MPTP: insights into parkinsonian neurodegeneration.

MPTP burst upon the medical landscape two decades ago, first as a mysterious parkinsonian epidemic, triggering an unparalleled quest for the toxin's identity, and closely followed by an intense pursuit of its cellular mechanisms of action. MPTP treatment created an animal model of many features of Parkinson's disease (PD), used primarily in primates and later in mice. The critical role of oxidative stress damage to vulnerable dopamine neurons, as well as for neurodegenerative diseases in general, emerged from MPTP neurotoxicity. A remarkable cross-fertilization of basic and clinical findings, including genetic and epidemiologic studies, has greatly advanced our understanding of PD and revealed multiple factors contributing to the parkinsonian phenotypes. Brain imaging localizes sites of action and provides potential presymptomatic diagnostic testing. Epidemiologic reports linking PD with pesticide exposure were complimented by supportive evidence from biochemical studies of MPTP and structurally related compounds, especially after low-level, long-term exposure. Genetic studies on the role of risk genes, such as alpha-synuclein or parkin, have been validated by biochemical, anatomical and neurochemical investigations showing factors interacting to produce pathophysiology in the animal model. Focusing on the pivotal role of mitochondria, subcellular pathways participating in cell death have been clarified by unraveling similar sites of action of MPTP. Along the way, compounds antagonizing or potentiating MPTP effects indicated new PD therapies, some of the former achieving clinical trials. The future is encouraging for combating PD and will continue to benefit from the MPTP neurotoxicity model.