Alfa-sinukleina biomarkatzaile gisa Parkinson gaixotasunaren diagnostikoan

Laburpena

Parkinson disease (PD) is a common neurodegenerative disease, characterized pathologically by the presence of Lewy bodies and the progressive loss of dopaminergic neurons. Currently, the diagnosis of PD is based on clinical criteria; that is, it is diagnosed when motor symptoms appear such as limb tremor, slowness of movement or muscle stiffness. However, by the time motor symptoms appear, more than half of the dopaminergic neurons in the midbrain have been lost. Furthermore, as clinical diagnosis of PD is challenging, misdiagnosis is common. This highlights the need for disease-specific and early-stage biomarkers. Lewy bodies are rich in α-synuclein protein, who plays a fundamental role in the pathogenesis of PD. Therefore, α-synuclein may be useful as a PD biomarker. Therefore, the objective of this review is to summarize the efficacy of body fluid α-synuclein and its proteoforms measurements in the detection of PD. In fact, the identification of specific, sensitive, and non-invasive biomarkers is essential especially in regard to existing and future disease modifying treatments. Although the main candidate has been the measurement of α-synuclein in cerebrospinal fluid (CSF), CSF collection procedure is quite invasive and unsuitable in most clinical settings. Consequently, the presence of this protein and its proteoforms in biofluids such as blood plasma, saliva and tears has been investigated. Based on the results of these studies, phosphorylated and oligomeric α-synuclein are the best candidates for PD diagnosis. Until now, the measurement of α-synuclein has had multiple technical limitations, but the repeatability and reliability of immunoassays created in the last years has increased considerably. Therefore, it is expected that the potential of the main candidate biomarkers for PD diagnosis will be verified in the upcoming years.