Parkinson's disease is characterized by motor and non-motor clinical manifestations for which there is an effective treatment. However, its therapeutic approach is a puzzle in which many pieces are still unknown. Scientists at research center Applied Medicine (CIMA ) of the University of Navarra review in Nature Medicine the current status of this neurodegenerative pathology. The group of Dr. Manuel Rodríguez, from the University of La Laguna (Tenerife), and several international experts have collaborated in the work .

It is now known that there is no single cause of the disease. "Some neurons are more sensitive than others to dopamine deficiency. We must also take into account some environmental factors, such as coffee and tobacco consumption, which reduce the risk of developing Parkinson's disease; however, for the moment we do not know their protective mechanism," explains Dr. José A. Obeso, manager of the laboratory of Movement Disorders at CIMA and lead author of work.

One of the great challenges is to define the subtypes of the disease, since each case evolves differently. "When there is a classification of the disease, it will be possible to carry out more reliable clinical trials aimed at halting the progression of the disease, given that they now encompass patients with different clinical profiles and evolution."

Combined therapies

According to Dr. Obeso, "the treatment of Parkinson's disease will be accompanied by a combination of molecular therapies, anti-inflammatory drugs and techniques that reduce the excess activity of glutamate (a neurotransmitter involved in this disease). On the other hand, work with neurotrophic factors has given good results in experimentation, but in clinical trials has been ineffective result . A pilot study with nerturin (another neurotrophic factor subject ) is underway, which gives some hope".

The management of Parkinson's disease has improved considerably over the past two decades thanks to the development of new therapies and better use of other known therapies. "Today, most patients have a relatively normal quality of life for many years. In any case, the knowledge of the molecular mechanisms of the disease is the core topic to advance against its progression and guide its cure."