Parkin gene therapy for alpha-synucleinopathy: a rat model of Parkinson's disease

Parkin is known to mitigate alpha-synuclein-induced neuronal cell death in vitro, which suggests that the parkin gene therapy is a candidate for therapeutic strategies for Parkinson's disease (PD). In the present study, the parkin gene therapy was investigated for its ameliorative effects on alpha-synucleinopathy in substantia nigra (SN) of rats. A recombinant adeno-associated viral (rAAV) vector system has frequently been used for the gene transfer to rat SN, and we have previously demonstrated that this technique induced the alpha-synucleinopathy, which closely resembles pathogenetic changes in PD. Therefore, in the present study, the effect of parkin was examined by co-infection of rAAV-parkin with rAAV-alpha-synuclein into dopaminergic neurons in SN. At 13 weeks post-rAAV infection, alpha-synuclein overexpression induced dopaminergic neuron loss, while co-expression of parkin mitigated the alpha-synuclein toxicity. Moreover, alpha-synuclein-induced dopaminergic neuron loss consequently resulted in motor dysfunction, which was also mitigated by parkin. Taken together, our results indicate that the parkin gene therapy is effective against alpha-synucleinopathy, suggesting its potential suitability for patients with PD.     

A pulmonary formulation of L-dopa enhances its effectiveness in a rat model of Parkinson's disease

The efficacy of oral L-dopa becomes problematic with the progression of Parkinson's disease, due in large part to a lost ability to accommodate L-dopa's inherently poor pharmacokinetics. Pulmonary delivery represents a novel approach to reducing this problem. L-dopa was formulated into inhalable (Alkermes AIR) particles, and its pharmacokinetics and pharmacodynamics compared with those of an oral formulation. Pulmonary administration of L-dopa (2 mg) to rats resulted in a rapid elevation of plasma levels (C(max) = 4.8 +/- 1.10 microg/ml at 2 min), whereas oral administration of L-dopa produced a much delayed and lower C(max) (1.8 +/- 0.40 microg/ml at 30 min). In a rat model of Parkinson's disease (unilateral 6-hydroxydopamine lesion), the pulmonary formulation of L-dopa (0.5-2.0 mg) yielded more rapid and robust elevations in striatal L-dopa, dopamine, and dihydroxyphenylacetic acid levels, as well as 2.5 to 3.7 times as many c-fos-expressing striatal neurons. Moreover, motor function was significantly improved by 10 min after administration, with peak improvements occurring within 15 to 30 min. In contrast, considerably higher doses (6.8-10 mg) of orally administered L-dopa took over three times longer to produce similar effects. These results suggest that an inhalable formulation of l-dopa has superior pharmacokinetic properties and may provide patients with a more effective form of rescue therapy as well as being a reliable adjuvant or replacement for first-line oral therapy.     

Dinapsoline: characterization of a D1 dopamine receptor agonist in a rat model of Parkinson's disease

Dinapsoline is a new potent, full agonist at D1 dopamine receptors with limited selectivity relative to D2 receptors. The efficacy of this compound was assessed in rats with unilateral 6-hydroxydopamine lesions of the medial forebrain bundle, a standard rat model of Parkinson's disease. Dinapsoline produced robust contralateral rotation after either subcutaneous or oral administration. This rotational behavior was attenuated markedly by the D1 receptor antagonist SCH-23390, but not by the D2 receptor antagonist raclopride. During a chronic 14-day treatment period in which rats received dinapsoline either once or twice a day, dinapsoline did not produce tolerance (in fact, some sensitization of the rotational response was observed in one experiment). Because dinapsoline shows less D1:D2 selectivity in vitro than other D1 agonists, the contribution of D2 activity to tolerance was assessed. Chronic daily cotreatment with dinapsoline and raclopride did not enable the development of tolerance to chronic dinapsoline treatment. In contrast, when dinapsoline was administered by osmotic minipump, rapid tolerance was observed. To explore further the contribution of D1 and D2 receptors to tolerance, experiments were performed with the selective D1 agonist A-77636. Daily dosing with A-77636 rapidly produced complete tolerance, as previously observed, whereas coadministration of the D2 agonist quinpirole plus A-77636 failed to either delay or prevent tolerance. Taken together, these results indicate that the development of tolerance to D1 receptor agonists is influenced by the pattern of drug exposure but not by the D1:D2 selectivity of the agonist.     

Evidence of functional zinc deficiency in Parkinson's disease

One of the primary areas of investigation in the pathophysiology of Parkinson's disease (PD) is the loss of the dopamine-producing cells in the melanized neurons of the substantia nigra, believed to be caused by oxidative stress resulting from excessive free radical activity. The cuprozinc enzyme, superoxide dismutase (SODCu2Zn2), catalyzes the dismutation of superoxide anions to hydrogen peroxide plus oxygen, and is normally found in high concentrations in the substantia nigra where it protects neurons by scavenging free radicals. Zinc supplementation has been shown to significantly increase SODCu2Zn2 in vitro. A novel oral zinc tally test (ZTT) used in the assessment of zinc status was administered to 100 PD patients and 25 controls. Patients with PD showed a significantly decreased zinc status as compared to controls (p < 0.001). Significance was also established for 3 self-reported health-related variables thought to be related to zinc status: vision problems, olfactory loss, and taste loss (p < 0.05). Relative risks for patients with PD for these variables were 1.51, 1.56, and 1.33, respectively. Zinc status as measured by the ZTT is negatively correlated with PD status. PD status is positively correlated with self-reported vision problems, and olfactory and taste loss. Further study of the role of zinc in the development and treatment of PD is warranted.     

Rating scale and functional prognosis of Parkinson's disease

Parkinson's disease is a progressive neurodegenerative disorder. Motor functions of patients with Parkinson's disease are determined by its cardinal symptoms: akinesia, tremor, rigidity and disturbed righting reflexes. To evaluate degree of disability and rate of its progression in Parkinson disease, simple but reliable and reproducible rating scales are essential. Those that essentially fulfil such conditions are Hoehn and Yahr Scale, Schwab and England Scale, and Unified Parkinson's Disease Rating Scale (UPDRS). Levodopa, the major anti-parkinsonian agent, has greatly improved the motor functions of the Parkinson's disease patients and prolonged their life expectancy. Studies using the above mentioned scales compared the rate of disability progression and the motor functional prognosis between pre- and post-levodopa era, and always demonstrated the levodopa's benefits for the prognosis. Side effects of long administration of levodopa such as motor fluctuation, dyskinesia, wearing-off or on-off phenomenon, and psychosis, however, are disability factors to the patients' motor functions. Rating scales that can integrate the side effects to evaluate the functions will be required.     

帕金森病静息状态下纹状体功能连接的fMRI研究

目的应用血氧水平依赖的功能性磁共振成像研究帕金森病(Parkinson's disease,PD)静息状态下功能连接的改变。材料与方法对35例符合PD诊断标准的患者及20名健康者行静息态脑功能性磁共振成像,选双侧纹状体(striaum,STR)为感兴趣区,采用双样本t检验分别比较左侧STR(L-STR)、右侧STR(R-STR)在两组间的脑功能连接的差异。结果 (1)以L-STR为种子点时,PD组右侧前额叶背外侧部、双侧后扣带回皮质、左侧中央前后回、顶下小叶、左侧楔前叶、左侧缘上回等脑区的正连接较正常组减弱(P0.05,Alpha Sim校正),额下回、海马旁回、左侧海马、左侧岛叶正连接增强(P0.05,Alpha Sim校正)。(2)以R-STR为种子点时,PD组右侧前额叶背外侧部、双侧后扣带回皮质等脑区正连接较正常组减弱(P0.05,Alpha Sim校正),右侧舌回、岛叶、海马旁回、双侧海马、左侧丘脑等脑区正连接增强(P0.05,Alpha Sim校正)。结论静息状态下PD患者的脑功能连接网络存在异常。     

Transgenic expression of the endothelin-B receptor prevents congenital intestinal aganglionosis in a rat model of Hirschsprung disease.

The spotting lethal rat, a naturally occurring rodent model of Hirschsprung disease, carries a deletion in the endothelin-B receptor (EDNRB) gene that abrogates expression of functional EDNRB receptors. Rats homozygous for this mutation (sl) exhibit coat color spotting and congenital intestinal aganglionosis. These deficits result from failure of the neural crest-derived epidermal melanoblasts and enteric nervous system (ENS) precursors to completely colonize the skin and intestine, respectively. We demonstrate that during normal rat development, the EDNRB mRNA expression pattern is consistent with expression by ENS precursors throughout gut colonization. We used the human dopamine-beta-hydroxylase (DbetaH) promoter to direct transgenic expression of EDNRB to colonizing ENS precursors in the sl/sl rat. The DbetaH-EDNRB transgene compensates for deficient endogenous EDNRB in these rats and prevents the intestinal defect. The transgene has no effect on coat color spotting, indicating the critical time for EDNRB expression in enteric nervous system development begins after separation of the melanocyte lineage from the ENS lineage and their common precursor. The transgene dosage affects both the incidence and severity of the congenital intestinal defect, suggesting dosage-dependent events downstream of EDNRB activation in ENS development.     

Modes of drug delivery used to manage Parkinson's disease

Parkinson's disease is the second most frequent neurodegenerative condition after Alzheimer's disease and with an ageing population, the burden of care will only increase. This article presents an overview of the condition, its pharmacological and care management, and novel treatment approaches.     

Defective Fas expression exacerbates neurotoxicity in a model of Parkinson's disease

Fas (CD95), a member of the tumor necrosis factor-receptor superfamily, has been studied extensively as a death-inducing receptor in the immune system. However, Fas is also widely expressed in a number of other tissues, including in neurons. Here, we report that defects in the Fas/Fas ligand system unexpectedly render mice highly susceptible to neural degeneration in a model of Parkinson's disease. We found that Fas-deficient lymphoproliferative mice develop a dramatic phenotype resembling clinical Parkinson's disease, characterized by extensive nigrostriatal degeneration accompanied by tremor, hypokinesia, and loss of motor coordination, when treated with the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) at a dose that causes no neural degeneration or behavioral impairment in WT mice. Mice with generalized lymphoproliferative disease, which express a mutated Fas ligand, display an intermediate phenotype between that of lymphoproliferative and WT mice. Moreover, Fas engagement directly protects neuronal cells from MPTP/1-methyl-4-phenylpyridinium ion toxicity in vitro. Our data show that decreased Fas expression renders dopaminergic neurons highly susceptible to degeneration in response to a Parkinson-causing neurotoxin. These findings constitute the first evidence for a neuroprotective role for Fas in vivo.     

Doxycycline-regulated GDNF expression promotes axonal regeneration and functional recovery in transected peripheral nerve

Increased production of neurotrophic factors (NTFs) is one of the key responses seen following peripheral nerve injury, making them an attractive choice for pro-regenerative gene therapies. However, the downside of over-expression of certain NTFs, including glial cell line-derived neurotrophic factor (GDNF), was earlier found to be the trapping and misdirection of regenerating axons, the so-called ‘candy-store’ effect. We report a proof-of-principle study on the application of conditional GDNF expression system in injured peripheral nerve. We engineered Schwann cells (SCs) using dendrimers or lentiviral transduction with the vector providing doxycycline-regulated GDNF expression. Injection of GDNF-modified cells into the injured peripheral nerve followed by time-restricted administration of doxycycline demonstrated that GDNF expression in SCs can also be controlled locally in the peripheral nerves of the experimental animals. Cell-based GDNF therapy was shown to increase the extent of axonal regeneration, while controlled deactivation of GDNF effectively prevented trapping of regenerating axons in GDNF-enriched areas, and was associated with improved functional recovery.     

Delivery of GDNF by an E1,E3/E4 deleted adenoviral vector and driven by a GFAP promoter prevents dopaminergic neuron degeneration in a rat model of Parkinson's disease

A new adenoviral vector (Ad-GFAP-GDNF) (Ad=adenovirus, GFAP=glial fibrillary acidic protein, GDNF=glial cell line-derived neurotrophic factor) was constructed in which (i) the E1,E3/E4 regions of Ad5 were deleted and (ii) the GDNF transgene is driven by the GFAP promoter. We verified, in vitro, that the recombinant GDNF was expressed in primary cultures of astrocytes. In vivo, the Ad-GFAP-GDNF was injected into the striatum of rats 1 week before provoking striatal 6-OHDA lesion. After 1 month, the striatal GDNF levels were 37 pg/microg total protein. This quantity was at least 120-fold higher than in nontransduced striatum or after injection of the empty adenoviral vector. At 3 months after viral injection, GDNF expression decreased, whereas the viral DNA remained unchanged. Furthermore, around 70% of the dopaminergic (DA) neurons were protected from degeneration up to 3 months as compared to about 45% in the control groups. In addition, the amphetamine-induced rotational behavior was decreased. The results obtained in this study on DA neuron protection and rotational behavior are similar to those previously reported using vectors with viral promoters. In addition to these results, we established that a high level of GDNF was present in the striatum and that the period of GDNF expression was prolonged after injection of our adenoviral vector.     

Parkin protects against neurotoxicity in the 6-hydroxydopamine rat model for Parkinson's disease.

Loss-of-function mutations in the PARK2 gene are the major cause of early onset familial Parkinson's disease. The gene product, parkin, is an E3 ligase of the ubiquitin-proteasome pathway involved in protein degradation. Dopaminergic neuron loss may result from the toxic accumulation of parkin substrates, suggesting a key role for parkin in dopaminergic neuron survival. In this study, we have investigated the neuroprotective capacity of parkin in the 6-OHDA rat model for Parkinson's disease. 6-OHDA induces the generation of reactive oxygen species leading to the degeneration of catecholaminergic neurons, but may also impair proteasome activity. Lentiviral vectors encoding human wild-type parkin or green fluorescent protein were stereotactically injected into the substantia nigra 2 weeks prior to a striatal 6-OHDA lesion. Histological analysis 1 and 3 weeks after lesioning showed a significant preservation of dopaminergic cell bodies and nerve terminals. Moreover, lesioned rats overexpressing parkin displayed a corresponding behavioral improvement as measured by the amphetamine-induced rotation test and the cylinder test. The improved performance in the amphetamine-induced rotation test lasted until 20 weeks after lesioning. Our results demonstrate that parkin acts as a potent neuroprotective agent in vivo against 6-OHDA toxic insults. These data support the therapeutic potential of parkin for the treatment of not only familial but also sporadic Parkinson's disease.     

Diagnostic use of functional imaging in Parkinson's disease and related disorders

We reviewed the roles of functional neuroimaging in the diagnosis of Parkinson's disease and related disorders. Positron emission tomography or single photon emission computed tomography measurements in combination with various markers for brain metabolism and pre- and post-synaptic dopamine systems have a potential to enhance an accurate pre-mortem diagnosis of akinetic-rigid syndrome. Using information from magnetic resonance imaging technique seems helpful, too. Furthermore, these methods appear to be useful in pre-morbid diagnosis of Parkinson's disease and longitudinal follow-up for reassessing the rationality of treatment. The sensitivity and specificity of these diagnostic tools still wait for future evaluation, and we foresee further refinement of imaging and analytic methods.     

Deferoxamine promotes survival and prevents electrocardiographic abnormalities in the gerbil model of iron-overload cardiomyopathy

We investigated the time course of electrocardiographic (ECG) changes in the Mongolian gerbil model of iron overload and the effects of the iron chelator deferoxamine (DFO) on these changes. Iron overload was produced with weekly subcutaneous injections of low doses (200 mg/kg/wk) or high doses (800 mg/kg/wk) of iron-dextran. DFO was administered subcutaneously at a dose of 200 mg/kg/day to high-dose animals. Our results show that (1) survival of iron-overloaded gerbils is dose-dependent, with median survival times of 68 and 14 weeks for low- and high-dose animals, respectively; (2) both low and high doses produce prolongation of the PR interval and bradycardia in early stages and prolongation of the QT interval, premature ventricular contractions, variable degrees of atrioventricular block, changes in the ST segment, and T-wave inversion at later stages coinciding with the development of heart failure; (3) DFO prevented death during 20 weeks of high-dose iron-dextran; (4) DFO prevented ECG changes, although delayed prolongation of PR intervals and QRS complexes occurred; and (5) despite marked prolongation of survival and prevention of ECG changes, DFO had modest effects on total cardiac iron content. We speculate that DFO chelates a small iron pool located within the cytoplasm of iron-overloaded cardiomyocytes.     

In vivo imaging of disturbed pre- and post-synaptic dopaminergic signaling via arachidonic acid in a rat model of Parkinson's disease

BACKGROUND: Parkinson's disease involves loss of dopamine (DA)-producing neurons in the substantia nigra, associated with fewer pre-synaptic DA transporters (DATs) but more post-synaptic dopaminergic D2 receptors in terminal areas of these neurons. HYPOTHESIS: Arachidonic acid (AA) signaling via post-synaptic D2 receptors coupled to cytosolic phospholipase A2 (cPLA2) will be reduced in terminal areas ipsilateral to a chronic unilateral substantia nigra lesion in rats given D-amphetamine, which reverses the direction of the DAT, but will be increased in rats given quinpirole, a D2-receptor agonist. METHODS: D-amphetamine (5.0 mg/kg i.p.), quinpirole (1.0 mg/kg i.v.), or saline was administered to unanesthetized rats having a chronic unilateral lesion of the substantia nigra. AA incorporation coefficients, k* (radioactivity/integrated plasma radioactivity), markers of AA signaling, were measured using quantitative autoradiography in 62 bilateral brain regions following intravenous [1-(14)C]AA. RESULTS: In rats given saline (baseline), k* was elevated in 13 regions in the lesioned compared with intact hemisphere. Quinpirole increased k* in frontal cortical and basal ganglia regions bilaterally, more so in the lesioned than intact hemisphere. D-amphetamine increased k* bilaterally but less so in the lesioned hemisphere. CONCLUSIONS: Increased baseline elevations of k* and increased responsiveness to quinpirole in the lesioned hemisphere are consistent with their higher D2-receptor and cPLA2 activity levels, whereas reduced responsiveness to D-amphetamine is consistent with dropout of pre-synaptic elements containing the DAT. In vivo imaging of AA signaling using dopaminergic drugs can identify pre- and post-synaptic DA changes in animal models of Parkinson's disease.     

功能性步态评价应用于帕金森病患者的信度分析

目的:验证功能性步态评价(FGA)在帕金森病(PD)患者中的组间信度、重测信度、内部一致性及分半信度,为临床提供评价工具.方法:121例住院帕金森病患者(平均年龄61.9岁)入选.两名评价者同时评定PD患者的FGA表现,进行组间信度分析.评价过程同时记录为视频资料,4周后其中一名评定者对视频资料进行二次评价,进行重测信度分析.内部一致性信度采用克朗巴赫α系数来评价.分半信度:将FGA各单项以奇数项、偶数项分为两半,计算其分半信度.结果:FGA总分的组间信度和重测信度均为0.99,各单项组间信度波动于0.49-0.98之间,重测信度波动于0.91-0.99之间.FGA内部一致性Cronbach α为0.94,分半信度为0.97.结论:FGA用于评价PD患者的平衡及步态障碍,其组间信度、重测信度、内部一致性及分半信度极佳.     

白藜芦醇对神经干细胞诱导分化为多巴胺能神经元移植治疗帕金森模型鼠的影响

背景:目前神经干细胞体外诱导分化的多巴胺能神经元移植治疗帕金森病仍面临细胞存活率低的问题,大部分细胞因氧自由基形成及脂质过氧化而发生程序性凋亡.目的:探讨白藜芦醇对神经干细胞体外诱导分化的多巴胺能神经元移植至帕金森模型鼠后的细胞存活及移植效果的影响.设计、时间及地点:随机对照动物实验,于2007-10/2008-06在中山大学动物实验中心完成.材料:成年健康雄性SD大鼠32只,随机分为模型对照组、多巴胺能神经元组、白藜芦醇组、联合组,8只/组;孕十四五天的健康SD大鼠4只,取胎鼠用于神经干细胞的分离培养.白藜芦醇为深圳晶美生物工程有限公司产品.方法:取体外分离培养的胎鼠中脑神经干细胞,在含表皮生长因子、碱性成纤维细胞生长因子的无血清培养液中传代扩增后,在分化液中诱导向多巴胺能神经元方向分化.各组大鼠均应用6-羟基多巴胺制备帕金森病模型.采用两点移植法,多巴胺能神经元组向大鼠毁损同侧纹状体注入多巴胺能神经元细胞悬液3μL(1×105个/μL):白藜芦醇组注入40 mg/L白藜芦醇3 μL;联合组注入40 mg/L白藜芦醇3 μL+多巴胺能神经元细胞悬液3 pL(1×105个/μL).模型对照组注入DMEM/F12细胞培养液3 μL.主要观察指标:胎鼠神经干细胞诱导分化的酪氨酸羟化酶染色阳性细胞率,细胞移植后帕金森模型鼠不对称旋转行为的变化,纹状体移植区酪氨酸羟化酶染色阳性细胞存活情况.结果:流式细胞仪检测诱导分化6 d的细胞中酪氨酸羟化酶染色阳性细胞率为(17.8±4.2)%.与模型对照组比较,联合组大鼠移植后10d不对称旋转行为有显著性改善(P<0.01),移植后20d不对称旋转圈数开始明显下降(P<0.01).移植后10～60 d,联合组大鼠的不对称旋转圈数明显低于多巴胺能神经元组(P<0.01).白藜芦醇组、模型对照组均未见酪氨酸羟化酶染色阳性细胞,联合组酪氨酸羟化酶染色阳性细胞数明显多于多巴胺能神经元组(P<0.01).结论:胎鼠神经干细胞诱导分化的多巴胺能神经元移植至帕金森模型鼠后,白藜芦醇可提高纹状体移植区植入细胞的存活率,改善大鼠不对称旋转行为.