This review article explores the relationship between alpha-synuclein and mitochondrial dysfunction in Parkinson’s disease (PD), focusing on the role of hypoxia as an intermediate factor. The interaction between alpha-synuclein and mitochondria, particularly through membranal lipids such as cardiolipins, is highlighted as a key factor in mitochondrial disruption and neurodegeneration. Hypoxia, caused by oxygen deprivation, is identified as a crucial link between alpha-synuclein and mitochondrial regulation, leading to neuronal death in PD. The article also discusses the involvement of other proteins, such as peroxisome proliferator-activated receptor gamma coactivator, Sirtuin-1, Sirtuin-3 and adenosine monophosphate-activated protein kinase, in maintaining mitochondrial biogenesis during hypoxia. The study emphasizes the need for further research to understand the complex molecular interactions causing Lewy body aggregation, improper mitochondrial functioning and neurodegeneration in PD, with a specific focus on the role of hypoxia. Alpha-synuclein aggregation disrupts mitochondrial respiration, leading to mitochondrial dysfunction and increased production of reactive oxygen species. Mitochondrial dysfunction, in turn, causes neurodegeneration in PD. Oligomeric alpha-synuclein results in mitochondrial dysfunction, lethal synaptic disruption and reduced adenosine triphosphate generation. Oligomeric alpha-synuclein also increases the accumulation of mitochondrial rho nucleotide guanosine triphosphate, leading to delayed mitophagy. Hypoxia, another factor in PD, alters both alpha-synuclein and mitochondria. Controlling hypoxia reduces the oligomerization of alpha-synuclein. The interaction between alpha-synuclein and mitochondria is complex, and determining the primary player in inducing the other is still debatable.
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