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

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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.

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Acknowledgements

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

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  1. Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy

    Luca Magistrelli & Cristoforo Comi

  2. PhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, Varese, Italy

    Luca Magistrelli

  3. Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy

    Cristoforo Comi

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Magistrelli, L., Comi, C. Beta2-Adrenoceptor Agonists in Parkinson’s Disease and Other Synucleinopathies. J Neuroimmune Pharmacol 15, 74–81 (2020). https://doi.org/10.1007/s11481-018-09831-0

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