Oxidative Stress Mechanisms and Parkinson's Disease Treatment

A special issue of Antioxidants (ISSN 2076-3921). This special issue belongs to the section "Health Outcomes of Antioxidants and Oxidative Stress".

Deadline for manuscript submissions: closed (31 May 2026) | Viewed by 5380

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Molecular & Clinical Pharmacology, Instituto de Ciencias Biomédicas (ICBM), Faculty of Medicine, University of Chile, Santiago 8380453, Chile
Interests: Parkinson's disease; neuromelanin; neuroprotection; neurodegeneration; dopamine oxidation; preclinical model for Parkinson's disease
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Dear Colleagues,

It has been 57 years since the introduction of L-dopa in the treatment of idiopathic Parkinson's disease, and it is still the most effective drug in the treatment of this disease despite severe side effects after chronic treatment for 4 to 6 years. However, the failure of clinical studies involving antioxidants such as coenzyme Q raises the need for a thorough analysis of the role of oxidative stress in triggering the loss of neuromelanin-containing dopaminergic neurons of the nigrostriatal system, as well as possible factors that have influenced the failure of these clinical studies. In addition to the role of oxidative stress in the loss of dopaminergic neurons containing neuromelanin from the nigrostriatal system, other mechanisms are also involved, such as the formation of neurotoxic oligomers of alpha-synuclein, mitochondrial dysfunction, endoplasmic reticulum stress, dysfunction of both lysosomal and proteasomal protein degradation systems, and neuroinflammation. Therefore, in order to develop new treatments for idiopathic Parkinson's disease, a critical discussion of both the mechanisms that trigger the loss of neuromelanin-containing dopaminergic neurons from the nigrostriatal system and the preclinical models that we use to evaluate the effectiveness of a drug in this disease is required.

I invite you to submit your latest research findings, hypothesis papers, and review articles to this Special Issue, which will help us both to understand the failure of these clinical studies and to shed light on how to search for new drugs that can halt or modify the progression of this disease.

Prof. Dr. Juan Segura-Aguilar
Guest Editor

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Keywords

  • Parkinson’s disease
  • dopamine
  • dopamine oxidation
  • neuromelanin
  • dopaminergic neurons
  • antioxidants
  • neuroprotection
  • neurodegeneration
  • oxidative stress
  • protein degradation dysfunction
  • neuroinflammation
  • mitochondrial dysfunction
  • endoplasmic reticulum stress
  • alpha-synuclein oligomers
  • glutathione
  • glutathione transferase
  • DT-diaphorase
  • preclinical model for Parkinson's disease
  • VMAT2
  • dopamine transporter
  • tyrosine hydroxylase
  • dopamine-derived orto-quinones

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Published Papers (2 papers)

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18 pages, 2772 KB  
Article
Evaluation of Additive Neuroprotective Effect of Combination Therapy for Parkinson’s Disease Using In Vitro Models
by Alexander Shtilbans, Elise Esneault, Florian Simon, Joseph R. Mazzulli, Drew J. Quiriconi, Dror Rom, Wolfgang E. Reintsch, Andrea I. Krahn and Thomas M. Durcan
Antioxidants 2025, 14(4), 396; https://doi.org/10.3390/antiox14040396 - 27 Mar 2025
Cited by 3 | Viewed by 3525
Abstract
Background: All the processes leading to neurodegeneration cannot be addressed with just one medication. Combinations of drugs affecting various disease mechanisms concurrently could demonstrate improved effect in slowing the course of Parkinson’s disease (PD). Objective: This was a drug-repurposing experiment designed to assess [...] Read more.
Background: All the processes leading to neurodegeneration cannot be addressed with just one medication. Combinations of drugs affecting various disease mechanisms concurrently could demonstrate improved effect in slowing the course of Parkinson’s disease (PD). Objective: This was a drug-repurposing experiment designed to assess several combinations of nine drugs for possible added or synergistic efficacy using in vitro models of PD. Methods: We evaluated 44 combinations of the nine medications (sodium phenylbutyrate, terazosin, exenatide, ambroxol, deferiprone, coenzyme-Q10, creatine, dasatinib and tauroursodeoxycholic acid) selected for their previously demonstrated evidence of their impact on different targets, showing neuroprotective properties in preclinical models of PD. We utilized wild-type induced pluripotent stem-cell-derived human dopaminergic neurons treated with 1-methyl-4-phenylpyridinium for initial screening. We retested some combinations using an idiopathic PD patient-derived induced pluripotent stem cell line and alpha-synuclein triplication line. We assessed anti-neuroinflammatory effects using human microglia cells. As metrics, we evaluated neurite length, number of branch points per mm2, the number of live neurons, neurofilament heavy chain and pro-inflammatory cytokines. Results: We have identified four combinations of two to three drugs that showed an additive protective effect in some endpoints. Only the combination of sodium phenylbutyrate, exenatide and tauroursodeoxycholic acid showed improvement in four endpoints studied. Conclusions: We demonstrated that some of the medications, used in combination, can exert an additive neuroprotective effect in preclinical models of PD that is superior to that of each of the compounds individually. This project can lead to the development of the first treatment for PD that can slow or prevent its progression. Full article
(This article belongs to the Special Issue Oxidative Stress Mechanisms and Parkinson's Disease Treatment)
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18 pages, 1533 KB  
Hypothesis
A Pathophysiological Model of Parkinson’s Disease Based on Microvascular Flow Disturbance and Leukocyte-Mediated Oxidative Injury in Critical Pigmented Neuronal Niches
by Emilio Fernández-Espejo and Fernando Rodríguez de Fonseca
Antioxidants 2026, 15(2), 201; https://doi.org/10.3390/antiox15020201 - 3 Feb 2026
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Abstract
The authors hypothesize that idiopathic Parkinson’s disease may result from an alteration in microvascular flow at a “critical point” in the nervous system that is characterized by pigmented cells that express neuromelanin and/or lipofuscin. “Critical points” include the olfactory epithelium/bulb, the autonomic nervous [...] Read more.
The authors hypothesize that idiopathic Parkinson’s disease may result from an alteration in microvascular flow at a “critical point” in the nervous system that is characterized by pigmented cells that express neuromelanin and/or lipofuscin. “Critical points” include the olfactory epithelium/bulb, the autonomic nervous system, the enteric nervous system, the prefrontal–cortico-pontine network, and the amygdala. Hypoxia–ischemia following blood flow disturbance would recruit and activate leukocytes and induce the infiltration of peripheral immune cells into neural tissue. The excess of toxic factors produced by hyperactive immune cells, such as myeloperoxidase and its derivatives, would cause the oxidation of lipids, proteins, and biogenic monoamines such as dopamine, which in turn would facilitate the accumulation and precipitation of neuromelanin, lipofuscin, and alpha-synuclein. In addition, neuromelanin and lipofuscin precipitates may accentuate the misfolding and aggregation of alpha-synuclein. This “amplification” mechanism could help explain the crucial role of pigmented neurons in the onset of Parkinson’s disease pathology, triggering abnormal neurotoxic alpha-synuclein spread throughout the nervous system from the “critical point” of origin, and enabling a self-perpetuating degenerative process. The proposed hypothesis may have implications for the identification of new therapeutic targets, early prevention strategies, and the development of vascular and/or immune biomarkers. Full article
(This article belongs to the Special Issue Oxidative Stress Mechanisms and Parkinson's Disease Treatment)
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