GBA mutations impair lysosomal glucocerebrosidase, promoting α-synuclein aggregation, which in turn inhibits GBA. This vicious cycle amplifies pathology. Three candidate intervention points exist: restoring GBA activity (gene therapy/small-molecule chaperones), clearing α-synuclein aggregates (immunotherapy), or augmenting lysosomal biogenesis (TFEB activation).
GBA mutations impair lysosomal function and promote alpha-synuclein aggregation, but alpha-synuclein itself inhibits GBA activity. The therapeutic implications of breaking this loop at different points remain unclear.