Title Nove mogućnosti liječenja Parkinsonove bolesti
Title (english) New possibilities in Parkinson's disease treatment
Author Mario Hero
Mentor Vladimira Vuletić (mentor)
Committee member Mira Bučuk (predsjednik povjerenstva)
Committee member Tea Schnurrer-Luke-Vrbanić (član povjerenstva)
Committee member Olivio Perković (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Neurology) Rijeka
Defense date and country 2021-07-16, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Neurology
Abstract PB je kronična progresivna neurodegenerativna bolest u kojoj dolazi do odlaganja abnormalnih agregata u područje pars compacte substantie nigre, što dovodi do gubitka dopaminergičnih neurona i strijatalne dopaminske deficijencije. To je najčešći poremećaj kretanja i drugi najučestaliji neurodegenerativni poremećaj koji pogađa čak 2-3% populacije u dobi od ≥65 godina. Bolest se najčešće pojavljuje između 65. i 70. godine života, a početak prije 40. godine uočava se u manje od 5% slučajeva. Nažalost, točan uzrok PB je još uvijek nepoznat, ali se pretpostavlja da bi bolest mogla biti multifaktorijalne, što bi uključivalo genetske i okolišne čimbenike. Patološko obilježje PB je prisutnost abnormalnih intracitoplazmatskih inkluzija, Lewyjevih koja su građena od proteina alfa-sinukleina. Glavni motorički simptomi PB, još se nazivaju i kardinalnim, mogu se nabrojati akronimom TRAP, što bi predstavljalo tremor u mirovanju, rigiditet, akineziju (ili bradikineziju) i posturalnu nestabilnost. Uz motoričke simptome prisutni su i NMS-i, poput senzornih, neuropsihijatrijskih, poremećaja spavanja i budnosti i poremećaja autonomnog živčanog sustava. Levodopa je već 60 godina zlatni standard u liječenju PB. Iako ima dobar učinak na većinu simptoma PB, postoje simptomi koji su rezistentni na njenu primjenu. Također, dugotrajnim korištenjem levodope dolazi do nastupa motoričkih komplikacija. Drugi konvencionalni lijekovi su manje efikasni i teže se podnose, dok starije neurokirurške metode, talamotomija i palidotomija, imaju značajan rizik mortaliteta i morbiditeta. Novija saznanja o patogenezi i genetici PB otvorila su put k razvoju novih terapijskih metoda. Brojne obećavajuće i inovativne metode napredovale su do faza kliničkih ispitivanja te bi se za nekoliko godina mogle široko upotrebljavati u klinici.
Abstract (english) PB is a chronic progressive neurodegenerative disease in which abnormal aggregates are deposited in the area of the pars compacta substantia nigra, leading to loss of dopaminergic neurons and striatal dopamine deficiency. It is the most common movement disorder and the second most common neurodegenerative disorder affecting as many as 2-3% of the population aged ≥65 years. The disease most often occurs between the ages of 65 and 70, and onset before the age of 40 is observed in less than 5% of cases. Unfortunately, the exact cause of PB is still unknown, but it is hypothesized that the disease could be multifactorial, involving genetic and environmental factors. The pathological feature of PB is the presence of abnormal intracytoplasmic inclusions, Lewy bodies that are constructed from the alpha-synuclein protein. The main motor symptoms of PB, also called cardinal, can be listed by the acronym TRAP, representing tremor at rest, rigidity, akinesia (or bradykinesia), and postural instability. In addition to motor symptoms, NMSs are present, such as sensory, neuropsychiatric, sleep and wakefulness disorders, and autonomic nervous system disorders. Levodopa has been the gold standard in the treatment of PB for 60 years. Although it has a good effect on most symptoms of PB, some symptoms are resistant to its application. Also, long-term use of levodopa leads to motor complications. Other conventional drugs are less effective and more difficult to tolerate, while older neurosurgical methods, thalamotomy and pallidotomy, have a significant risk of mortality and morbidity. Recent findings on the pathogenesis and genetics of PD have paved the way for developing new therapeutic methods. Numerous promising and innovative approaches have advanced to the stages of clinical trials and could be widely used in the clinic in a few years.
Keywords
Parkinsonova bolest
terapije
terapija
levodopa
Keywords (english)
Parkinson's disease
therapy
levodopa
Language croatian
URN:NBN urn:nbn:hr:184:128785
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2021-06-29 17:02:44