Neuroprotective compounds and innovative therapeutic strategies for Parkinson’s disease: experimental and clinical studies

Fabio Blandini

Interdepartmental Research Center for Parkinson’s Disease (CRIMP), IRCCS Neurological Institute “C. Mondino Foundation”, Pavia, Italy

Abstract: Identifying new therapeutic strategies capable of modifying the course of Parkinson’s disease (PD) is currently one of the major goals for the researchers of this field. Various mechanistic definitions have been proposed to describe the hypothetical ability of a therapeutic intervention to prevent, block or reverse the neurodegenerative process underlying PD. The general term “neuroprotection” has been related to the capacity of interfering with the ongoing process of neuronal cell death, in order to slow or halt disease progression, while a term such as “neurorestoration” would apply to any intervention capable of increasing the number of surviving dopaminergic neurons. Although none of the therapeutic approaches tested in PD patients has so far shown the ability to stop or reverse disease progression, a certain degree of neuroprotection can be achieved with compounds that are already available in the pharmacological armamentarium of the neurologist. Treatment with dopamine agonists or MAO-B inhibitors, particularly when started in the very early phases of the disease, may play disease-modifying effects and even L-DOPA, at low doses, may be slightly neuroprotective. For a true neurorestorative intervention, promising perspectives are being provided by neurotrophic factors and stem cells, which, however, still need to unveil their full potential.

Keywords: L-DOPA, dopamine agonists, MAO-B inhibitors, trophic factors, stem cells