Autophagy is an essential pathway to scavenge toxic α-synuclein aggregates.810,811 Downregulation of neutral sphingomyelinase-2 (nSMase2) can inhibit exosome production and thus block the transmission of toxic α-synuclein via exosomes.812,813 Thus, simultaneous enhancement of autophagy and inhibition of exosome generation hold promise for the combined treatment of PD. This evidence concerns the gene SNCA and Parkinson disease.