Although researchers are pursuing "disease modifying" medications to slow or stop Parkinson's disease (PD) progression, a myriad of agents with protective properties in cell cultures and animal models have yielded few treatments in clinical practice. Developing safe and effective treatments with disease-modifying/neuroprotective mechanisms of action and identifying patients in the pre-motor phase will be a challenge. The implication of tyrosine hydroxylase (TH), the enzyme that catalyzes the formation of L-3,4-dihydroxyphenylalanine, in the pathogenesis of PD at different levels makes it a promising candidate for developing efficient treatment based on correcting or bypassing the enzyme deficiency. TH is also the key enzyme for immunorreactivity in PD models and is used to assess the efficacy of novel disease-modifying medications. PD animal models are genetic: alpha-synuclein models, parkin (PINK 1 and DJ1) and leucine-rich repeat kinase 2 or pharmacological and neurotoxic: reserpine, 6-hydroxydopamine, 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine, rotenone, paraquat/maneb, and trichloroethylene. This review is focused on the state of art of PD models, the relationship with TH, and potential neuroprotective agents to treat PD. The latter include gene therapy, transplantation, erythropoietin, natural phenolic compounds, doxycycline, ethyl pyruvate, 9-methyl-beta-carboline, vascular endothelial growth factor, simvastatin, zonisamide, modafinil, melatonin, cannabinoids, rottlerin, fluoxetine, paroxetine, coenzyme Q10, N-acetylcysteine and vaccines like Bacille Calmette-Guerin, with different proposed mechanisms of action. Also of note is the link between hypovitaminosis D and neurodegeneration opening new perspectives in research with TH genes and PD models treated with vitamin D. Translational scientists can contribute to a better understanding of the pathogenesis of PD and lead to more effective treatments.
