The mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's disease

Parkinson's disease, a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, is strongly associated with the death of dopaminergic neurons in the brain's substantia nigra. Although dopamine replacement therapy temporarily helps patients manage their motor sy...

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Main Authors: Norwitz, N, Hu, M, Clarke, K
Format: Journal article
Language:English
Published: Frontiers Media 2019
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author Norwitz, N
Hu, M
Clarke, K
author_facet Norwitz, N
Hu, M
Clarke, K
author_sort Norwitz, N
collection OXFORD
description Parkinson's disease, a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, is strongly associated with the death of dopaminergic neurons in the brain's substantia nigra. Although dopamine replacement therapy temporarily helps patients manage their motor symptoms, this current standard of care fails to address the underlying network of pathologies that contribute to the persistent death of dopaminergic neurons. Thus, new treatment approaches are needed that address the underlying pathologies and, thereby, slow or halt the progression of the actual disease. D-β-hydroxybutyrate – a ketone body produced by the liver to support brain function during periods of starvation – may provide an option. Lifestyle interventions that induce endogenous D-β-hydroxybutyrate production, such as caloric restriction and ketogenic diets, are known to increase healthspan and lifespan in animal models and are used to treat neurological disorders. The efficacy of these ketosis-inducing interventions, along with the recent development of commercially available D-β-hydroxybutyrate-based nutritional supplements, should inspire interest in the possibility that D-β-hydroxybutyrate itself exerts neuroprotective effects. This review provides a molecular model to justify the further exploration of such a possibility. Herein, we explore the cellular mechanisms by which the ketone body, D-β-hydroxybutyrate, acting both as a metabolite and as a signaling molecule, could help to prevent the development, or slow the progression of, Parkinson's disease. Specifically, the metabolism of D-β-hydroxybutyrate may help neurons replenish their depleted ATP stores and protect neurons against oxidative damage. As a G-protein-coupled receptor ligand and histone deacetylase inhibitor, D-β-hydroxybutyrate may further protect neurons against energy deficit and oxidative stress, while also decreasing damaging neuroinflammation and death by apoptosis. Restricted to the available evidence, our model relies largely upon the interpretation of data from the separate literatures on the cellular effects of D-β-hydroxybutyrate and on the pathogenesis of Parkinson's disease. Future studies are needed to reveal whether D-β-hydroxybutyrate actually has the potential to serve as an adjunctive nutritional therapy for Parkinson's disease.
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spelling oxford-uuid:2c228b12-84f4-4ecc-bac3-5dee910a152a2022-03-26T12:35:09ZThe mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's diseaseJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:2c228b12-84f4-4ecc-bac3-5dee910a152aEnglishSymplectic Elements at OxfordFrontiers Media2019Norwitz, NHu, MClarke, KParkinson's disease, a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, is strongly associated with the death of dopaminergic neurons in the brain's substantia nigra. Although dopamine replacement therapy temporarily helps patients manage their motor symptoms, this current standard of care fails to address the underlying network of pathologies that contribute to the persistent death of dopaminergic neurons. Thus, new treatment approaches are needed that address the underlying pathologies and, thereby, slow or halt the progression of the actual disease. D-β-hydroxybutyrate – a ketone body produced by the liver to support brain function during periods of starvation – may provide an option. Lifestyle interventions that induce endogenous D-β-hydroxybutyrate production, such as caloric restriction and ketogenic diets, are known to increase healthspan and lifespan in animal models and are used to treat neurological disorders. The efficacy of these ketosis-inducing interventions, along with the recent development of commercially available D-β-hydroxybutyrate-based nutritional supplements, should inspire interest in the possibility that D-β-hydroxybutyrate itself exerts neuroprotective effects. This review provides a molecular model to justify the further exploration of such a possibility. Herein, we explore the cellular mechanisms by which the ketone body, D-β-hydroxybutyrate, acting both as a metabolite and as a signaling molecule, could help to prevent the development, or slow the progression of, Parkinson's disease. Specifically, the metabolism of D-β-hydroxybutyrate may help neurons replenish their depleted ATP stores and protect neurons against oxidative damage. As a G-protein-coupled receptor ligand and histone deacetylase inhibitor, D-β-hydroxybutyrate may further protect neurons against energy deficit and oxidative stress, while also decreasing damaging neuroinflammation and death by apoptosis. Restricted to the available evidence, our model relies largely upon the interpretation of data from the separate literatures on the cellular effects of D-β-hydroxybutyrate and on the pathogenesis of Parkinson's disease. Future studies are needed to reveal whether D-β-hydroxybutyrate actually has the potential to serve as an adjunctive nutritional therapy for Parkinson's disease.
spellingShingle Norwitz, N
Hu, M
Clarke, K
The mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's disease
title The mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's disease
title_full The mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's disease
title_fullStr The mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's disease
title_full_unstemmed The mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's disease
title_short The mechanisms by which the ketone body D-β-Hydroxybutyrate may improve the multiple cellular pathologies of Parkinson's disease
title_sort mechanisms by which the ketone body d β hydroxybutyrate may improve the multiple cellular pathologies of parkinson s disease
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