Glucagon-like peptide-1 (GLP-1)-based receptor agonists as a treatment for Parkinson's disease

Expert Opin Investig Drugs. 2020 Jun;29(6):595-602. doi: 10.1080/13543784.2020.1764534. Epub 2020 May 15.

Abstract

Introduction: Accumulating evidence supports the evaluation of glucagon-like peptide-1 (GLP-1) receptor (R) agonists for the treatment of the underlying pathology causing Parkinson's Disease (PD). Not only are these effects evident in models of PD and other neurodegenerative disorders but recently in a randomized, double-blind, placebo-controlled clinical trial, a GLP-1R agonist has provided improved cognition motor functions in humans with moderate PD.

Areas covered: In this mini-review, we describe the development of GLP-1R agonists and their potential therapeutic value in treating PD. Many GLP-1R agonists are FDA approved for the treatment of metabolic disorders, and hence can be rapidly repositioned for PD. Furthermore, we present preclinical data offering insights into the use of monomeric dual- and tri-agonist incretin-based mimetics for neurodegenerative disorders. These drugs combine active regions of GLP-1 with those of glucose-dependent insulinotropic peptide (GIP) and/or glucagon (Gcg).

Expert opinion: GLP-1Ragonists offer a complementary and enhanced therapeutic value to other drugs used to treat PD. Moreover, the use of the dual- or tri-agonist GLP-1-based mimetics may provide combinatory effects that are even more powerful than GLP-1R agonism alone. We advocate for further investigations into the repurposing of GLP-1R agonists and the development of classes of multi-agonists for PD treatment.

Keywords: Glucagon-like peptide-1 (GLP-1); Parkinson’s disease; brain trauma; glucagon (Gcg); glucose-dependent insulinotropic peptide (GIP); incretin mimetics; microglia; neurodegeneration.

Publication types

  • Review

MeSH terms

  • Animals
  • Antiparkinson Agents / pharmacology*
  • Drug Development
  • Drug Repositioning
  • Glucagon-Like Peptide-1 Receptor / agonists*
  • Humans
  • Neurodegenerative Diseases / drug therapy
  • Neurodegenerative Diseases / physiopathology
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology
  • Randomized Controlled Trials as Topic

Substances

  • Antiparkinson Agents
  • Glucagon-Like Peptide-1 Receptor