Enhancing glycolysis attenuates Parkinson's disease progression in models and clinical databases

J Clin Invest. 2019 Oct 1;129(10):4539-4549. doi: 10.1172/JCI129987.

Abstract

Parkinson's disease (PD) is a common neurodegenerative disease that lacks therapies to prevent progressive neurodegeneration. Impaired energy metabolism and reduced ATP levels are common features of PD. Previous studies revealed that terazosin (TZ) enhances the activity of phosphoglycerate kinase 1 (PGK1), thereby stimulating glycolysis and increasing cellular ATP levels. Therefore, we asked whether enhancement of PGK1 activity would change the course of PD. In toxin-induced and genetic PD models in mice, rats, flies, and induced pluripotent stem cells, TZ increased brain ATP levels and slowed or prevented neuron loss. The drug increased dopamine levels and partially restored motor function. Because TZ is prescribed clinically, we also interrogated 2 distinct human databases. We found slower disease progression, decreased PD-related complications, and a reduced frequency of PD diagnoses in individuals taking TZ and related drugs. These findings suggest that enhancing PGK1 activity and increasing glycolysis may slow neurodegeneration in PD.

Keywords: Neuroscience; Parkinson’s disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Triphosphate / metabolism
  • Aged
  • Aged, 80 and over
  • Animals
  • Brain / drug effects
  • Brain / metabolism
  • Disease Progression
  • Dopamine / metabolism
  • Drosophila melanogaster / drug effects
  • Drosophila melanogaster / metabolism
  • Female
  • Glycolysis / drug effects*
  • Humans
  • Induced Pluripotent Stem Cells / drug effects
  • Induced Pluripotent Stem Cells / metabolism
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Nerve Degeneration / drug therapy
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / metabolism*
  • Parkinsonian Disorders / drug therapy
  • Parkinsonian Disorders / metabolism
  • Phosphoglycerate Kinase / metabolism
  • Prazosin / analogs & derivatives*
  • Prazosin / pharmacology
  • Rats

Substances

  • Terazosin
  • Adenosine Triphosphate
  • PGK1 protein, human
  • Phosphoglycerate Kinase
  • Dopamine
  • Prazosin