Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—Viewpoint
To date, there are no clinically effective neuroprotective or disease-modifying treatments that can halt Parkinson's disease (PD) progression. The current clinical approach focuses on symptomatic management. This failure may relate to the complex neurobiology underpinning the development of PD...
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doaj-c10ca2a913bb41a1a0ea5162b2d90bda2020-11-25T02:52:43ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-06-011110.3389/fneur.2020.00556548894Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—ViewpointCarolina Sportelli0Daniele Urso1Daniele Urso2Peter Jenner3K. Ray Chaudhuri4K. Ray Chaudhuri5National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United KingdomNational Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United KingdomInstitute of Psychiatry, Psychology & Neuroscience, King's College, London, United KingdomInstitute of Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College, London, United KingdomNational Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United KingdomInstitute of Psychiatry, Psychology & Neuroscience, King's College, London, United KingdomTo date, there are no clinically effective neuroprotective or disease-modifying treatments that can halt Parkinson's disease (PD) progression. The current clinical approach focuses on symptomatic management. This failure may relate to the complex neurobiology underpinning the development of PD and the absence of true translational animal models. In addition, clinical diagnosis of PD relies on presentation of motor symptoms which occur when the neuropathology is already established. These multiple factors could contribute to the unsuccessful development of neuroprotective treatments for PD. Prodromal symptoms develop years prior to formal diagnosis and may provide an excellent tool for early diagnosis and better trial design. Patients with idiopathic rapid eye movement behavior disorder (iRBD) have the highest risk of developing PD and could represent an excellent group to include in neuroprotective trials for PD. In addition, repurposing drugs with excellent safety profiles is an appealing strategy to accelerate drug discovery. The anti-diabetic drug metformin has been shown to target diverse cellular pathways implicated in PD progression. Multiple studies have, additionally, observed the benefits of metformin to counteract other age-related diseases. The purpose of this viewpoint is to discuss metformin's neuroprotective potential by outlining relevant mechanisms of action and the selection of iRBD patients for future clinical trials in PD.https://www.frontiersin.org/article/10.3389/fneur.2020.00556/fullParkinson's diseaseprodromalmetforminneuroprotectionidiopathic REM behavior disorder |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Carolina Sportelli Daniele Urso Daniele Urso Peter Jenner K. Ray Chaudhuri K. Ray Chaudhuri |
spellingShingle |
Carolina Sportelli Daniele Urso Daniele Urso Peter Jenner K. Ray Chaudhuri K. Ray Chaudhuri Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—Viewpoint Frontiers in Neurology Parkinson's disease prodromal metformin neuroprotection idiopathic REM behavior disorder |
author_facet |
Carolina Sportelli Daniele Urso Daniele Urso Peter Jenner K. Ray Chaudhuri K. Ray Chaudhuri |
author_sort |
Carolina Sportelli |
title |
Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—Viewpoint |
title_short |
Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—Viewpoint |
title_full |
Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—Viewpoint |
title_fullStr |
Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—Viewpoint |
title_full_unstemmed |
Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease—Viewpoint |
title_sort |
metformin as a potential neuroprotective agent in prodromal parkinson's disease—viewpoint |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2020-06-01 |
description |
To date, there are no clinically effective neuroprotective or disease-modifying treatments that can halt Parkinson's disease (PD) progression. The current clinical approach focuses on symptomatic management. This failure may relate to the complex neurobiology underpinning the development of PD and the absence of true translational animal models. In addition, clinical diagnosis of PD relies on presentation of motor symptoms which occur when the neuropathology is already established. These multiple factors could contribute to the unsuccessful development of neuroprotective treatments for PD. Prodromal symptoms develop years prior to formal diagnosis and may provide an excellent tool for early diagnosis and better trial design. Patients with idiopathic rapid eye movement behavior disorder (iRBD) have the highest risk of developing PD and could represent an excellent group to include in neuroprotective trials for PD. In addition, repurposing drugs with excellent safety profiles is an appealing strategy to accelerate drug discovery. The anti-diabetic drug metformin has been shown to target diverse cellular pathways implicated in PD progression. Multiple studies have, additionally, observed the benefits of metformin to counteract other age-related diseases. The purpose of this viewpoint is to discuss metformin's neuroprotective potential by outlining relevant mechanisms of action and the selection of iRBD patients for future clinical trials in PD. |
topic |
Parkinson's disease prodromal metformin neuroprotection idiopathic REM behavior disorder |
url |
https://www.frontiersin.org/article/10.3389/fneur.2020.00556/full |
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