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A new study in the April 3rd issue of the journal Cell, a Cell Press 
publication, helps to explain why people who carry mutations in a gene known 
as Nurr1 develop a rare, inherited form of Parkinson's disease, the most 
prevalent movement disorder in people over the age of 65. 
They have found evidence that the gene normally acts to suppress an 
inflammatory response and, in turn, the production of neurotoxins in the 
brain. Those neurotoxins can otherwise spawn the damage to dopaminergic 
neurons that is characteristic of Parkinson's disease. The findings not only 
offer new insight into the causes of the disease, but also may point to new 
avenues for therapy, according to the researchers. 
In its normal form, "the gene protects against Parkinson's," said Christopher 
Glass of the University of California, San Diego. "This system functions in 
the brain, and probably in other parts of the body, to protect from the 
deleterious effects of excessive inflammation." When the Nurr1 gene is 
disabled, as it is in those with the rare familial form of Parkinson's 
disease, it leads to a pattern of inflammation that is exaggerated in both 
magnitude and duration, he added. 
The causes of most common forms of Parkinson's remain poorly understood, but 
the disease is generally associated with an inflammatory component involving 
cells known as microglia, the researchers explained. Those microglia act as 
sentinel cells, keeping a lookout for potential infection or tissue injury in 
the central nervous system. 
As for Nurr1, studies had found it plays an important role in dopaminergic 
neurons and that people with a rare mutant form of the gene produce too little 
of the protein it encodes, leading them to develop Parkinson's disease late in 
life. Earlier reports also showed that Nurr1 operates in cells other than 
neurons, where its activity is increased by inflammatory factors. 
Glass and his colleague Kaoru Saijo, also of UCSD, suspected that Nurr1's 
roles outside of neurons might also be involved in Parkinson's disease. 
Indeed, they've now shown that Nurr1 limits the activity of pro-inflammatory 
neurotoxic mediators in microglia and in cells known as astrocytes, which 
serve as support cells to neurons. When Nurr1's activity is reduced, microglia 
launch an exaggerated inflammatory response that is amplified further by 
astrocytes. It is this overreaction that leads to the production of factors 
that ultimately kill dopaminergic neurons. 
The findings suggest that inflammation may be an important general contributor 
to Parkinson's disease, which in the vast majority of cases has not been 
traced to any genetic cause, Saijo said. The researchers noted that while 
experts have grown to appreciate that Parkinson's disease has an inflammatory 
component, questions still remain about its role as a cause or consequence of 
the disease. 
"We think if inflammation is not an initiating event, it is definitely a part 
of the process that could amplify the disease," Glass said. That's a key point 
moving forward, he said, because it suggests there should be further efforts 
to evaluate and test anti-inflammatory therapies in the treatment of 
Parkinson's. Treatments designed to interrupt the signals between microglia 
and astrocytes might hold additional promise for fighting the disease. 
The new results may also have implications for the ultimate success or failure 
of stem cell therapies, Glass said. If the progression of Parkinson's disease 
is significantly influenced by inflammation as the researchers suggest, then 
any cell-based therapies designed to replace the dopaminergic neurons that are 
lost with new ones will also "have to deal with this process."
### 
The researchers include Kaoru Saijo, University of California, San Diego, La 
Jolla, California, CA; Beate Winner, The Salk Institute for Biological 
Studies, La Jolla, CA; Christian T. Carson, The Salk Institute for Biological 
Studies, La Jolla, CA; Jana G. Collier, University of California, San Diego, 
La Jolla, California, CA; Leah Boyer, University of California, San Diego, La 
Jolla, California, CA, The Salk Institute for Biological Studies, La Jolla, 
CA; Michael G. Rosenfeld, University of California, San Diego, La Jolla, 
California, CA, Howard Hughes Medical Institute; Fred H. Gage, The Salk 
Institute for Biological Studies, La Jolla, CA; and Christopher K. Glass, 
University of California, San Diego, La Jolla, California, CA. 


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