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Beta2-Adrenoceptor Agonists in Parkinson’s Disease and Other Synucleinopathies

  • Luca Magistrelli
  • Cristoforo ComiEmail author
INVITED REVIEW

Abstract

Evidence supporting the use of β2AR agonists in synucleinopathies is rapidly growing. Findings come from different scientific approaches. Molecular and immunological data suggest that adrenergic stimulation may decrease both α-synuclein (α-syn) deposition and pro-inflammatory/neurotoxic molecules release. Small open label clinical trials including a total number of 25 Parkinson’s disease (PD) patients, in which the β2AR agonist salbutamol was added to levodopa, suggest a promising symptomatic benefit. In line with these findings, epidemiological studies investigating the risk of PD development suggest that long term exposure to the agonist salbutamol might be protective, while the antagonist propranolol possibly detrimental. Nonetheless, in both lines of investigation the studies performed so far present important limitations. On the clinical side, large randomized controlled trials are lacking, whereas on the epidemiological side the presence of co-morbid conditions (i.e. smoking and essential tremor) potentially influencing PD risk should taken into consideration. In summary, it is our opinion that β2AR stimulation in synucleinopathies has a rationale and therefore merits further investigation.

Graphical Abstract

Keywords

Parkinson’s disease Immune system Adrenergic system beta2 adrenergic agonists Alpha-synuclein 

Notes

Acknowledgements

This study was funded by the AGING PROJECT – Department of Excellence – Università del Piemonte Orientale.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 1.Movement Disorders Centre, Neurology Unit, Department of Translational MedicineUniversity of Piemonte OrientaleNovaraItaly
  2. 2.PhD Program in Clinical and Experimental Medicine and Medical HumanitiesUniversity of InsubriaVareseItaly
  3. 3.Interdisciplinary Research Center of Autoimmune Diseases (IRCAD)University of Piemonte OrientaleNovaraItaly

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