[Is there an effective neuroprotective treatment of Parkinson's disease? (therapeutic possibilities against the background of etiopathogenetic concepts].
The author presents current views on neuroprotective strategies in therapy of idiopathic Parkinson's disease. They are the result of different aetiopathogenetic concepts of Parkinson's disease. The concepts of loss of nigral cells as a result of aging, apoptosis or genetic defect (alpha-synucleine) are not sufficiently proven and their role is only hypothetic. Therapeutic use of nerve growth factors seems to be a promising novel strategy but there are technical problems how to deliver them to the brain. One of the most and widely acceptable concept is the theory of the role of oxidative stress in pathogenesis of Parkinson's disease. It was a scientific basis for clinical trials with selegiline (DATATOP, SINDEPAR, PDRG) which results were unfortunately disappointing, mostly because of symptomatic effect of selegiline. Another interesting concept seems to be the excitotoxicity of amino acids (like glutamate) and amantadine is the well known drug with recently discovered antagonism to NMDA receptors. In only one retrospective clinical trial in humans its neuroprotective effect was proven, but we need now well prepared prospective trials with this drug to confirm this result. So far, despite the hopes concerning selegiline no one effective neuroprotective agent is available in treatment of Parkinson's disease.
Sławek
J
J
Wojewódzkiego Oddziału Neurologii, Szpitala Specjalistycznego św. Wojciecha w Gdańsku.
D000547:Amantadine / Q000494:pharmacology* / Q000627:therapeutic use*; D017209:Apoptosis / Q000502:physiology; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D002986:Clinical Trials as Topic; D006801:Humans; D009474:Neurons / Q000473:pathology; D018696:Neuroprotective Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000235:genetics
D018696:Neuroprotective Agents; D000547:Amantadine