医学
疾病
帕金森病
脑深部刺激
临床试验
左旋多巴
药物开发
不利影响
重症监护医学
药理学
药品
生物信息学
内科学
生物
作者
Ahmad Elkouzi,Vinata Vedam‐Mai,Robert S. Eisinger,Michael S. Okun
标识
DOI:10.1038/s41582-019-0155-7
摘要
Parkinson disease (PD) treatment options have conventionally focused on dopamine replacement and provision of symptomatic relief. Current treatments cause undesirable adverse effects, and a large unmet clinical need remains for treatments that offer disease modification and that address symptoms resistant to levodopa. Advances in high-throughput drug screening methods for small molecules, developments in disease modelling and improvements in analytical technologies have collectively contributed to the emergence of novel compounds, repurposed drugs and new technologies. In this Review, we focus on disease-modifying and symptomatic therapies under development for PD. We review cellular therapies and repurposed drugs, such as nilotinib, inosine, isradipine, iron chelators and anti-inflammatories, and discuss how their success in preclinical models has paved the way for clinical trials. We provide an update on immunotherapies and vaccines. In addition, we review non-pharmacological interventions targeting motor symptoms, including gene therapy, adaptive deep brain stimulation (DBS) and optogenetically inspired DBS. Given the many clinical phenotypes of PD, individualization of therapy and precision of treatment are likely to become important in the future. Conventional therapies for Parkinson disease (PD) include dopamine replacement and therapies targeting symptomatic relief, but these approaches fail to modify the underlying disease. This Review explores the novel PD treatment strategies currently being investigated, including pharmaceuticals, cell therapies, immunotherapies, gene therapies and new technologies.
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