Is the answer for Parkinson disease already in the medicine cabinet?
Unfortunately not
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There have been an increasing number of publications in support of the inflammatory hypothesis of Parkinson disease (PD). Proinflammatory cytokines and microglia occur in human PD brains,1,2 and inflammation may initiate a chain reaction leading to neuronal death.3 Cyclooxygenase inhibitors provide neuroprotection in animal models of PD.4 Nonsteroidal anti-inflammatory drugs (NSAIDs) lower the risk of developing another neurodegenerative disease, Alzheimer disease.5 A recent meta-analysis of observational studies in humans showed a 15% reduction in PD incidence among users of non-aspirin NSAIDs (relative risk [RR] 0.85, 95% confidence interval [CI] 0.77–0.94), although protection by ibuprofen was not specifically assessed.6 No association was apparent for aspirin (RR 1.08, 95% CI 0.92–1.27) or acetaminophen (RR 1.06, 95% CI 0.87–1.30).
In the current issue of Neurology®, Gao et al.7 examine new data from 2 large prospective cohorts and in addition conduct a different meta-analysis. The authors asked whether ibuprofen specifically is associated with a lower risk of developing PD using participants in the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS), 2 well-established prospective cohorts. Because they had reported in 2003 that nonaspirin …
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