Protection against Parkinson's disease progression: clinical experience.
Treatments with potential neuroprotective capability for Parkinson's disease (PD) have been investigated in randomized, controlled, clinical trials and other studies since the mid-1980s. Although promising leads have arisen, no therapy has been proven to halt or slow disease progression. Several large-scale studies have highlighted progress in methodology, as well as the frustrations of translating laboratory science to practical applications. This review summarizes findings from clinical trials with several classes of compounds, including monoamine oxidase-B inhibitors (selegiline, lazabemide, rasagiline), dopaminergic drugs (ropinirole, pramipexole, levodopa), antioxidant strategies (alpha-tocopherol), mitochondrial energy enhancers (coenzyme Q(10), creatine), antiapoptotic agents (TCH346, minocycline, CEP-1347), and antiglutamatergic compounds (riluzole). Beyond small-molecule pharmacology, gene therapy approaches, such as delivering neurotrophic substances (e.g., neurturin) by viral vector, are the next generation of treatment options.
LeWitt
Peter A
PA
Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA. palewitt@ameritech.net
Taylor
Danette C
DC
D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000379:methods*; D018450:Disease Progression; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D010300:Parkinson Disease / Q000473:pathology / Q000517:prevention & control*
D000975:Antioxidants; D018491:Dopamine Agonists; D008996:Monoamine Oxidase Inhibitors