NF‐κB/NLRP3 inflammasome axis and risk of Parkinson's disease in Type 2 diabetes mellitus: A narrative review and new perspective

• Published in: Journal of cellular and molecular medicine Vol. 27; no. 13; pp. 1775 - 1789
• Main Authors: Alrouji, Mohammed, Al‐kuraishy, Hayder M., Al‐Gareeb, Ali I., Alexiou, Athanasios, Papadakis, Marios, Jabir, Majid S., Saad, Hebatallah M., Batiha, Gaber El‐Saber
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-07-2023; John Wiley and Sons Inc
• Subjects: alpha-Synuclein; Alzheimer's disease; Apoptosis; Autoimmune diseases; Beta cells; Biomarkers; Body fat; Cytokines; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Dopamine receptors; Glucose; Health care; Hemoglobin; Humans; Hyperglycemia; Inflammasomes; Inflammasomes - metabolism; Inflammation; Inflammatory diseases; Insulin resistance; Kinases; Movement disorders; Nervous system; Neurodegeneration; Neurodegenerative Diseases; Neuroinflammatory Diseases; Neuropathology; NF-kappa B - metabolism; NF-κB protein; NF‐κB; NLR Family, Pyrin Domain-Containing 3 Protein - metabolism; NLR Proteins; NLRP3 inflammasome; Oxidative stress; Parkinson disease; Parkinson Disease - metabolism; Parkinson's disease; Pathogenesis; Pathology; Pesticides; Pyrin; Pyrin protein; Review; Reviews; Risk factors; Signal transduction; Substantia nigra; Synuclein; Systematic review; T2DM; Tumor necrosis factor-TNF; Parkinson disease; NF-κB; T2DM; NLRP3 inflammasome
• ISSN: 1582-1838; 1582-4934
• DOI: 10.1111/jcmm.17784

Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease (AD). Genetic predisposition and immune dysfunction are involved in the pathogenesis of PD. Notably, peripheral inflammatory disorders and neuroinflammation are associated with PD neuropathology. Type 2 diabetes mellitus (T2DM) is associated with inflammatory disorders due to hyperglycaemia‐induced oxidative stress and the release of pro‐inflammatory cytokines. Particularly, insulin resistance (IR) in T2DM promotes the degeneration of dopaminergic neurons in the substantia nigra (SN). Thus, T2DM‐induced inflammatory disorders predispose to the development and progression of PD, and their targeting may reduce PD risk in T2DM. Therefore, this narrative review aims to find the potential link between T2DM and PD by investigating the role of inflammatory signalling pathways, mainly the nuclear factor kappa B (NF‐κB) and the nod‐like receptor pyrin 3 (NLRP3) inflammasome. NF‐κB is implicated in the pathogenesis of T2DM, and activation of NF‐κB with induction of neuronal apoptosis was also confirmed in PD patients. Systemic activation of NLRP3 inflammasome promotes the accumulation of α‐synuclein and degeneration of dopaminergic neurons in the SN. Increasing α‐synuclein in PD patients enhances NLRP3 inflammasome activation and the release of interleukin (IL)‐1β followed by the development of systemic inflammation and neuroinflammation. In conclusion, activation of the NF‐κB/NLRP3 inflammasome axis in T2DM patients could be the causal pathway in the development of PD. The inflammatory mechanisms triggered by activated NLRP3 inflammasome lead to pancreatic β‐cell dysfunction and the development of T2DM. Therefore, attenuation of inflammatory changes by inhibiting the NF‐κB/NLRP3 inflammasome axis in the early T2DM may reduce future PD risk.