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Rose KN, Zorlu M, Fassini A, Lee H, Cai W, Xue X, Lin S, Kivisakk P, Schwarzschild MA, Chen X, Gomperts SN. Neuroprotection of low dose carbon monoxide in Parkinson's disease models commensurate with the reduced risk of Parkinson's among smokers. NPJ Parkinsons Dis 2024; 10:152. [PMID: 39174550 PMCID: PMC11341721 DOI: 10.1038/s41531-024-00763-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024] Open
Abstract
Paradoxically, cigarette smoking is associated with a reduced risk of Parkinson's Disease (PD). This led us to hypothesize that carbon monoxide (CO) levels, which are constitutively but modestly elevated in smokers, might contribute to neuroprotection. Using rodent models of PD based on α-synuclein (αSyn) accumulation and oxidative stress, we show that low-dose CO mitigates neurodegeneration and reduces αSyn pathology. Oral CO administration activated signaling cascades mediated by heme oxygenase-1 (HO-1), which have been implicated in limiting oxidative stress, and in promoting αSyn degradation, thereby conferring neuroprotection. Consistent with the neuroprotective effect of smoking, HO-1 levels in cerebrospinal fluid were higher in human smokers compared to nonsmokers. Moreover, in PD brain samples, HO-1 levels were higher in neurons without αSyn pathology. Thus, CO in rodent PD models reduces pathology and increases oxidative stress responses, phenocopying possible protective effects of smoking evident in PD patients. These data highlight the potential for low-dose CO-modulated pathways to slow symptom onset and limit pathology in PD patients.
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Affiliation(s)
- K N Rose
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - M Zorlu
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - A Fassini
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - H Lee
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - W Cai
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - X Xue
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - S Lin
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - P Kivisakk
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - M A Schwarzschild
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - X Chen
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - S N Gomperts
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, 02115, USA.
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2
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An D, Xu Y. Environmental risk factors provoke new thinking for prevention and treatment of dementia with Lewy bodies. Heliyon 2024; 10:e30175. [PMID: 38707435 PMCID: PMC11068646 DOI: 10.1016/j.heliyon.2024.e30175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
In recent years, environmental factors have received attention in the pathogenesis of neurodegenerative diseases. Other than genetic factors, the identification of environmental factors and modifiable risk factors may create opportunities to delay the onset or slow the progression of Lewy body disease. Researchers have made significant progress in understanding environmental and modifiable risk factors over the past 30 years. To date, despite the increasing number of articles assessing risk factors for Lewy body disease, few reviews have focused on their role in its onset. In this review, we reviewed the literature investigating the relationship between Lewy body disease and several environmental and other modifiable factors. We found that some air pollutants, exposure to some metals, and infection with some microorganisms may increase the risk of Lewy body disease. Coffee intake and the Mediterranean diet are protective factors. However, it is puzzling that low educational levels and smoking may have some protective effects. In addition, we proposed specific protocols for subsequent research directions on risk factors for neurodegenerative diseases and improved methods. By conducting additional case-control studies, we could explore the role of these factors in the etiopathogenesis of Lewy body disease, establishing a foundation for strategies aimed at preventing and reducing the onset and burden of the disease.
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Affiliation(s)
- Dinghao An
- Department of Neurology, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- State Key Laboratory of Pharmaceutical Biotechnology and Institute of Translational Medicine for Brain Critical Diseases, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Nanjing Neurology Clinical Medical Center, Nanjing, China
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3
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Rose KN, Zorlu M, Xue X, Fassini A, Cai W, Lin S, Webb P, Schwarzschild MA, Chen X, Gomperts SN. Neuroprotection of low dose carbon monoxide in Parkinson's disease models commensurate with the reduced risk of Parkinson's among smokers. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.05.27.542565. [PMID: 37398030 PMCID: PMC10312428 DOI: 10.1101/2023.05.27.542565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Paradoxically, cigarette smoking is associated with a reduced risk of Parkinson's disease (PD). This led us to hypothesize that carbon monoxide (CO) levels, which are constitutively but modestly elevated in smokers, might contribute to neuroprotection. Using rodent models of PD based on α-synuclein (αSyn) accumulation and oxidative stress, we show that low-dose CO mitigates neurodegeneration and reduces αSyn pathology. Oral CO administration activated signaling cascades mediated by heme oxygenase-1 (HO-1), which have been implicated in limiting oxidative stress, and in promoting αSyn degradation, thereby conferring neuroprotection. Consistent with a neuroprotective effect of smoking, HO-1 levels in cerebrospinal fluid were higher in human smokers compared to nonsmokers. Moreover, in PD brain samples, HO-1 levels were higher in neurons without αSyn pathology. Thus, CO in rodent PD models reduces pathology and increases oxidative stress responses, phenocopying possible protective effects of smoking evident in PD patients. These data highlight the potential for low-dose CO modulated pathways to slow symptom onset and limit pathology in PD patients.
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4
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Liu P, Liu J, Zhang Y, Xing X, Zhou L, Qu J, Yan X. Elevated serum LDL-C increases the risk of Lewy body dementia: a two-sample mendelian randomization study. Lipids Health Dis 2024; 23:42. [PMID: 38331880 PMCID: PMC10851540 DOI: 10.1186/s12944-024-02032-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/28/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Lewy body dementia (LBD) ranks second among prevalent neurodegenerative dementias. Previous studies have revealed associations of serum lipid measures with several neurodegenerative diseases. Nevertheless, the potential connection between serum lipids and LBD remains undetermined. In this study, Mendelian randomization (MR) analyses were carried out to assess the causal relationships of several serum lipid measures with the risk of developing LBD. METHODS Genome-wide association study (GWAS) data for serum lipids and LBD in European descent individuals were acquired from publicly available genetic summary data. A series of filtering procedures were conducted to identify the genetic variant candidates that are related to serum lipids, including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). The causal effects were primarily determined through inverse-variance weighting (IVW)-based analyses. RESULTS Neither TG (odds ratio [OR] = 1.149; 95% confidence interval [CI], 0.887-1.489; P = 0.293) nor HDL-C (OR = 0.864; 95% CI, 0.718-1.041; P = 0.124) had causal effects on LBD. However, a causal relationship was identified between LDL-C and LBD (OR = 1.343; 95% CI, 1.094-1.649; P = 0.005), which remained significant (OR = 1.237; 95% CI, 1.015-1.508; P = 0.035) following adjustment for HDL-C and TG in multivariable MR. CONCLUSIONS Elevated serum LDL-C increases the risk of LBD, while HDL-C and TG have no significant causal effects on LBD.
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Affiliation(s)
- Pengdi Liu
- Department of Neurosurgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710004, China
| | - Jin Liu
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital of Air Force Medical University, Xi'an, Shaanxi Province, 710032, China
| | - Yafei Zhang
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450052, China
| | - Xin Xing
- Department of Cardiology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710004, China
| | - Le Zhou
- Department of Neurosurgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710004, China
| | - Jianqiang Qu
- Department of Neurosurgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710004, China.
| | - Xianxia Yan
- Department of Neurosurgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710004, China.
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Rose KN, Schwarzschild MA, Gomperts SN. Clearing the Smoke: What Protects Smokers from Parkinson's Disease? Mov Disord 2024; 39:267-272. [PMID: 38226487 PMCID: PMC10923097 DOI: 10.1002/mds.29707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/22/2023] [Accepted: 12/15/2023] [Indexed: 01/17/2024] Open
Abstract
The link between smoking and a lower risk of Parkinson's disease (PD) is one of the strongest environmental or lifestyle associations in neuroepidemiology. Growing evidence supports the hypothesis that the association is based on a neuroprotective effect of smoking on PD, despite the plausible alternative that smoking serves as a marker for a proximal protective influence without itself conferring benefit. But how smoking could protect against neurodegeneration in PD is not well understood. Of several candidate molecules and mechanisms that have been nominated, nicotine has received the most attention. However, randomized controlled clinical trials of nicotine in PD have failed to demonstrate benefit on motor endpoints, including the NIC-PD study in which recently diagnosed participants were randomly assigned to placebo or nicotine treatment for 1 year. Given these results, the time is right to evaluate the neuroprotective potential of other molecules and biochemical cascades triggered by smoking. Here, we review the evidence supporting smoking's possible protective effect on PD, compounds in tobacco and smoke that might mediate such benefit, and non-causal classes of explanation, including reverse causation and the prospect of shared genetic determinants of smoking and PD resistance. The therapeutic potential of non-nicotine components of smoke is suggested by studies supporting multiple alternative mechanisms ranging from monoamine oxidase inhibitors to gut microbiome disruption to antioxidant response induction by chronic exposure to low levels of carbon monoxide. Rigorous investigation is warranted to evaluate this molecule and others for disease-preventing and disease-modifying activity in PD models and, if warranted, in clinical trials. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Kenneth N. Rose
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Stephen N. Gomperts
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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6
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Cornelis MC, Bennett DA, Weintraub S, Schneider JA, Morris MC. Caffeine Consumption and Dementia: Are Lewy Bodies the Link? Ann Neurol 2022; 91:834-846. [PMID: 35288978 PMCID: PMC9310711 DOI: 10.1002/ana.26349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/11/2022] [Accepted: 03/10/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to examine the association between caffeine intake and cognitive impairment. Caffeine-neuropathology correlations and interactions with lifestyle and genetic factors impacting caffeine metabolism and response were also tested. METHODS We included 888 participants aged 59+ years from the Rush Memory and Aging Project (MAP) and 303,887 participants aged 55+ years from the UK Biobank (UKB). MAP participants took part in annual cognitive testing. Diagnosis of dementia was based on clinical neurological examination and standardized criteria. A subset provided postmortem tissue for neuropathologic evaluation for common age-related diseases (eg, Alzheimer's disease [AD], Lewy bodies, and vascular). For UKB, dementia was determined by linked hospital and death records. Self-reported caffeine intake was estimated using food-frequency questionnaires in both cohorts. Cox proportional hazard ratio (HR), regression, and mixed models were used to examine associations of caffeine intake with incident dementia, cognitive decline, and neuropathology. RESULTS In MAP, compared to ≤100 mg/day, caffeine intake >100 mg/day was associated with a significantly higher HR (95% confidence interval [CI]) of all-cause (HR = 1.35, 95% CI = 1.03-1.76) and AD (HR = 1.41, 95% CI = 1.07-1.85) dementia. Caffeine intake was not associated with cognitive decline. In UKB, compared to ≤100 mg/day, the HRs (95% CI) of all-cause dementia for consuming 100 ≤ 200, 200 ≤ 300, 300 ≤ 400, and > 400 mg/day were 0.83 (95% CI = 0.72-0.94), 0.74 (95% CI = 0.64-0.85), 0.74 (95% CI = 0.64-0.85), and 0.92 (95% CI = 0.79-1.08), respectively. Similar results were observed for Alzheimer's dementia. In MAP, caffeine intake was inversely associated with postmortem Lewy bodies but no other age-related pathologies. Caffeine intake >100 mg/day was associated with lower neocortical type Lewy bodies (odds ratio (95%CI): 0.40 (95% CI = 0.21-0.75). INTERPRETATION Caffeine intake was inconsistently associated with clinical dementia; potentially explained by cohort differences in underlying dementia etiology. Lewy bodies may link caffeine to lower risk in some persons. ANN NEUROL 2022;91:834-846.
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Affiliation(s)
- Marilyn C Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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7
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Shaffer RM, Li G, Adar SD, Dirk Keene C, Latimer CS, Crane PK, Larson EB, Kaufman JD, Carone M, Sheppard L. Fine Particulate Matter and Markers of Alzheimer's Disease Neuropathology at Autopsy in a Community-Based Cohort. J Alzheimers Dis 2021; 79:1761-1773. [PMID: 33459717 PMCID: PMC8061707 DOI: 10.3233/jad-201005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Evidence links fine particulate matter (PM2.5) to Alzheimer's disease (AD), but no community-based prospective cohort studies in older adults have evaluated the association between long-term exposure to PM2.5 and markers of AD neuropathology at autopsy. OBJECTIVE Using a well-established autopsy cohort and new spatiotemporal predictions of air pollution, we evaluated associations of 10-year PM2.5 exposure prior to death with Braak stage, Consortium to Establish a Registry for AD (CERAD) score, and combined AD neuropathologic change (ABC score). METHODS We used autopsy specimens (N = 832) from the Adult Changes in Thought (ACT) study, with enrollment ongoing since 1994. We assigned long-term exposure at residential address based on two-week average concentrations from a newly developed spatiotemporal model. To account for potential selection bias, we conducted inverse probability weighting. Adjusting for covariates with tiered models, we performed ordinal regression for Braak and CERAD and logistic regression for dichotomized ABC score. RESULTS 10-year average (SD) PM2.5 from death across the autopsy cohort was 8.2 (1.9) μg/m3. Average age (SD) at death was 89 (7) years. Each 1μg/m3 increase in 10-year average PM2.5 prior to death was associated with a suggestive increase in the odds of worse neuropathology as indicated by CERAD score (OR: 1.35 (0.90, 1.90)) but a suggestive decreased odds of neuropathology as defined by the ABC score (OR: 0.79 (0.49, 1.19)). There was no association with Braak stage (OR: 0.99 (0.64, 1.47)). CONCLUSION We report inconclusive associations between PM2.5 and AD neuropathology at autopsy among a cohort where 94% of individuals experienced 10-year exposures below the current EPA standard. Prior studies of AD risk factors and AD neuropathology are similarly inconclusive, suggesting alternative mechanistic pathways for disease or residual confounding.
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Affiliation(s)
- Rachel M. Shaffer
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Ge Li
- VA Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Sara D. Adar
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - C. Dirk Keene
- Division of Neuropathology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Caitlin S. Latimer
- Division of Neuropathology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Paul K. Crane
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Eric B. Larson
- School of Medicine, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Departments of Medicine and Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Marco Carone
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
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8
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Abstract
A number of studies reported the possible differences between men and women in movement disorders. Evidence shows that estrogens may have a neuroprotective effect and may modulate the neurodevelopment of the different brain structures. Movement disorders including Parkinson's disease, dementia with Lewy body, Huntington's disease, Tourette's syndrome, and dystonia among others display significant clinical differences between sexes, with structural differences in the dopaminergic pathways between men and women. Here we summarize the most relevant clinical aspects of some of the most common movement disorders, highlighting the differences in disease onset, clinical presentation, therapy, and outcomes. Increased recognition of these differences may help physicians better understand the pathophysiology of these conditions and provide a tailored therapeutic approach.
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Affiliation(s)
- Pierpaolo Turcano
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States.
| | - Rodolfo Savica
- Department of Neurology and Health Science Research, Mayo Clinic, Rochester, MN, United States
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9
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Guttuso T. High lithium levels in tobacco may account for reduced incidences of both Parkinson's disease and melanoma in smokers through enhanced β-catenin-mediated activity. Med Hypotheses 2019; 131:109302. [PMID: 31443765 DOI: 10.1016/j.mehy.2019.109302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/03/2019] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) patients have higher rates of melanoma and vice versa, observations suggesting that the two conditions may share common pathogenic pathways. β-Catenin is a transcriptional cofactor that, when concentrated in the nucleus, upregulates the expression of canonical Wnt target genes, such as Nurr1, many of which are important for neuronal survival. β-Catenin-mediated activity is decreased in sporadic PD as well as in leucine-rich repeat kinase 2 (LRRK2) and β-glucosidase (GBA) mutation cellular models of PD, which is the most common genetic cause of and risk for PD, respectively. In addition, β-catenin expression is significantly decreased in more aggressive and metastatic melanoma. Multiple observational studies have shown smokers to have significantly lower rates of PD as well as melanoma implying that tobacco may contain one or more elements that protect against both conditions. In support, smoker's brains have significantly reduced levels of α-synuclein, a pathological intracellular protein found in PD brain and melanoma cells. Tobacco contains very high lithium levels compared to other plants. Lithium has a broad array of neuroprotective actions, including enhancing autophagy and reducing intracellular α-synuclein levels, and is effective in both neurotoxin and transgenic preclinical PD models. One of lithium's neuroprotective actions is enhancement of β-catenin-mediated activity leading to increased Nurr1 expression through its ability to inhibit glycogen synthase kinase-3 β (GSK-3β). Lithium also has anti-proliferative effects on melanoma cells and the clinical use of lithium is associated with a reduced incidence of melanoma as well as reduced melanoma-associated mortality. This is the first known report hypothesizing that inhaled lithium from smoking may account for the associated reduced rates of both PD and melanoma and that this protection may be mediated, in part, through lithium-induced GSK-3β inhibition and consequent enhanced β-catenin-mediated activity. This hypothesis could be directly tested in clinical trials assessing lithium therapy's ability to affect β-catenin-mediated activity and slow disease progression in patients with PD or melanoma.
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Affiliation(s)
- Thomas Guttuso
- Comprehensive Movement Disorders Center, University at Buffalo, 3435 Main Street, 97 Farber Hall, Buffalo, NY 14214, United States.
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10
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Chronic Nicotine Mitigates Aberrant Inhibitory Motor Learning Induced by Motor Experience under Dopamine Deficiency. J Neurosci 2017; 36:5228-40. [PMID: 27170121 DOI: 10.1523/jneurosci.2754-15.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 03/26/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Although dopamine receptor antagonism has long been associated with impairments in motor performance, more recent studies have shown that dopamine D2 receptor (D2R) antagonism, paired with a motor task, not only impairs motor performance concomitant with the pharmacodynamics of the drug, but also impairs future motor performance once antagonism has been relieved. We have termed this phenomenon "aberrant motor learning" and have suggested that it may contribute to motor symptoms in movement disorders such as Parkinson's disease (PD). Here, we show that chronic nicotine (cNIC), but not acute nicotine, treatment mitigates the acquisition of D2R-antagonist-induced aberrant motor learning in mice. Although cNIC mitigates D2R-mediated aberrant motor learning, cNIC has no effect on D1R-mediated motor learning. β2-containing nicotinic receptors in dopamine neurons likely mediate the protective effect of cNIC against aberrant motor learning, because selective deletion of β2 nicotinic subunits in dopamine neurons reduced D2R-mediated aberrant motor learning. Finally, both cNIC treatment and β2 subunit deletion blunted postsynaptic responses to D2R antagonism. These results suggest that a chronic decrease in function or a downregulation of β2-containing nicotinic receptors protects the striatal network against aberrant plasticity and aberrant motor learning induced by motor experience under dopamine deficiency. SIGNIFICANCE STATEMENT Increasingly, aberrant plasticity and aberrant learning are recognized as contributing to the development and progression of movement disorders. Here, we show that chronic nicotine (cNIC) treatment or specific deletion of β2 nicotinic receptor subunits in dopamine neurons mitigates aberrant motor learning induced by dopamine D2 receptor (D2R) blockade in mice. Moreover, both manipulations also reduced striatal dopamine release and blunt postsynaptic responses to D2R antagonists. These results suggest that chronic downregulation of function and/or receptor expression of β2-containing nicotinic receptors alters presynaptic and postsynaptic striatal signaling to protect against aberrant motor learning. Moreover, these results suggest that cNIC treatment may alleviate motor symptoms and/or delay the deterioration of motor function in movement disorders by blocking aberrant motor learning.
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11
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Costa-Mallen P, Zabetian CP, Hu SC, Agarwal P, Yearout D, Checkoway H. Smoking and haptoglobin phenotype modulate serum ferritin and haptoglobin levels in Parkinson disease. J Neural Transm (Vienna) 2016; 123:1319-1330. [PMID: 27349967 DOI: 10.1007/s00702-016-1590-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 06/16/2016] [Indexed: 01/15/2023]
Abstract
The phenotype Hp 2-1 of haptoglobin has been previously associated with increased risk of Parkinson disease (PD) and with serum iron abnormalities in PD patients. Tobacco smoking has been consistently observed in epidemiology studies to be inversely related to PD risk, with mechanisms that remain uncertain. We recently observed that the protective effect of smoking on PD risk is stronger among subjects of haptoglobin Hp 2-2 and Hp 1-1 phenotypes, and weaker among subjects of haptoglobin Hp 2-1 phenotype. In this PD case-control study, we investigated whether tobacco smoking was associated with changes in serum haptoglobin and ferritin concentration that depended on haptoglobin phenotype among 106 PD patients and 238 controls without PD or other neurodegenerative disorders. Serum ferritin concentration, serum haptoglobin concentration, haptoglobin phenotype, and smoking data information of cases and controls were obtained. Differences in haptoglobin and ferritin concentration by smoking status and pack-years of smoking were calculated as well as regression between pack-years and haptoglobin and ferritin concentration, and the effect of haptoglobin phenotype on these parameters. Tobacco smoking was associated with an elevation in serum haptoglobin concentration, especially among healthy controls of haptoglobin Hp 2-2 phenotype, and with an elevation in ferritin concentration especially among PD patients of haptoglobin Hp 2-1 phenotype. These findings suggest that an elevation in haptoglobin concentration, preferentially among subjects of haptoglobin Hp 2-2 phenotype, could be a contributing factor to the protective effect of smoking on PD risk.
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Affiliation(s)
- Paola Costa-Mallen
- Bastyr University Research Institute, 14500 Juanita Drive NE, Kenmore, WA, 98028, USA.
| | - Cyrus P Zabetian
- Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.,Department of Neurology, University of Washington, 325 Ninth Avenue, 3EH70, Seattle, WA, 98104, USA
| | - Shu-Ching Hu
- Department of Neurology, University of Washington, 325 Ninth Avenue, 3EH70, Seattle, WA, 98104, USA
| | - Pinky Agarwal
- Booth Gardner Parkinson's Care Center, Evergreen Health, 12040 NE 128th Street, Mailstop 11, Kirkland, WA, 98034, USA
| | - Dora Yearout
- Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA
| | - Harvey Checkoway
- Department of Family and Public Health, University of California San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093, USA
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12
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Costa-Mallen P, Zabetian CP, Agarwal P, Hu SC, Yearout D, Samii A, Leverenz JB, Roberts JW, Checkoway H. Haptoglobin phenotype modifies serum iron levels and the effect of smoking on Parkinson disease risk. Parkinsonism Relat Disord 2015; 21:1087-92. [PMID: 26228081 DOI: 10.1016/j.parkreldis.2015.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/05/2015] [Accepted: 07/07/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Haptoglobin is a hemoglobin-binding protein that exists in three functionally different phenotypes, and haptoglobin phenotype 2-1 has previously been associated with Parkinson disease (PD) risk, with mechanisms not elucidated. Some evidence is emerging that low levels of serum iron may increase PD risk. In this study we investigated whether PD patients have lower serum iron and ferritin than controls, and whether this is dependent on haptoglobin phenotype. We also investigated the effect of Hp phenotype as a modifier of the effect of smoking on PD risk. METHODS The study population consisted of 128 PD patients and 226 controls. Serum iron, ferritin, and haptoglobin phenotype were determined, and compared between PD cases and controls. Stratified analysis by haptoglobin phenotype was performed to determine effect of haptoglobin phenotype on serum iron parameter differences between PD cases and controls and to investigate its role in the protective effect of smoking on PD risk. RESULTS PD cases had lower serum iron than controls (83.28 ug/100 ml vs 94.00 ug/100 ml, p 0.006), and in particular among subjects with phenotype 2-1. The protective effect of smoking on PD risk resulted stronger in subjects with phenotype 1-1 and 2-2, and weakest among subjects with phenotype 2-1. Ferritin levels were higher in PD cases than controls among subjects of White ethnicity. CONCLUSIONS Our results report for the first time that the haptoglobin phenotype may be a contributor of iron levels abnormalities in PD patients. The mechanisms for these haptoglobin-phenotype specific effects will have to be further elucidated.
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Affiliation(s)
| | - Cyrus P Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Pinky Agarwal
- Booth Gardner Parkinson's Care Center, Evergreen Health, Kirkland, WA, USA
| | - Shu-Ching Hu
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Dora Yearout
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Ali Samii
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Harvey Checkoway
- University of California San Diego, Department of Family & Preventive Medicine, La Jolla, USA
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Cerebral cortical Aβ42 and PHF-τ in 325 consecutive brain autopsies stratified by diagnosis, location, and APOE. J Neuropathol Exp Neurol 2015; 74:100-9. [PMID: 25575135 DOI: 10.1097/nen.0000000000000153] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We used a novel approach to molecular quantification in standard fixed and embedded tissue to measure amyloid β 42 (Aβ(42)) and paired helical filament-τ (PHF-τ) in frontal, temporal, and parietal cortices from 325 consecutive brain autopsies collected as part of a population-based study of brain aging and incident dementia in the Seattle area. We observed significant effects of APOE ε4 on Aβ(42) levels in both diagnostic groups by disease stage and region. In contrast, we did not observe a significant effect of APOE ε4 on PHF-τ levels by disease stage in any region. Levels of Aβ(42) and PHF-τ in cerebral cortex were correlated more strongly in the Dementia group, and these measures had independent explanatory power for dementia beyond those of standard neuropathologic indices. Associations between Lewy body disease and Aβ(42) or PHF-τ levels and between Aβ(42) levels and microvascular brain injury suggested that these comorbid diseases enhanced the penetrance of Alzheimer disease. Our novel approach brings additional insights into the molecular pathogenesis of common causes of dementia and may serve as a platform for future studies pursuing associations between molecular changes in Alzheimer disease and genetic or environmental risk.
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Gelber RP, Redline S, Ross GW, Petrovitch H, Sonnen JA, Zarow C, Uyehara-Lock JH, Masaki KH, Launer LJ, White LR. Associations of brain lesions at autopsy with polysomnography features before death. Neurology 2014; 84:296-303. [PMID: 25503626 DOI: 10.1212/wnl.0000000000001163] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To determine how sleep-disordered breathing, nocturnal hypoxia, and changes in sleep architecture in the elderly may be related to the development of the neuropathologic correlates of dementia. METHODS The Honolulu-Asia Aging Study is a prospective cohort study of Japanese American men in Honolulu, HI. We examined brain lesions at autopsy (Braak stage, neurofibrillary tangle and neuritic plaque counts, microinfarcts, generalized brain atrophy, lacunar infarcts, Lewy bodies [LBs], neuronal loss and gliosis in the locus ceruleus) in 167 participants who underwent polysomnography in 1999-2000 (mean age, 84 years) and died through 2010 (mean 6.4 years to death). Polysomnography measures included the apnea-hypopnea index, duration of apnea or hypopnea, duration of hypoxemia, minimum oxygen saturation (SpO₂), duration of slow-wave sleep (SWS, non-REM stage N3), and arousals. RESULTS Sleep duration with SpO₂ <95% was associated with higher levels of microinfarcts (adjusted odds ratio [OR] 3.88, 95% confidence interval [CI] 1.10-13.76, comparing the highest to lowest quartiles of %sleep with SpO₂ <95%). Greater SWS duration was associated with less generalized atrophy (adjusted OR 0.32, 95% CI 0.10-1.03, comparing highest to lowest quartiles of %sleep in SWS). LBs were less common with greater %sleep with SpO₂ <95% (adjusted OR 0.17, 95% CI 0.04-0.78, comparing highest to lowest quartiles). Higher minimum SpO₂ during REM sleep was associated with less gliosis and neuronal loss in the locus ceruleus. Cognitive scores declined less among men with greater SWS duration. CONCLUSIONS The findings support a role for lower nocturnal oxygenation and SWS in the development of microinfarcts and brain atrophy, but not Alzheimer lesions or LBs.
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Affiliation(s)
- Rebecca P Gelber
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD.
| | - Susan Redline
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - G Webster Ross
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - Helen Petrovitch
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - Joshua A Sonnen
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - Chris Zarow
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - Jane H Uyehara-Lock
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - Kamal H Masaki
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - Lenore J Launer
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
| | - Lon R White
- From the VA Pacific Islands Health Care System (R.P.G., G.W.R., H.P.), Pacific Health Research and Education Institute (R.P.G., G.W.R., H.P., J.H.U.-L., L.R.W.), Departments of Medicine (G.W.R., H.P.), Geriatric Medicine (G.W.R., H.P., K.H.M., L.R.W.), and Pathology (J.H.U.-L.), University of Hawaii John A. Burns School of Medicine, and Kuakini Medical Center (K.H.M.), Honolulu, HI; Department of Pathology (J.A.S.), University of Utah, Salt Lake City; Department of Neurology (C.Z.), Keck School of Medicine, University of Southern California, Los Angeles; Departments of Medicine and Neurology, Brigham and Women's Hospital (S.R.), Department of Medicine, Beth Israel Deaconess Medical Center (S.R.), and Harvard Medical School (S.R.), Boston, MA; and the Laboratory of Epidemiology and Population Sciences (L.J.L., L.R.W.), Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD
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Athauda D, Foltynie T. The ongoing pursuit of neuroprotective therapies in Parkinson disease. Nat Rev Neurol 2014; 11:25-40. [PMID: 25447485 DOI: 10.1038/nrneurol.2014.226] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many agents developed for neuroprotective treatment of Parkinson disease (PD) have shown great promise in the laboratory, but none have translated to positive results in patients with PD. Potential neuroprotective drugs, such as ubiquinone, creatine and PYM50028, have failed to show any clinical benefits in recent high-profile clinical trials. This 'failure to translate' is likely to be related primarily to our incomplete understanding of the pathogenic mechanisms underlying PD, and excessive reliance on data from toxin-based animal models to judge which agents should be selected for clinical trials. Restricted resources inevitably mean that difficult compromises must be made in terms of trial design, and reliable estimation of efficacy is further hampered by the absence of validated biomarkers of disease progression. Drug development in PD dementia has been mostly unsuccessful; however, emerging biochemical, genetic and pathological evidence suggests a link between tau and amyloid-β deposition and cognitive decline in PD, potentially opening up new possibilities for therapeutic intervention. This Review discusses the most important 'druggable' disease mechanisms in PD, as well as the most-promising drugs that are being evaluated for their potential efficiency in treatment of motor and cognitive impairments in PD.
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Affiliation(s)
- Dilan Athauda
- Sobell Department of Motor Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
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16
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Chang RCC, Ho YS, Wong S, Gentleman SM, Ng HK. Neuropathology of cigarette smoking. Acta Neuropathol 2014; 127:53-69. [PMID: 24240736 DOI: 10.1007/s00401-013-1210-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 11/05/2013] [Indexed: 02/02/2023]
Abstract
It is well established that cigarette smoking is hazardous to health and is a risk factor for many chronic diseases. However, its impact on the brain, whether it be from prenatal exposure to maternal cigarette smoking, cerebrovascular disease, Alzheimer's disease (AD) or Parkinson's disease, is still not very clear. Neuroimaging and neuropathological investigations suggest that there are heterogeneous effects of cigarette smoking on the brain. On the one hand, it is quite clear that cigarette smoking causes damage to endothelial cells, resulting in increased risk of cerebrovascular disease. On the other hand, it seems to be associated with different Alzheimer's pathologies in post-mortem brains and experimental models, despite the fact that epidemiological studies clearly indicate a positive correlation between cigarette smoking and increased risk for AD. Interestingly, cigarette smoking appears to be associated with reduced Parkinson's pathology in post-mortem brains. However, although nicotine in cigarettes may have some neuroprotective actions, the effects of all the other toxic compounds in cigarettes cannot be ignored. It is, therefore, our aim to summarize what is known about the neuropathology of cigarette smoking and, in particular, its implications for neurodegenerative diseases.
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Affiliation(s)
- Raymond Chuen-Chung Chang
- Laboratory of Neurodegenerative Diseases, Department of Anatomy, LKS Faculty of Medicine, The University of Hong Kong, Rm. L1-49, Laboratory Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong,
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Quik M, Wonnacott S. α6β2* and α4β2* nicotinic acetylcholine receptors as drug targets for Parkinson's disease. Pharmacol Rev 2012; 63:938-66. [PMID: 21969327 DOI: 10.1124/pr.110.003269] [Citation(s) in RCA: 144] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Parkinson's disease is a debilitating movement disorder characterized by a generalized dysfunction of the nervous system, with a particularly prominent decline in the nigrostriatal dopaminergic pathway. Although there is currently no cure, drugs targeting the dopaminergic system provide major symptomatic relief. As well, agents directed to other neurotransmitter systems are of therapeutic benefit. Such drugs may act by directly improving functional deficits in these other systems, or they may restore aberrant motor activity that arises as a result of a dopaminergic imbalance. Recent research attention has focused on a role for drugs targeting the nicotinic cholinergic systems. The rationale for such work stems from basic research findings that there is an extensive overlap in the organization and function of the nicotinic cholinergic and dopaminergic systems in the basal ganglia. In addition, nicotinic acetylcholine receptor (nAChR) drugs could have clinical potential for Parkinson's disease. Evidence for this proposition stems from studies with experimental animal models showing that nicotine protects against neurotoxin-induced nigrostriatal damage and improves motor complications associated with l-DOPA, the "gold standard" for Parkinson's disease treatment. Nicotine interacts with multiple central nervous system receptors to generate therapeutic responses but also produces side effects. It is important therefore to identify the nAChR subtypes most beneficial for treating Parkinson's disease. Here we review nAChRs with particular emphasis on the subtypes that contribute to basal ganglia function. Accumulating evidence suggests that drugs targeting α6β2* and α4β2* nAChR may prove useful in the management of Parkinson's disease.
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Affiliation(s)
- Maryka Quik
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA.
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18
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Montine TJ, Sonnen JA, Montine KS, Crane PK, Larson EB. Adult Changes in Thought study: dementia is an individually varying convergent syndrome with prevalent clinically silent diseases that may be modified by some commonly used therapeutics. Curr Alzheimer Res 2012; 9:718-23. [PMID: 22471861 PMCID: PMC3409333 DOI: 10.2174/156720512801322555] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 12/28/2011] [Accepted: 01/14/2012] [Indexed: 11/22/2022]
Abstract
The Adult Changes in Thought (ACT) study is a longitudinal population-based prospective cohort study of brain aging and incident dementia in the Seattle metropolitan area. Observational studies using autopsies from ACT indicate that dementia is a convergent syndrome that commonly derives from Alzheimer's disease (AD), microvascular brain injury (mVBI), and Lewy body disease (LBD), and that these diseases have prevalent subclinical forms that also are commonly co-morbid. The existence of subclinical diseases highlights potential opportunities to intervene before the development of clinically apparent impairments. Our observations suggest that some such interventions already may exist to suppress processes of AD (statin therapy) or mVBI (treatment of hypertension). Reduced burden of LBD is associated with cigarette smoking; although smoking is not recommended as an intervention, these exposure data may provide clues to alternative neuroprotective mechanisms. Self reported anti-oxidant supplementation was without apparent effect in this cohort on indices of AD, mVBI, or LBD. Continued observational studies of brain aging will provide further insight into the convergent complexity of the dementia syndrome and its subclinical forms as well as highlight potential interventions that will require validation in clinical trials.
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Affiliation(s)
- Thomas J Montine
- Department of Pathology, University of Washington, Seattle, WA 98104, USA.
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Mehta M, Adem A, Kahlon MS, Sabbagh MN. The nicotinic acetylcholine receptor: smoking and Alzheimer's disease revisited. Front Biosci (Elite Ed) 2012; 4:169-80. [PMID: 22201862 PMCID: PMC5502782 DOI: 10.2741/367] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Epidemiological studies regarding Alzheimer's disease (AD) in smokers currently suggest inconsistent results. The clinicopathological findings also vary as to how AD pathology is affected by smoking behavior. Even though clinicopathological, functional, and epidemiological studies in humans do not present a consistent picture, much of the in vitro data implies that nicotine has neuroprotective effects when used in neurodegenerative disorder models. Current studies of the effects of nicotine and nicotinic agonists on cognitive function in both the non-demented and those with AD are not convincing. More data is needed to determine whether repetitive activation of nAChR with intermittent or acute exposure to nicotine, acute activation of nAChR, or long-lasting inactivation of nAChR secondary to chronic nicotine exposure will have a therapeutic effect and/or explain the beneficial effects of those types of drugs. Other studies show multifaceted connections between nicotine, nicotinic agonists, smoking, and nAChRs implicated in AD etiology. Although many controversies still exist, ongoing studies are revealing how nicotinic receptor changes and functions may be significant to the neurochemical, pathological, and clinical changes that appear in AD.
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Affiliation(s)
- Mona Mehta
- Banner Sun Health Research Institute, Sun City, AZ
| | - Abdu Adem
- Department of Pharmacology, Faculty of Medicine and Health Sciences, Al Ain, United Arab Emirates 3. Arizona Neurological Institute, Sun City, AZ
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Association between male gender and cortical Lewy body pathology in large autopsy series. J Neurol 2010; 257:1875-81. [PMID: 20563821 DOI: 10.1007/s00415-010-5630-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 06/04/2010] [Accepted: 06/07/2010] [Indexed: 01/10/2023]
Abstract
Sex-linked factors may alter risk for neurodegenerative diseases. Definitive diagnoses are not established until autopsy, so neuropathological studies are critical. There have not been reported gender-related differences in neocortical Lewy bodies (LBs) using large multi-center autopsy series. We evaluated the associations between gender and pathologically characterized neurodegenerative diseases. Cases with Alzheimer's disease (AD), neocortical LBs, AD + neocortical LBs, or neither pathology were evaluated as separate groups. Results were corrected for possible confounders including age at death, smoking history, and education. The settings were the University of Kentucky Alzheimer's Disease Center and the National Alzheimer's Coordinating Center (NACC) Registry autopsy series; 3,830 subjects met inclusion criteria. Patients with neocortical ("diffuse") or intermediate ("limbic") LB pathologies tended to be male (male:female odds ratios ~2.9 with 95% CI 2.02-4.18). The preponderance of males dying with neocortical LB pathology was seen consistently across age groups and was not due to the potential confounders evaluated. By contrast, individuals dying with AD pathology were more likely to be female if dying over 80 (male:female odds ratio 0.66, 95% CI 0.50-0.88), but that tendency was not seen in individuals dying with AD pathology prior to age 80. Increased understanding of the male predominance in neocortical LB pathology may help guide clinicians, because males are more likely to be "undercalled" for neocortical LBs clinically, and females are more likely to be "overcalled" (P < 0.05 for both). Males are far more likely than females to die with neocortical LB pathology. This phenomenon may help guide medical practice including clinical trial study design.
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