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" ... multiple-system atrophy may offer certain advantages in terms of clinical trials (Good!) given its orphan-disease status and potentially shorter expected duration of therapy because of the rapidly progressive nature of the disease. (Egads!)"
"Kam et al.2 recently described a new mechanism driving α-synuclein toxicity, as well as a potential biomarker and a “repurposing” target: poly(adenosine 5′-diphosphate-ribose) (PAR) and PAR polymerase 1 (PARP1), respectively. PARP1 modifies nuclear proteins by adding units of PAR to them, a process known as polyADP-ribosylation. Since the discovery of this protein’s role in DNA damage repair, PARP1 has been found to participate in several cellular processes, including the regulation of chromatin structure, alterations in transcriptional machinery, RNA processing, and parthanatos (PARP1-dependent cell death, a form of programmed cell death). PARP1 represents an attractive therapeutic target for drug repurposing because inhibitors have been approved by the Food and Drug Administration to treat several types of cancer. In their recent study, Kam et al. defined a new role for PAR and PARP1 in α-synuclein toxicity."
"Pathological synuclein was found to activate nitric oxide synthase (NOS), causing DNA dam-age and poly(adenosine 5′-diphosphate–ribose)polymerase-1 (PARP-1) activation, leading tocell death via parthanatos.a-Synuclein PFF was found to primarily kill neurons via parthanatos, because necroptosis and autophagy inhibition had no effect on a-synuclein PFF neurotoxicity and there was only modest pro-tection by caspase inhibition. Neuron-to-neuron transmission of pathologic a-synucleinand accompanying path-ology and neurotoxicity in primary neuronal cul-tures were completely attenuated by clinically available PARP inhibitors or by deletion of PARP-1"
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