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Triggers, Facilitators, and Aggravators: Redefining Parkinson's Disease Pathogenesis.

Read time: 1 mins
Published:1st Jan 2019
Author: Johnson ME, Stecher B, Labrie V, Brundin L, Brundin P.
Availability: Free full text
Ref.:Trends Neurosci. 2019;42(1):4-13.

We hypothesize that Parkinson's disease (PD) pathogenesis can be divided into three temporal phases. During the first phase, 'triggers', such as viral infections or environmental toxins, spark the disease process in the brain and/or peripheral tissues. Triggers alone, however, may be insufficient, requiring 'facilitators' like peripheral inflammation for PD pathology to develop.

Once the disease manifests, 'aggravators' spur further neurodegeneration and exacerbate symptoms. Aggravators are proposed to include impaired autophagy and cell-to-cell propagation of α-synuclein pathology. We believe clinical trials need to consider these three phases and target potential therapies at the appropriate stage of the disease process in order to be effective.


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