Adenosine A2A Receptor Antagonists as a Treatment Option for Parkinson's Disease?

In Parkinson's disease, the focus has long been on motor symptoms and therapy with dopaminergic substances. In recent years, the importance of non-motor symptoms has been increasingly recognized, as they occur early in the course of the disease and restrict considerably the quality of life. However, this also made the need for treatment of non-dopaminergic deficits obvious. Adenosine A (2A) receptor antagonists were identified as an additional therapy, since the adenosine A (2A) receptors are non-dopaminergic and selectively localized in the basal ganglia. This means that the striato-thalamo-cortical loops can be modulated. An adenosine A (2A) receptor antagonist was already approved in Japan in 2013 and in the USA in 2019 as an add-on to L-DOPA. Approval for this drug in Europe is expected in the near future. In this overview, we present the theoretical basis and current data on its efficacy and therapeutic use.

Automated summary

In Parkinson's disease, the focus has traditionally been on motor symptoms and dopaminergic therapy. However, the importance of non-motor symptoms has gained recognition, highlighting the need for treatment of non-dopaminergic deficits. Adenosine A (2A) receptor antagonists have been identified as an additional therapy, as they can modulate the striato-thalamo-cortical loops.