New Frontiers in Parkinson's Disease: From Genetics to the Clinic

J Neurosci. 2018 Oct 31;38(44):9375-9382. doi: 10.1523/JNEUROSCI.1666-18.2018.

Abstract

The greatest unmet therapeutic need in Parkinson's disease (PD) is a treatment that slows the relentless progression of the symptoms and the neurodegenerative process. This review highlights the utility of genetics to understand the pathogenic mechanisms and develop novel therapeutic approaches for PD. The focus is on strategies provided by genetic studies: notably via the reduction and clearance of α-synuclein, inhibition of LRRK2 kinase activity, and modulation of glucocerebrosidase-related substrates. In addition, the critical role of precompetitive public-private partnerships in supporting trial design optimization, overall drug development, and regulatory approvals is illustrated. With these great advances, the promise of developing transformative therapies that halt or slow disease progression is a tangible goal.

Keywords: GBA; LRRK2; Parkinson's disease; alpha-synuclein; disease-modifying therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antiparkinson Agents / administration & dosage*
  • Clinical Trials as Topic / methods
  • Drug Delivery Systems / methods
  • Drug Delivery Systems / trends*
  • Humans
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 / genetics
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 / metabolism
  • Mutation / drug effects
  • Mutation / physiology*
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / genetics*
  • Parkinson Disease / metabolism
  • alpha-Synuclein / genetics
  • alpha-Synuclein / metabolism

Substances

  • Antiparkinson Agents
  • alpha-Synuclein
  • LRRK2 protein, human
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2