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Hölscher C. Glucagon-like peptide-1 class drugs show clear protective effects in Parkinson's and Alzheimer's disease clinical trials: A revolution in the making? Neuropharmacology 2024; 253:109952. [PMID: 38677445 DOI: 10.1016/j.neuropharm.2024.109952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024]
Abstract
Parkinson's disease (PD) is a complex syndrome for which there is no disease-modifying treatment on the market. However, a group of drugs from the Glucagon-like peptide-1 (GLP-1) class have shown impressive improvements in clinical phase II trials. Exendin-4 (Bydureon), Liraglutide (Victoza, Saxenda) and Lixisenatide (Adlyxin), drugs that are on the market as treatments for diabetes, have shown clear effects in improving motor activity in patients with PD in phase II clinical trials. In addition, Liraglutide has shown improvement in cognition and brain shrinkage in a phase II trial in patients with Alzheimer disease (AD). Two phase III trials testing the GLP-1 drug semaglutide (Wegovy, Ozempic, Rybelsus) are ongoing. This perspective article will summarize the clinical results obtained so far in this novel research area. We are at a crossroads where GLP-1 class drugs are emerging as a new treatment strategy for PD and for AD. Newer drugs that have been designed to enter the brain easier are being developed already show improved effects in preclinical studies compared with the older GLP-1 class drugs that had been developed to treat diabetes. The future looks bright for new treatments for AD and PD.
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Affiliation(s)
- Christian Hölscher
- Henan Academy of Innovations in Medical Science, Neurodegeneration Research Group, 451100 Xinzheng, Henan province, China.
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Müller T, Möhr JD. Negative findings from trials with NLY01 or deferiprone for Parkinson's disease. Lancet Neurol 2024; 23:558-559. [PMID: 38760091 DOI: 10.1016/s1474-4422(24)00097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/04/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Thomas Müller
- Department of Neurology, St Joseph Hospital Berlin-Weissensee, 13088 Berlin, Germany.
| | - Jan Dominique Möhr
- Department of Internal Medicine, St Elisabeth Hospital, Ruhr University of Bochum, Bochum, Germany
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McGarry A. Negative findings from trials with NLY01 or deferiprone for Parkinson's disease - Author's reply. Lancet Neurol 2024; 23:559. [PMID: 38760092 DOI: 10.1016/s1474-4422(24)00163-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Andrew McGarry
- Cooper Medical School at Rowan University, Camden 08103, NJ, USA; Clintrex Research Corporation, Sarasota, FL, USA.
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Le Guiniec M, Borel AL. Effects of GLP1 receptor analogues in obesity with neurodevelopmental disorder: case report of a patient with holoprosencephaly. Eur J Clin Nutr 2024:10.1038/s41430-024-01450-8. [PMID: 38802605 DOI: 10.1038/s41430-024-01450-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024]
Abstract
Holoprosencephaly is an anomaly in the division of the prosencephalon into cerebral hemispheres during the second month of gestation. Patients can present with early-onset obesity favoured by the cognitive impairment. We present a case of a 24 year-old woman with holoprosencephaly and class III obesity who was treated by 2.4 mg/week SEMAGLUTIDE. Her body weight decreased from 115.3 to 94.3 kg after one-year (18% of total body weight loss). In addition, she presented a marked reduction in self- and hetero-aggressive behaviour when exposed to the sight of food. The treatment was well tolerated, with the exception of a few vomiting when eating palatable food too quickly. GLP1-RAs may be interesting for obesity treatment in the context of neurodevelopmental disorders. They appear to reduce compulsive eating and aggressive behaviour, particularly in relation to exposure to food, and lead to weight loss similar to that seen in people without neurodevelopmental disorders.
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Affiliation(s)
- Manon Le Guiniec
- Univ. Grenoble Alpes, Endocrinology Diabetology Nutrition department, Grenoble University Hospital, Grenoble, France
| | - A L Borel
- Univ. Grenoble Alpes, INSERM U1300, Endocrinology Diabetology Nutrition department, Grenoble University Hospital, Grenoble, France.
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Irfan H, Muneer SU, Maheshwari AB, Kumar N, Iftikhar S. Lixisenatide in early parkinson's disease: efficacy, safety, and future directions: a correspondence. Neurosurg Rev 2024; 47:232. [PMID: 38787469 DOI: 10.1007/s10143-024-02475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/11/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Abstract
Parkinson's disease (PD) presents as a complex neurodegenerative disorder characterized by motor and non-motor symptoms, resulting from dopaminergic neuron degeneration. Current treatment strategies primarily aim to alleviate symptoms through pharmacotherapy and supportive therapies. However, emerging research explores novel therapeutic avenues, including the repurposing of drugs like lixisenatide, a GLP-1 receptor agonist initially developed for type 2 diabetes. This correspondence summarizes a phase 2 clinical trial investigating lixisenatide's efficacy in early PD, demonstrating a potential for mitigating motor disability progression. Findings reveal a marginal improvement or stabilization in motor function among lixisenatide-treated individuals compared to placebo, emphasizing its therapeutic promise. Nonetheless, the emergence of gastrointestinal adverse events underscores the need for careful monitoring and management. Further extensive trials are warranted to delineate lixisenatide's efficacy and safety profile, fostering collaborative efforts towards precision treatments in PD.
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Affiliation(s)
- Hamza Irfan
- Department of Medicine, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, G855 + XRM, Sheikh Zayed Medical Complex, Khayaban-e-Jamia Punjab, Block D Muslim Town, Lahore, Punjab, Pakistan.
| | - Siraj Ul Muneer
- Department of Medicine, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, G855 + XRM, Sheikh Zayed Medical Complex, Khayaban-e-Jamia Punjab, Block D Muslim Town, Lahore, Punjab, Pakistan
| | - Ashoney Bai Maheshwari
- Liaquat University of Medical and Health Sciences, C7P9 + 4W6, Jamshoro, Sindh, Pakistan
| | - Nikil Kumar
- Jinnah Medical and Dental College, 22-23 Shaheed-e-Millat Rd, Bihar Muslim Society BMCHS Sharafabad, Karachi City, Sindh, 74800, Pakistan
| | - Sana Iftikhar
- Department of Medicine, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, G855 + XRM, Sheikh Zayed Medical Complex, Khayaban-e-Jamia Punjab, Block D Muslim Town, Lahore, Punjab, Pakistan
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Di Vincenzo A, Vettor R, Rossato M. Contrasting obesity: is something missing here? Comment. Intern Emerg Med 2024:10.1007/s11739-024-03646-z. [PMID: 38769234 DOI: 10.1007/s11739-024-03646-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 05/12/2024] [Indexed: 05/22/2024]
Affiliation(s)
- Angelo Di Vincenzo
- Internal Medicine III Unit and Center for the Study and the Integrated Treatment of Obesity, Department of Medicine, University-Hospital of Padova, Padova, Italy.
| | - Roberto Vettor
- Internal Medicine III Unit and Center for the Study and the Integrated Treatment of Obesity, Department of Medicine, University-Hospital of Padova, Padova, Italy
| | - Marco Rossato
- Internal Medicine III Unit and Center for the Study and the Integrated Treatment of Obesity, Department of Medicine, University-Hospital of Padova, Padova, Italy
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Lauretani F, Giallauria F, Testa C, Zinni C, Lorenzi B, Zucchini I, Salvi M, Napoli R, Maggio MG. Dopamine Pharmacodynamics: New Insights. Int J Mol Sci 2024; 25:5293. [PMID: 38791331 PMCID: PMC11121567 DOI: 10.3390/ijms25105293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Dopamine is a key neurotransmitter involved in physiological processes such as motor control, motivation, reward, cognitive function, and maternal and reproductive behaviors. Therefore, dysfunctions of the dopaminergic system are related to a plethora of human diseases. Dopamine, via different circuitries implicated in compulsive behavior, reward, and habit formation, also represents a key player in substance use disorder and the formation and perpetuation of mechanisms leading to addiction. Here, we propose dopamine as a model not only of neurotransmission but also of neuromodulation capable of modifying neuronal architecture. Abuse of substances like methamphetamine, cocaine, and alcohol and their consumption over time can induce changes in neuronal activities. These modifications lead to synaptic plasticity and finally to morphological and functional changes, starting from maladaptive neuro-modulation and ending in neurodegeneration.
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Affiliation(s)
- Fulvio Lauretani
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy; (C.T.); (C.Z.); (B.L.); (I.Z.); (M.S.); (M.G.M.)
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
| | - Francesco Giallauria
- Department of Translational Medical Sciences, “Federico II” University of Naples, via S. Pansini 5, 80131 Naples, Italy; (F.G.); (R.N.)
| | - Crescenzo Testa
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy; (C.T.); (C.Z.); (B.L.); (I.Z.); (M.S.); (M.G.M.)
| | - Claudia Zinni
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy; (C.T.); (C.Z.); (B.L.); (I.Z.); (M.S.); (M.G.M.)
| | - Beatrice Lorenzi
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy; (C.T.); (C.Z.); (B.L.); (I.Z.); (M.S.); (M.G.M.)
| | - Irene Zucchini
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy; (C.T.); (C.Z.); (B.L.); (I.Z.); (M.S.); (M.G.M.)
| | - Marco Salvi
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy; (C.T.); (C.Z.); (B.L.); (I.Z.); (M.S.); (M.G.M.)
| | - Raffaele Napoli
- Department of Translational Medical Sciences, “Federico II” University of Naples, via S. Pansini 5, 80131 Naples, Italy; (F.G.); (R.N.)
| | - Marcello Giuseppe Maggio
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy; (C.T.); (C.Z.); (B.L.); (I.Z.); (M.S.); (M.G.M.)
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
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Standaert DG. GLP-1, Parkinson's Disease, and Neuroprotection. N Engl J Med 2024; 390:1233-1234. [PMID: 38598580 DOI: 10.1056/nejme2401743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- David G Standaert
- From the Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
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Adam D. Diabetes drug slows development of Parkinson's disease. Nature 2024:10.1038/d41586-024-00974-0. [PMID: 38570659 DOI: 10.1038/d41586-024-00974-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
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