Tetracycline repurposing in neurodegeneration: focus on Parkinson's disease

J Neural Transm (Vienna). 2018 Oct;125(10):1403-1415. doi: 10.1007/s00702-018-1913-1. Epub 2018 Aug 14.

Abstract

The prevalence of Parkinson's disease, which affects millions of people worldwide, is increasing due to the aging population. In addition to the classic motor symptoms caused by the death of dopaminergic neurons, Parkinson's disease encompasses a wide range of nonmotor symptoms. Although novel disease-modifying medications that slow or stop Parkinson's disease progression are being developed, drug repurposing, which is the use of existing drugs that have passed numerous toxicity and clinical safety tests for new indications, can be used to identify treatment compounds. This strategy has revealed that tetracyclines are promising candidates for the treatment of Parkinson's disease. Tetracyclines, which are neuroprotective, inhibit proinflammatory molecule production, matrix metalloproteinase activity, mitochondrial dysfunction, protein misfolding/aggregation, and microglial activation. Two commonly used semisynthetic second-generation tetracycline derivatives, minocycline and doxycycline, exhibit effective neuroprotective activity in experimental models of neurodegenerative/ neuropsychiatric diseases and no substantial toxicity. Moreover, novel synthetic tetracyclines with different biological properties due to chemical tuning are now available. In this review, we discuss the multiple effects and clinical properties of tetracyclines and their potential use in Parkinson's disease treatment. In addition, we examine the hypothesis that the anti-inflammatory activities of tetracyclines regulate inflammasome signaling. Based on their excellent safety profiles in humans from their use for over 50 years as antibiotics, we propose the repurposing of tetracyclines, a multitarget antibiotic, to treat Parkinson's disease.

Keywords: Antibiotic; Doxycycline; Drug repurposing; Neuroprotection; Parkinson’s disease; Tetracycline.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use
  • Apoptosis / drug effects
  • Doxycycline / pharmacology
  • Doxycycline / therapeutic use
  • Drug Repositioning*
  • Free Radical Scavengers / pharmacology
  • Free Radical Scavengers / therapeutic use
  • Humans
  • Inflammasomes / antagonists & inhibitors
  • Minocycline / pharmacology
  • Minocycline / therapeutic use
  • Mitochondria / drug effects
  • Molecular Structure
  • Neuroprotective Agents / pharmacology
  • Neuroprotective Agents / therapeutic use*
  • Parkinson Disease / drug therapy*
  • Poly(ADP-ribose) Polymerase Inhibitors / pharmacology
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use
  • Protease Inhibitors / pharmacology
  • Protease Inhibitors / therapeutic use
  • Protein Aggregates / drug effects
  • Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I / administration & dosage
  • Structure-Activity Relationship
  • Tetracyclines / chemistry
  • Tetracyclines / pharmacology
  • Tetracyclines / therapeutic use*

Substances

  • Anti-Inflammatory Agents
  • Free Radical Scavengers
  • Inflammasomes
  • Neuroprotective Agents
  • Poly(ADP-ribose) Polymerase Inhibitors
  • Protease Inhibitors
  • Protein Aggregates
  • Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I
  • Tetracyclines
  • Minocycline
  • Doxycycline