Diagnostic value of determination of synuclein in patients with Parkinson,s disease

Abstract

Parkinson’s disease is the second most important neurodegenerative disease and the main cause of disability and reduced quality of life, steadily progressing with a wide range of motor and non-motor disorders. Currently, the diagnosis of Parkinson’s disease is based on clinical criteria and can be confirmed only after the death of the patient on the basis of a pathological study of the brain, allowing to identify incorrectly folded α-synuclein protein as Levi cells associated with the loss of nerve cells in the substance of the nigra. In vivo, diagnostic biomarkers of Parkinson’s disease are currently virtually absent, which to some extent makes it difficult to identify patients at the preclinical stage prior to the loss of nerve cells in the nigra substance. Biomarkers of Parkinson’s disease are necessary to identify risk groups for this disease, monitor the progression of the disease and evaluate the effectiveness of therapeutic measures. The accumulation of α-synuclein is not limited to the Central nervous system. Aggregates of α-synuclein are detected in the peripheral nervous system. Experimental and pathomorphological data show that the accumulation of α-synuclein aggregates plays a key role in the development and progression of neurodegenerative diseases, including Parkinson’s disease. It is shown that α-synuclein pathology can begin and initially be detected not in the brain, but only in other organs and systems of the body, for example, in the gastrointestinal tract, in the prodromal phase of Parkinson’s disease long before it reaches the brain. According to one of the modern hypotheses, α-synuclein aggregates are initially registered in the peripheral nervous system as a result of certain external or genetic influences, and subsequently spread to the Central nervous system by means of pre-ganglion branches of ntrvus vagus. This hypothesis is confirmed by certain evidence in vivo, indicating that the progression of pathology from the periphery to the Central nervous system is due to intramuscular and intragastric injections of α-synucleic fibrils, or vagotomy, which significantly reduces the risk of Parkinson’s disease. Currently, α-synuclein is a potential biomarker of Parkinson’s disease. However, there is no clear information on the extent to which itsdetection in the biological fluids of the macroorganism in the absence of clinical manifestations of the disease can have diagnostic value and contribute to the earliest possible diagnosis of Parkinson’s disease.

Keywords

neurodegenerative disorders / Parkinson’s disease / α-synuclein / interleukins / mitochondrial dysfunction / dyslipidemia / apolipoproteins / oxidative stress / laboratory methods of detection of α-synuclein in body fluids

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