In neurologically normal brain expression of proteinase-activated receptor-2, activating proteinases and proteinase inhibitors was found in neurons and microglia and did not specifically associate with regions prone to neurodegeneration in Parkinson's disease. InParkinson's disease brain, alterations in the amount of immunoreactivity for proteinaseactivated receptor-2, trypsin-2 and both serpin proteinase inhibitors were found throughout the brain. In neurons, there was a decrease in neurons positive for proteinase inhibitors with increasing Braak α-synuclein stage in the dorsal motor nucleus, locus coeruleus, substantia nigra and primary motor cortex. In contrast, in the cingulate cortex, proteinase-activated receptor-2 expression had a positive correlation to increase with higher Braak α-synuclein stage rating and serpin-A13 was increased in early Parkinson's disease cases compared to controls. In microglia, increased expression occurred for the serpins (dorsal motor nucleus of vagus and substantia nigra), trypsin-2 (dorsal motor nucleus of vagus and primary motor cortex) and proteinase-activated receptor-2 (locus coeruleus and cingulate cortex) that progressively increased with advancing Parkinson's disease severity.In cingulate cortex, the covariate dyskinesia had a significant effect on the the adjusted means for trypsin-2 labelled neurons and microglia and the covariate psychosis had a significant effect on neurons labelled with serpin-A5. While in primary motor cortex, the covariate dyskinesia had a significant effect on the the adjusted means for neurons labelled with serpin-A5, serpin-A13 and trypsin-2. Analysis of Parkinson's disease cases found that serpin and trypsin-2 expression in midbrain and cerebral cortex was different in cases with dyskinesia and psychosis compared to those with no treatment induced side-effects. This study showed that there was altered expression in brain of proteinase-activated receptor-2 and some proteins that can control its function in Parkinson's disease. Given the role of PAR2 expression in Parkinson's disease 3 proteinase-activated receptor-2 in neuroinflammation, drugs that mitigate these changes could be neuroprotective when administered to patients with Parkinson's disease.