Cholesterol Homeostasis and the Pathogenesis of Multiple System Atrophy

Multiple system atrophy (MSA) is a sporadic neurodegenerative disease among adults, which can be characterized by autonomic nerve dysfunction, Parkinsonism, ataxia and pyramidal tract dysfunction, or overlapped symptoms. It can mainly be divided into two types: Parkinsonism (MSA-P) and cerebellum type (MSA-C). The pathology of this disease is the accumulation of alpha-synuclein in oligodendrocyte. And because of this, it belongs to synucleinopathies. Alpha-synuclein is a kind of protein, which has a close connection with lipid membrane in the process of biosynthesis of central nervous system, and this close relationship may play a crucial role in the mechanism of alpha-synucleinopathies. Recently researchers who have focused on the serum lipids level in MSA patients are taking a stab at finding the diagnostic biomarkers, like serum cholesterol level, so as to develop effective therapies in the early stage of MSA. Therefore, the purpose of our review is to summarize the valuable part of recent researches on cholesterol level of MSA patients and to discuss the optimal way to evaluate MSA disease in a simple way to diagnose it early.