Inflammatory profile discriminates clinical subtypes in LRRK2-associated Parkinson's disease

Eur J Neurol. 2017 Feb;24(2):427-e6. doi: 10.1111/ene.13223.

Abstract

Background and purpose: The presentation of Parkinson's disease patients with mutations in the LRRK2 gene (PDLRRK2 ) is highly variable, suggesting a strong influence of modifying factors. In this context, inflammation is a potential candidate inducing clinical subtypes.

Methods: An extensive battery of peripheral inflammatory markers was measured in human serum in a multicentre cohort of 142 PDLRRK2 patients from the MJFF LRRK2 Consortium, stratified by three different subtypes as recently proposed for idiopathic Parkinson's disease: diffuse/malignant, intermediate and mainly pure motor.

Results: Patients classified as diffuse/malignant presented with the highest levels of the pro-inflammatory proteins interleukin 8 (IL-8), monocyte chemotactic protein 1 (MCP-1) and macrophage inflammatory protein 1-β (MIP-1-β) paralleled by high levels of the neurotrophic protein brain-derived neurotrophic factor (BDNF). It was also possible to distinguish the clinical subtypes based on their inflammatory profile by using discriminant and area under the receiver operating characteristic curve analysis.

Conclusions: Inflammation seems to be associated with the presence of a specific clinical subtype in PDLRRK2 that is characterized by a broad and more severely affected spectrum of motor and non-motor symptoms. The pro-inflammatory metabolites IL-8, MCP-1 and MIP-1-β as well as BDNF are interesting candidates to be included in biomarker panels that aim to differentiate subtypes in PDLRRK2 and predict progression.

Keywords: LRRK2; Parkinson; inflammation; phenotype.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Brain-Derived Neurotrophic Factor / blood
  • Chemokine CCL2 / blood
  • Chemokine CCL4 / blood
  • Cohort Studies
  • Cytokines / blood
  • Disease Progression
  • Female
  • Humans
  • Inflammation / etiology*
  • Inflammation / genetics
  • Inflammation / pathology
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 / genetics*
  • Male
  • Middle Aged
  • Mutation
  • Parkinson Disease / genetics*
  • Parkinson Disease / pathology*

Substances

  • Biomarkers
  • Brain-Derived Neurotrophic Factor
  • CCL2 protein, human
  • CCL4 protein, human
  • Chemokine CCL2
  • Chemokine CCL4
  • Cytokines
  • BDNF protein, human
  • LRRK2 protein, human
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2