Inflammatory Responses and Regulation in Parkinson’s Disease

Abstract

Parkinson’s disease (PD) is a slow, progressive neurodegenerative disorder affecting an estimated 6 million people worldwide (Litteljohn, Mangano et al. 2011). The etiology of the disease is characterized by increasing loss over time of dopaminergic neurons (DA-neurons) in the substantia nigra (SN) as well as the depletion of dopamine in the striatum, which eventually leads to pathological and clinical symptoms (Jenner and Olanow 2006). PET imaging and post-mortem analyses of the brains of PD patients indicate that the appearance of symptoms, including tremor, bradykinesia, rigidity, slowness of movement, and postural instability (Jellinger 2001), generally are manifest once 60% of DA-neurons have died and a 70% threshold decrease in normal DA activity has been reached (Klockgether 2004; Litteljohn, Mangano et al. 2011). Epidemiological studies indicate that only about 10% of PD cases are early onset , i.e. prior to the age of 50 and occur mainly in familial clusters (Mizuno, Hattori et al. 2001). These cases have established genetic bases due to mutations in several recently identified genes, including parkin, leucine-rich repeat kinase 2 (LRRK2), α-synuclein, PINK-1, or DJ-1 (Polymeropoulos, Lavedan et al. 1997; Lucking, Durr et al. 2000; Abou-Sleiman, Healy et al. 2003; Farrer, Haugarvoll et al. 2006; Sun, Latourelle et al. 2006; Jiang, Wu et al. 2007; Weng, Chou et al. 2007; Bonifati, Wu-Chou et al. 2008). The majority of PD cases (approximately 90%) are late onset and idiopathic (Tanner 2003). Although the etiology of idiopathic PD is uncertain, this form of PD particularly affects the elderly, with average onset of clinical symptoms between 60 and 65 years of age (Litteljohn, Mangano et al. 2011). Idiopathic PD is thus age-associated, with approximately 1% of the population being affected by 65-70 year of age, increasing to 4-5% at 85 years (Fahn 2003; Tansey, McCoy et al. 2007). However, the causes of idiopathic non-familial PD are probably multifactorial, with some form of genetic predisposition, environmental insults and/or aging all likely to be important factors in disease initiation and progression (Nagatsu and Sawada 2006; Dickson 2007; Vilar, Coelho et al. 2007; Singh, Singh et al. 2008). While the exact cause of chronic neurodegeneration of PD is not known, increasing evidence suggests that chronic inflammation is the fundamental process mediating the progressive nature of the neurodegeneration characteristic of PD (McGeer, Yasojima et al. 2001; Hirsch and Hunot 2009). In animal PD models, long-term inflammation induces progressive loss of DA neurons within the SN brain region (Gao, Jiang et al. 2002; Dauer and Przedborski 2003; Bartels and Leenders 2007). Neuroinflammation, which is characterized by activation of