In spite of tremendous growth in recent years in our knowledge of the molecular basis of Parkinson’s disease and the molecular pathways of cell injury and death we remain without therapies that forestall disease progression. wide consensus. More importantly in view of growing evidence that the molecular mechanisms of axon degeneration are separate and distinct from the canonical pathways of programmed cell death that mediate soma destruction the possibility of early involvement of axons in PD has not been adequately emphasized as a rationale to Ibudilast explore the neurobiology of axons for novel therapeutic targets. We propose that it is ongoing degeneration of axons not cell bodies that is the primary determinant of clinically apparent progression of disease and that future experimental therapeutics intended to forestall disease progression will benefit from a new focus on the distinct mechanisms of axon degeneration. Parkinson’s disease (PD) has served as the prototypic adult-onset neurodegenerative disorder for which breakthroughs in experimental therapeutics have provided lasting clinically significant improvements in the quality of life. Such was the case for the discovery of RICTOR levodopa and more recently for the discovery that deep brain stimulation is an effective adjunctive treatment1 2 In spite of these important advances we remain unable to offer therapies that halt the progression of the disease and in this crucial respect therapies for PD are as limited as those for other degenerative neurological disorders. Towards the close of The Decade of the Brain (1990-2000) hope was expressed that an ability to forestall the progression of these devastating diseases was not far off3. Yet 10 years later we seem no closer to our goal despite a multitude of important advances in our understanding of the molecular and genetic Ibudilast basis of PD and neuron death. Why offers this therapeutic goal been so resistant to our best efforts? There are several possible reasons why this goal has remained elusive4. For instance suboptimal animal models of PD and the complexities of medical trial design may deter our ability to determine disease-modifying agents. In the molecular level the finding that neurodegeneration is definitely a highly controlled cell-autonomous process of programmed cell death (PCD)5 offers fostered hope that true protecting therapies may be within our grasp. It is reasoned that if neurodegeneration is an ordered process of PCD then it should be possible to intervene actually if the primary insult is definitely unknown. Indeed there have been numerous dramatic good examples in animal studies of the prevention of neuron death due even to the most harmful neurotoxins by experimental blockade of PCD. The impressive discordance between these dramatic neuroprotective effects and the complete failure of anti-apoptotic methods in human medical tests4 6 has been annoying and baffling. Yet with this discordance there may be hints for a better Ibudilast approach. In numerous animal studies it has been observed that remarkable safety of cell body achieved by obstructing PCD is definitely often not accompanied by safety in the axon level7-10. This discrepancy was not unexpected because there is considerable evidence the canonical pathways of PCD seem to play a minor part in axon degeneration11 12 The concept that destruction of the neuron cell body which is definitely brought about by these pathways is definitely a separate and unique process from your damage of axons by Ibudilast a process now sometimes called “programmed axonal death”13 has fairly broad acknowledgement among investigators in cell death. However this concept is not widely acknowledged in discussions about experimental therapeutics. This is somewhat surprising given that many investigators believe that in the onset of PD the brunt of the pathology is at the level of the axon terminal. Our purpose here therefore is definitely to propose that mechanisms of axon degeneration merit higher attention in thinking about neuroprotection in PD. SO HOW EXACTLY DOES the Disease Process of PD Propagate within Neurons? In the course of PD eventually both axons and cell body of neurons degenerate. But in what cell compartment does this process begin? Does dysfunction begin in the cell soma and result in a secondary anterograde degeneration of the axon? Or does.