Abstract

Parkinson’s disease (PD) is a chronic, progressive disease of the central nervous system (CNS),characterized by a slow loss of dopaminergic neurons in the substantia nigra, leading to significantdecrease in dopamine (DA) levels in the striatum. Currently used drugs, such as levodopa(L-DOPA), amantadine, dopamine agonists (D) or anticholinergic drugs, are not effective enough,and do not eliminate the causes of disease. Many research centers are conducting researchon new forms of currently used drugs (e.g. Duodopa, XP21279, IPX066), new drugs of alreadyknown groups (e.g. safinamide), medicines that suppress side effects of L-DOPA (e.g. AFQ056,fipamezole), and, finally, compounds with a novel mechanism of action (e.g. PMY50028, A2Areceptor antagonists). A lot of scientific reports indicate an important role of A2A receptorsin the regulation of the central movement system, so a new group of compounds – selectiveantagonists of A2A receptors (e.g. istradefylline, preladenant, SYN115) – has been developed and their potential use in PD has been examined. Clinical studies of A2A receptor antagonistshave shown that this group of compounds can shorten off periods and at the same time theydo not worsen dyskinesias in patients with PD. Moreover, there is ongoing research on newforms of treatment, such as gene therapy. Attempts to apply the viral vector AAV-2, whichwill be able to infect neurons with a variety of genes, including the gene of glutamate decarboxylase(GAD), neurturin (NTN), or aromatic L-amino acid decarboxylase, are currently beingcarried out. The results of phase I and II clinical studies showed some efficacy of this form oftreatment, but the method requires further studies. An analysis of potential future therapiesof Parkinson’s disease suggests that some progress in this field has been made.

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