- Mittal, Shuchi;
- Bjørnevik, Kjetil;
- Im, Doo Soon;
- Flierl, Adrian;
- Dong, Xianjun;
- Locascio, Joseph J;
- Abo, Kristine M;
- Long, Elizabeth;
- Jin, Ming;
- Xu, Bing;
- Xiang, Yang K;
- Rochet, Jean-Christophe;
- Engeland, Anders;
- Rizzu, Patrizia;
- Heutink, Peter;
- Bartels, Tim;
- Selkoe, Dennis J;
- Caldarone, Barbara J;
- Glicksman, Marcie A;
- Khurana, Vikram;
- Schüle, Birgitt;
- Park, David S;
- Riise, Trond;
- Scherzer, Clemens R
Copy number mutations implicate excess production of α-synuclein as a possibly causative factor in Parkinson's disease (PD). Using an unbiased screen targeting endogenous gene expression, we discovered that the β2-adrenoreceptor (β2AR) is a regulator of the α-synuclein gene (SNCA). β2AR ligands modulate SNCA transcription through histone 3 lysine 27 acetylation of its promoter and enhancers. Over 11 years of follow-up in 4 million Norwegians, the β2AR agonist salbutamol, a brain-penetrant asthma medication, was associated with reduced risk of developing PD (rate ratio, 0.66; 95% confidence interval, 0.58 to 0.76). Conversely, a β2AR antagonist correlated with increased risk. β2AR activation protected model mice and patient-derived cells. Thus, β2AR is linked to transcription of α-synuclein and risk of PD in a ligand-specific fashion and constitutes a potential target for therapies.