title: Nonsteroidal anti-inflammatory drugs may protect against Parkinson disease.
abstract: OBJECTIVE
  Markers of neuroinflammation, including activated microglia and increased levels of circulating proinflammatory cytokines, have been observed in the brains and CSF of patients with Parkinson disease (PD). Yet the link between anti-inflammatory agents and PD in humans remains uncertain, despite indications that neuroinflammation may contribute to cell death in the PD brain and experimental evidence of anti-inflammatory agents such as nonsteroidal anti-inflammatory drugs (NSAIDs) exerting neuroprotective effects in animal models.
  
  
  METHODS
  Using a population-based approach, we studied NSAID use among 293 incident idiopathic PD cases and 286 age-, race-, and gender-matched controls from three rural California counties.
  
  
  RESULTS
  Our data suggested a decreased risk of PD among regular (>or=2 pills/week for at least 1 month) aspirin NSAID users (OR, 0.80; 95% CI, 0.56 to 1.15). A stronger protective effect was observed for regular nonaspirin NSAID users (OR, 0.52; 95% CI, 0.35 to 0.79), particularly those who reported 2 or more years of use (OR, 0.44; 95% CI, 0.26 to 0.74). The aspirin effect estimates differed by gender, showing a protective effect only in women, especially among long term (>or=24 months) regular users (OR, 0.51; 95% CI, 0.26 to 1.02).
  
  
  CONCLUSIONS
  Our study contributes to the growing body of literature suggesting a protective role for nonsteroidal anti-inflammatory drugs (NSAIDs) in Parkinson disease (PD). Given our results and the biologic plausibility of a neuroprotective function for NSAIDs there is a pressing need for further studies elucidating the protective role such drugs may play in PD.
authors.affiliation: Department of Epidemiology, UCLA School of Public Health, Box 951772, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA. awahner@ucla.edu
authors.forename: Angelika D
authors.initials: AD
authors.lastname: Wahner
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Bronstein
authors.forename: Yvette M
authors.initials: YM
authors.lastname: Bordelon
authors.forename: Beate
authors.initials: B
authors.lastname: Ritz
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000276:immunology / Q000503:physiopathology; D002140:California; D016022:Case-Control Studies; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004660:Encephalitis / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use; D010300:Parkinson Disease / Q000503:physiopathology / Q000517:prevention & control*; D040242:Risk Reduction Behavior; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000978:Antiparkinson Agents; D018696:Neuroprotective Agents; D001241:Aspirin