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Highly Accessed Review

Does a prion-like mechanism play a major role in the apparent spread of α-synuclein pathology?

Amanda N Sacino and Benoit I Giasson*

Author Affiliations

Department of Neuroscience, Center for Translational Research in Neurodegenerative Disease, University of Florida, 1275 Center Drive, BMS Building J-483, P.O. Box 100159, Gainesville, FL 32610-0244, USA

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Alzheimer's Research & Therapy 2012, 4:48  doi:10.1186/alzrt151

Published: 17 December 2012

Abstract

Parkinson's disease, the most common movement disorder, results in an insidious reduction for patients in quality of life and ability to function. A hallmark of Parkinson's disease is the brain accumulation of neuronal cytoplasmic inclusions comprised of the protein α-synuclein. The presence of α-synuclein brain aggregates is observed in several neurodegenerative diseases, including dementia with Lewy bodies and Lewy body variant of Alzheimer's disease. These disorders, as a group, are termed synucleinopathies. Mounting evidence indicates that α-synuclein amyloid pathology may spread during disease progression by a prion-like (self-templating alteration in protein conformation) mechanism. Clear in vitro and cell culture data demonstrate that amyloidogenic α-synuclein can readily induce the conversion of other α-synuclein molecules into this conformation. Some data from experimental mouse studies and autopsied brain analyses also are consistent with the notion that a self-promoting process of α-synuclein amyloid inclusion formation may lead to a progressive spread of disease in vivo. However, as pointed out in this review, there are alternative explanations and interpretations for these findings. Therefore, from a therapeutic perspective, it is critical to determine the relative importance and contribution of α-synuclein prionlike spread in disease before embarking on elaborate efforts to target this putative pathogenic mechanism.