Preventive treatments to slow substantia nigra damage and Parkinson's disease progression: A critical perspective review

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#animals #anti-inflammatory-agents #antioxidants #antiparkinson-agents #dietary-supplements

Preventive treatments to slow substantia nigra damage and Parkinson's disease progression: A critical perspective review

Bjørklund et al., 2020 | Pharmacol Res | Systematic Review

Citation

Bjørklund Geir, Dadar Maryam, ... Maes Michael. Preventive treatments to slow substantia nigra damage and Parkinson's disease progression: A critical perspective review. Pharmacol Res. 2020-Nov;161:105065. doi:10.1016/j.phrs.2020.105065

Abstract

Restoring the lost physiological functions of the substantia nigra in Parkinson's disease (PD) is an important goal of PD therapy. The present article reviews a) novel drug targets that should be targeted to slow PD progression, and b) clinical and experimental research data reporting new treatments targeting immune-inflammatory and oxidative pathways. A systematic search was performed based on the major databases, i.e., ScienceDirect, Web of Science, PubMed, CABI Direct databases, and Scopus, on relevant studies performed from 1900 to 2020. This review considers the crucial roles of mitochondria and immune-inflammatory and oxidative pathways in the pathophysiology of PD. High levels of oxidative stress in the substantia nigra, as well as modifications in glutathione regulation, contribute to mitochondrial dysfunction, with a decline in complex I of the mitochondrial electron transport chain reported in PD patients. Many papers suggest that targeting antioxidative systems is a crucial aspect of preventive and protective therapies, even justifying the utilization of N-acetylcysteine (NAC) supplementation to fortify the protection afforded by intracellular glutathione. Dietary recommended panels including ketogenetic diet, muscular exercise, nutraceutical supplementation including NAC, glutathione, nicotine, caffeine, melatonin, niacin, and butyrate, besides to nonsteroidal anti-inflammatory drugs (NSAIDs), and memantine treatment are important aspects of PD therapy. The integration of neuro-immune, antioxidant, and nutritional approaches to treatment should afford better neuroprotection, including by attenuating neuroinflammation, nitro-oxidative stress, mitochondrial dysfunction, and neurodegenerative processes. Future research should clarify the efficacy, and interactions, of nicotine receptor agonists, gut microbiome-derived butyrate, melatonin, and NSAIDs in the treatment of PD.

Key Findings

Future research should clarify the efficacy, and interactions, of nicotine receptor agonists, gut microbiome-derived butyrate, melatonin, and NSAIDs in the treatment of PD.

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition stress

MeSH Terms

  • Animals
  • Anti-Inflammatory Agents
  • Antioxidants
  • Antiparkinson Agents
  • Dietary Supplements
  • Disease Progression
  • Humans
  • Inflammation Mediators
  • Nutritional Status
  • Oxidative Stress
  • Parkinson Disease
  • Substantia Nigra

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: niacin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09