Neuroprotection in Parkinson's disease; a commentary.

Parkinson's disease (PD) is a worldwide neurodegenerative disorder. Although the etiology has been linked to genetic and environmental factors, curative treatment remains a challenge. Several hypotheses support different pathophysiological mechanisms related to oxidative stress, glutamate-mediated neurotoxicity, mitochondrial energetic impairment and nitric oxide (NO) over-production. Moreover, apoptotic mechanisms have been identified in PD. In this way, classical drugs such as amantadine, selegiline and dopamine agonists show only a modest neuroprotective effect. New strategies with enormous potential are now under development. These include neuroprotectants and agents that might rescue dopaminergic neurons. Glutamate receptor antagonists, neurotrophins, neuroimmunophilins, adenosine A2A receptor antagonists, iron-chelators and NO modulators, as well as caspase inhibitors have evident neuroprotective properties in experimental PD models.