabolism)
• Receptors, Growth Factor (drug effects, metabolism)
• Signal Transduction (drug effects)