MINIREVIEW
Emerging pathways in genetic Parkinson’s disease:
Autosomal-recessive genes in Parkinson’s disease –
a common pathway?
Julia C. Fitzgerald and Helene Plun-Favreau
Department of Molecular Neuroscience, Institute of Neurology, University College London, UK
Parkinson’s disease (PD) is a common neurode-
generative disorder with no known cure, estimated to
affect 4 million people worldwide. The disease is char-
acterized by the degeneration of dopaminergic neurons
in the substantia nigra pars compacta and the presence
of protein inclusions called Lewy bodies. The death of
dopamine neurons in the substantia nigra pars com-
pacta alters neurotransmitter balance in the striatum
resulting in the progressive loss of movement control,
the principal hallmark of PD, encompassing clinical
features such as resting tremor, bradykinesia, postural
instability and rigidity.
The most common form of PD is sporadic; there
are, however, inherited forms of PD, accounting for
5–10% of cases. Little is known about how or why
neurons die in PD, but similarities between both forms
of the disease have led researchers to believe that a
common set of molecular mechanisms may underlie
PD aetiology.
To date, six genes have been implicated in the
pathogenesis of PD, a-synuclein, Parkin, PTEN-
induced putative kinase 1 (PINK1), DJ-1, leucine-rich
repeat kinase 2 (LRRK2) and ATP13A2. Mutations in
the genes encoding a-synuclein, LRRK2 and ATP13A2
cause autosomal-dominant forms of parkinsonism.
Parkinson’s disease; PINK1, PTEN-induced putative kinase 1; PTEN, phosphatase and tensin homologue deleted on chromosome 10;
TRAP1, tumour necrosis factor receptor-associated protein 1; UCH-L1, ubiquitin C-terminal hydrolase L1; UPS, ubiquitin proteasomal system.
5758 FEBS Journal 275 (2008) 5758–5766 ª 2008 The Authors Journal compilation ª 2008 FEBS
Autosomal-recessive Parkinson’s
disease genes and proteins
Parkin (PARK2)
Mutations in PARK2 were first reported in patients
with autosomal-recessive juvenile-onset PD (AR-JP) [1]
and are now known to be the predominant cause of
early-onset parkinsonism. A large number of patho-
genic mutations have been identified in Parkin, present
in 50% of individuals with AR-JP, and 77% of
sporadic cases with disease onset before the age of 20
[2]. Clinically, PD patients with mutations in PARK2
suffer a slow progression of the disease commonly
associated with early-onset dystonia and are l-Dopa
responsive [3]. Pathological studies on AR-JP patients
with Parkin mutations have revealed a lack of Lewy
body inclusions [4] except in some later onset cases
[5,6].
Parkin localizes predominantly to the cytosol and
cellular vesicles [7–9]. However, part of the cellular
Parkin pool associates with the outer mitochondrial
membrane [8]. Parkin is an E3 ubiquitin ligase, an
essential component of the ubiquitin-proteasomal
system (UPS) [7]. Parkin also has a proteasome-inde-
pendent role and a number of putative substrates for
Parkin have been described, including proteins impli-
cated in PD such as synphilin-1 and a glycosylated
form of a-synuclein [10]. It is worth noting, however,
DJ-1 mutation is a large deletion unlikely to produce
any protein. The other, a point mutation (L166P), has
been studied extensively. Later, several studies led to
the identification of a number of other pathogenic
mutations causing familial PD [21]. Clinically, age of
onset is usually in the third decade with a slow disease
progression and a good response to l-Dopa. DJ-1 is
localized to both the nucleus and cytoplasm in differ-
ent cell types [22,23], although a pool of wild-type
DJ-1 has been shown to localize to the mitochondria
[24]. The L166P mutant protein has been shown to be
associated with loss of nuclear localization and trans-
location to mitochondria [25] although this was not
confirmed in other studies [24]. Conversely, localiza-
tion of wild-type DJ-1 at the mitochondria is suggested
to be a requirement for neuroprotection [26]. DJ-1 has
been ascribed various functions, notably in resistance
to oxidative stress [11], but also transcription, cell sig-
nalling, apoptosis [27,28] and aggregation of a-synuc-
lein [29]. The protein may also act as a chaperone.
Finally, studies suggested that DJ-1 could possess cys-
teine protease activity. However, the protease activity
of DJ-1 is still a matter of debate [30,31]. But perhaps
the most important function with regard to PD is its
putative role in oxidative stress. DJ-1 is thought to
protect neurons from oxidative stress [19,32,33]
although exactly how it exerts its protective effects
remains to be determined.
Molecular pathways of
neurodegeneration in PD
rotenone-induced cytotoxicity [40]. Furthermore, it has
been reported very recently that germline deletion of
the PINK1 gene in mice significantly impairs mito-
chondrial functions and provides critical protection
against oxidative stress [41,42]. Neurons with reduced
levels of endogenous DJ-1 were also sensitized to
toxicity elicited by rotenone [43] and Drosophila DJ-1
mutants were selectively sensitive to environmental
toxins associated with PD [44].
Parkin and PINK1 have been shown to be located,
at least in part, to the mitochondria. In Drosophila
models of PINK1, several studies [45–47] strongly
suggested that PINK1 acts upstream of Parkin in a
common pathway that influences mitochondrial integ-
rity in a subset of tissues (including flight muscle and
dopaminergic neurons). Recent studies suggest that
the PINK1⁄ Parkin pathway regulates mitochondrial
morphology in Drosophila and mammalian models
[48–50].
DJ-1 does not seem to operate in the same pathway as
Parkin and PINK1. Muscle and dopaminergic pheno-
types associated with Drosophila PINK1 inactivation
can be suppressed by the overexpression of Parkin, but
not DJ-1 [24]. Although there is less evidence for a direct
role of DJ-1 in mitochondrial function, the fact that
Drosophila lacking DJ-1 exhibit increased sensitivity to
environmental mitochondrial toxins [44,51] does point
to a role for DJ-1 in mitochondrial function.
Drosophila studies suggest that PINK1 is required
for mitochondrial function and that the PINK1 ⁄ Parkin
Proteasomal dysfunction and proteolytic stress
The proteasome is a large multi-catalytic proteinase
complex found in the nucleus and cytoplasm of
eukaryotic cells [56,57]. UPS dysfunction and proteo-
lytic stress are likely to contribute to dopaminergic
neurodegeneration [58]. Moreover, mutations in two
components of the UPS; Parkin and ubiquitin C-termi-
nal hydrolase-L1 (UCH-L1) [59] in familial PD
strongly supports the hypothesis that proteasomal
dysfunction may contribute to PD aetiology [57].
Notably knockdown of DJ-1 [60] and Parkin [61,62]
enhances susceptibility to proteasome inhibition in cell
models. In addition, DJ-1-deficient mice treated with
the mitochondrial complex I inhibitor paraquat display
decreased proteasome activities and increased levels of
ubiquitinated protein [63]. Finally, the UPS has also
been shown to be important for the regulation of
PINK1 stability [63] and the degradation of DJ-1
[30,64], PINK1 [65] and Parkin [66,67] mutant
proteins.
Chaperones may be key players in PD pathogenesis.
PINK1 has been shown to interact with the Hsp90
molecular chaperone and it was proposed that the
inhibition of this interaction might contribute to the
pathogenesis of PD [65]. Furthermore, PINK1 has
been suggested to protect against oxidative stress by
phosphorylating the mitochondrial chaperone tumour
necrosis factor receptor-associated protein 1 (TRAP1)
Autosomal recessive genes in Parkinson’s disease J. C. Fitzgerald and H. Plun-Favreau
5760 FEBS Journal 275 (2008) 5758–5766 ª 2008 The Authors Journal compilation ª 2008 FEBS
shift in the isoelectric point of DJ-1 [26,32,74] sug-
gesting self-oxidation. Embryonic stem cells deficient
in DJ-1 display increased sensitivity to oxidative
stress and proteasome inhibition [75]. Following
exposure to oxidative stress, DJ-1 associates with
Parkin, potentially linking these proteins into a com-
mon molecular pathway leading to nigral degenera-
tion and PD [76]. Parkin knockout mice have
revealed an essential role for Parkin in oxidative
stress [77] and Drosophila Parkin mutants show
increased sensitivity to oxidative stress [78]. Implica-
tion of PINK1 in oxidative stress processes has also
been strongly suggested: inactivation of Drosophila
PINK1 using RNAi suggested that PINK1 maintains
neuronal survival by protecting neurons against oxi-
dative stress [79]. In mammalian cell culture, PINK1
protects against oxidative stress-induced cell death by
suppressing cytochrome c release from mitochondria,
with the protective action of PINK1 depending on
its ability to phosphorylate the mitochondrial chaper-
one TRAP1 [68].
Protein phosphorylation and signalling pathways
PINK1 has a strongly predicted, conserved serine ⁄ thre-
onine kinase domain [12] and has been shown to
exhibit autophosphorylation activity [15,80,81] in vitro.
In vivo, PINK1 has been shown to phosphorylate the
mitochondrial chaperone TRAP1, protecting against
oxidative stress-induced apoptosis [68] and to be
important for the phosphorylation of HtrA2 upon
activation of the p38 pathway, preventing against
ability of dopaminergic cells to cope with toxic insults in
PD [87]. To date, no direct phosphorylation of DJ-1 or
PINK1 has been reported.
Conclusion
A common pathway to parkinsonism?
There has been a great deal of interest from the PD
scientific community in linking the familial-associated
genes in a common pathogenic pathway of neurode-
generation. To date, however, a single pathway unify-
ing these proteins has not been fully mapped out.
J. C. Fitzgerald and H. Plun-Favreau Autosomal recessive genes in Parkinson’s disease
FEBS Journal 275 (2008) 5758–5766 ª 2008 The Authors Journal compilation ª 2008 FEBS 5761
PINK1 and Parkin seem to function, at least in part,
in the same pathway, with PINK1 acting upstream of
Parkin. Moreover, a recent study has proposed a role
for Cdc37 ⁄ Hsp90 chaperones and Parkin on PINK1
subcellular distribution, providing further evidence for a
Parkin ⁄ PINK1 common pathogenic pathway in reces-
sive PD [16]. The role of the PINK1–Parkin pathway in
regulating mitochondrial function underscores the
importance of mitochondrial impairment as a key
molecular mechanism underlying PD. Overexpression
experiments in SH-SY5Y human neuroblastoma cells
have shown that DJ-1 specifically interacts with Parkin
under stress conditions. Specifically, this association is
mediated by pathogenic DJ-1 mutations and oxidative
stress [76]. These data suggest a link DJ-1 and Parkin in
a common pathway in mammals. A described case of
autosomal-recessive PD with digenic inheritance,
suggested that DJ-1 and PINK1 might physically inter-
mon point? Answering these questions requires a good
PD model. Drosophila and more recently zebrafish [92]
models have recapitulated many of the phenotypic and
pathologic features of PD, however, these models are
far-removed from human DA neurons. Both primary
neurons and human neuronal cell lines better represent
the cell types involved in PD, but have major limita-
tions [93]. Advances in the field of stem cell research
might open up a new route to develop a cell model
that more closely mirrors the disease situation in
humans. The use of induced pluripotent stem cells as a
research tool has become very promising following a
number of publications showing re-programming of
human fibroblasts carrying mutations to induced
pluripotent stem cells [94,95] and recently their differ-
entiation into specific neuronal subtypes [96].
Understanding the exact function of Parkin, PINK1,
DJ-1 and HtrA2 proteins in age-matched healthy
volunteer (and ideally relatives) neurons compared with
the neurons of patients with AR-JP may allow us to
Fig. 1. Protein products of AR-JP genes: Proposed cross-talk of
pathways. Extracellular and intracellular cues activate universal cell-
signalling cascades including MAPK and phosphatidylinositol
3-kinase (PI3K) pathways that can target HtrA2, PINK1, Parkin and
DJ-1. Likely these PD-associated proteins are part of a complex
network including various signalling pathways. Although DJ-1
appears to act slightly more independently than PINK1, Parkin and
HtrA2, these PD-associated proteins seem to act in extremely com-
plex, multistepped and related pathways. The complexity and
cross-talk may be important in fine-tuning of cellular responses,
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Autosomal recessive genes in Parkinson’s disease J. C. Fitzgerald and H. Plun-Favreau
5766 FEBS Journal 275 (2008) 5758–5766 ª 2008 The Authors Journal compilation ª 2008 FEBS