Aug 2026· Frontiers in Aging Neuroscience· Vol 18, pp.
1905708
· 0 citations· 35 references
Medicine
TL;DR
The biomarker and therapeutic potential of STX1A remains preliminary because diagnostic performance, disease specificity, longitudinal stability, and causal relevance have not been adequately validated and future studies using cell-type-specific STX1A manipulation, rescue experiments, electrophysiology, and multicenter longitudinal cohorts are required to define the biological and clinical significance of STX1A in PD.
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by degeneration of substantia nigra dopaminergic neurons, α-synuclein pathology, and widespread synaptic dysfunction. Syntaxin-1A (STX1A), a presynaptic Qa-SNARE protein, is essential for synaptic vesicle fusion and also interacts with proteins involved in ion-channel regulation and neuronal excitability. Several animal, extracellular-vesicle, and peripheral-blood studies have reported reduced STX1A abundance in PD. However, the available evidence is predominantly cross-sectional and does not establish whether STX1A downregulation is a cause of PD pathology, a consequence of neuronal and synaptic loss, or a peripheral correlate of disease. This narrative review critically evaluates evidence linking STX1A to PD and distinguishes experimentally supported observations from mechanistic hypotheses. Potential relationships with calcium dysregulation, mitochondrial injury, ferroptosis, and neuroimmune signaling are discussed as testable models rather than established pathways. Direct evidence connecting STX1A to the gut-brain axis in PD is currently lacking and is therefore considered primarily as a future research direction. The biomarker and therapeutic potential of STX1A remains preliminary because diagnostic performance, disease specificity, longitudinal stability, and causal relevance have not been adequately validated. Future studies using cell-type-specific STX1A manipulation, rescue experiments, electrophysiology, and multicenter longitudinal cohorts are required to define the biological and clinical significance of STX1A in PD.
The urgent need for reliable biomarkers, early diagnosis, and multidisciplinary disease-modifying strategies for future therapeutic interventions is highlighted, with particular emphasis on challenges associated with bench-to-bedside translation.
Jeewanjot Singh, Subhi Sharma, Prabhjot Singh et al.· Advances in Modern Biomedici...· 0 citations
A narrative review evaluates the therapeutic potential of semaglutide in PD, focusing on its molecular mechanisms and preclinical and emerging clinical evidence, and suggests that semaglutide crosses the blood-brain barrier and activates GLP-1 receptors in neuronal and glial cells, reducing microglial activation, neuroinflammation, and oxidative stress while improving mitochondrial function, cellular metabolism, and neuronal survival.
Dipesh Kumar, Renuka Sahu, Naveen Kumar et al.· International Journal of Sci...· 0 citations
It is shown that early complement associated pruning of inhibitory synapses precedes overt α-synuclein aggregation and neuronal loss in prodromal synucleinopathy, indicating disease-context dependent relationships between αSyn pathology and neurodegeneration.
Svenja-Lotta Rumpf, Felix L. Struebing, Karsten Nalbach et al.· Nature Communications· 0 citations
Background: Parkinson’s disease (PD) exhibits remarkable clinical heterogeneity, with substantial variability in motor progression, cognitive decline, and the development of non-motor manifestations. Although the propagation of pathological alpha-synuclein is considered a central mechanism of PD pathogenesis, it does not fully explain why specific neuronal populations demonstrate differential susceptibility to degeneration. Emerging evidence suggests that selective neuronal vulnerability is determined by the interaction of multiple biological domains, including calcium homeostasis, mitochondrial bioenergetic capacity, lysosomal function, axonal architecture, synaptic resilience, and neuroinflammatory responses. Methods: A structured critical narrative review was performed using PubMed/MEDLINE, Scopus, and Web of Science databases from inception to March 2025. Only full-text articles published in English and peer-reviewed journals were included. Evidence from human post-mortem studies, genetic analyses, biomarker investigations, experimental models, induced pluripotent stem cell studies, and longitudinal clinical cohorts were systematically synthesised to identify the principal mechanisms underlying selective neuronal vulnerability and their potential translational application. To capture evidence published after this electronic cut-off, a supplementary manual review of reference lists of key systematic reviews and landmark publications was conducted up to the date of manuscript submission; references with 2025 or 2026 publication dates entered through this supplementary process. The supplementary manual review was conducted as a targeted scan of reference lists of key systematic reviews and high-impact publications identified during the primary search and did not constitute an independent updated systematic search. Results: Five interconnected biological domains emerged as key determinants of neuronal susceptibility in PD: calcium-mediated metabolic stress associated with autonomous pacemaker activity, mitochondrial dysfunction and energetic failure, impaired lysosomal degradation and proteostasis (particularly involving the GBA1–glucocerebrosidase pathway), vulnerability related to extensive axonal and synaptic architecture, and neuroinflammatory mechanisms involving microglial and astrocytic activation. Among these domains, the lysosomal pathway currently provides the strongest translational link between molecular mechanisms and measurable clinical outcomes. Based on this integrated framework, we propose the Parkinson’s Vulnerability Index (PVI), a hypothesis-generating multidimensional model combining genetic, enzymatic, alpha-synuclein seeding, cognitive, olfactory, and neuroimaging biomarkers to facilitate biological stratification and improve the design of mechanism-targeted clinical trials. Conclusions: Selective neuronal vulnerability provides a complementary framework to alpha-synuclein propagation models for understanding the heterogeneity of PD. The proposed PVI is not intended as a diagnostic or prognostic clinical instrument but as a research tool requiring prospective validation. Future precision medicine approaches in PD may benefit from integrating vulnerability-related biomarkers with existing biological staging systems to identify patients most likely to benefit from targeted disease-modifying therapies.
Livia Livinț-Popa, Andreea Nicolaie, A. Maștaleru et al.· Medical Science· 0 citations
This integrated framework reframes PD as a disorder of impaired cellular maintenance rather than solely a consequence of late-stage degenerative processes, and provides a translational shift from mechanism-based biomarkers to early detection of mitochondrial failure and supports therapeutic strategies aimed at restoring mitochondrial function and resilience.
Oscar Arias-Carrión, Magdalena Guerra-Crespo, L. O. Soto-Rojas et al.· Frontiers in Pharmacology· 0 citations
Overall, this review makes a case for integrative, pathway-based therapeutic models, and multiple approaches may facilitate for drug development, biomarker identification and patient management in Alzheimer's disease.
