P2X7 receptor/NLRP3 inflammasome complex and a-synuclein/parkin balance in neo-diagnosed, treatment-naïve Parkinson disease: a prospective study
Abstract Background Neuro, and likely systemic inflammation, with abnormal α-synuclein deposition, participate in the development of Parkinson’s disease (PD). The P2 × 7 receptor/NLRP3 inflammasome complex is upregulated in the brain of PD patients. Aim of this study was to explore whether the systemic activation of such complex might participate in the pathogenesis of PD. Methods Systemic expression and functional activity of the inflammasome were measured in 25 newly diagnosed PD patients and 25 controls at baseline and after twelve months of pharmacologic treatment, exploring the involved intracellular signalling and its epigenetic regulation. A putative mechanistic explanation of the results was validated in a murine model of neuroinflammation. Results De-novo PD patients were characterized by a systemic hyper-expression of the P2 × 7R/NLRP3 inflammasome platform, likely modulating circulating and lymphomonocyte α-synuclein, whose deposits represent the main pathogenetic factor of PD. A reduced JNK phosphorylation might be the involved intracellular signalling. miR-7 and miR-30, implied in the pathogenesis of PD and in the post-transcriptional control of α-synuclein and NLRP3 expression, were also increased in PD. After one year of usual anti-Parkinson treatments, such inflammatory platform was significantly reduced. In the substantia nigra of P2 × 7R KO mice, a neuroinflammatory stimulus induced a strong expression of parkin, a protective protein, suggesting that P2 × 7R activation might participate in the inflammatory damage occurring in specific brain areas also by inhibiting parkin expression. Conclusion Newly-diagnosed PD subjects display a systemic hyper-expression of the P2 × 7R/NLRP3 inflammasome platform that seems to modulate circulating and lymphomonocyte α-synuclein; a reduced JNK phosphorylation might be the intracellular signalling mediating this effect, undergoing an epigenetic regulation by miR-7 and miR-30. Trial registration ClinicalTrials.gov (NCT03918616).