Henry B, Crossman A R, Brotchie J M
Division of Neuroscience, School of Biological Sciences, University of Manchester, 1.124 Stopford Building, Manchester, M13 9PT, United Kingdom.
Exp Neurol. 1999 Feb;155(2):204-20. doi: 10.1006/exnr.1998.6996.
Abnormal involuntary movements, or dyskinesias, plague current symptomatic approaches to the treatment of Parkinson's disease. The neural mechanisms underlying the generation of dyskinesia following repeated l-3,4-dihydroxyphenylalanine (L-DOPA) or dopamine agonist administration in Parkinson's disease remain unknown. However, de novo administration of bromocriptine or lisuride to either l-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned primates or patients can alleviate parkinsonian symptoms without the development of dyskinesia. In this study, we have investigated behavioral responses and alterations in the expression of opioid neuropeptide precursors preproenkephalin-A (PPE-A, encoding methionine- and leucine-enkephalin) and preproenkephalin-B (PPE-B), the precursor encoding dynorphins (dynorphin A1-17 and B1-13, leucine-enkephalin, and alpha-neoendorphin) in striatal output pathways of the 6-hydroxydopamine (6-OHDA)-lesioned rat model of Parkinson's disease. Expression was assessed following repeated L-DOPA, bromocriptine, or lisuride administration. Given the functional organization of basal ganglia circuitry into anatomically discrete parallel circuits, we investigated alterations in peptide expression with reference to the detailed topography of the striatum. Following repeated L-DOPA administration (6.5 mg/kg, b.d., 21 days) in the 6-OHDA-lesioned rat a rotational response was observed. This became markedly enhanced with repeated treatment. We have previously characterized the pharmacology of this enhanced response and have suggested that it is a useful model for the elucidation of the cellular and molecular mechanisms underlying L-DOPA- and dopamine agonist-induced dyskinesia. In contrast to l-DOPA, de novo administration of bromocriptine (1 or 5 mg/kg, b.d., 21 days) or lisuride (0.01 or 0.1 mg/kg, b.d., 21 days) did not lead to an enhanced behavioral response. In vehicle-treated, 6-OHDA-lesioned animals, PPE-A expression was elevated rostrally and dorsally, while PPE-B expression was reduced in the striatum at all rostrocaudal levels. Repeated l-DOPA administration was accompanied by elevations in striatal PPE-B mRNA levels and a further elevation, above lesion-induced levels, in PPE-A expression. This further elevation was restricted to the dorsolateral striatum. However, following repeated bromocriptine or lisuride administration no increase in PPE-B expression was observed and the lesion-induced increase in PPE-A expression was normalized to prelesion levels. Increased PPE-A and PPE-B levels may, through decreasing GABA and glutamate release, respectively, in output nuclei of the basal ganglia, play a role in the development of L-DOPA- and dopamine-agonist induced dyskinesia in Parkinson's disease. These studies suggest that anti-parkinsonian treatments which are not associated with an elevation in PPE-B and/or normalize elevated PPE-A precursor expression, such as NMDA-receptor antagonists or long-acting dopamine D2 receptor agonists, e.g., cabergoline or ropinirole, may reduce dyskinesia in Parkinson's disease.
异常的不自主运动,即运动障碍,困扰着目前帕金森病的症状性治疗方法。帕金森病患者反复服用左旋3,4 - 二羟基苯丙氨酸(L - DOPA)或多巴胺激动剂后产生运动障碍的神经机制仍然未知。然而,对1 - 甲基 - 4 - 苯基 - 1,2,3,6 - 四氢吡啶损伤的灵长类动物或患者初次给予溴隐亭或利苏瑞得,可以缓解帕金森症状而不产生运动障碍。在本研究中,我们调查了6 - 羟基多巴胺(6 - OHDA)损伤的帕金森病大鼠模型纹状体输出通路中阿片样神经肽前体前脑啡肽原 - A(PPE - A,编码甲硫氨酸 - 脑啡肽和亮氨酸 - 脑啡肽)和前脑啡肽原 - B(PPE - B,强啡肽的前体,包括强啡肽A1 - 17和B1 - 13、亮氨酸 - 脑啡肽和α - 新内啡肽)表达的行为反应和变化。在反复给予L - DOPA、溴隐亭或利苏瑞得后评估表达情况。鉴于基底神经节回路在解剖学上组织成离散的平行回路,我们参照纹状体的详细地形图研究了肽表达的变化。在6 - OHDA损伤的大鼠中反复给予L - DOPA(6.5 mg/kg,每日两次,共21天)后,观察到旋转反应。随着反复治疗,这种反应明显增强。我们之前已经描述了这种增强反应的药理学特性,并认为它是阐明L - DOPA和多巴胺激动剂诱导运动障碍的细胞和分子机制的有用模型。与L - DOPA相反,初次给予溴隐亭(1或5 mg/kg,每日两次,共21天)或利苏瑞得(0.01或0.1 mg/kg,每日两次,共21天)不会导致行为反应增强。在给予溶剂处理的6 - OHDA损伤动物中,PPE - A表达在吻侧和背侧升高,而PPE - B表达在所有前后水平的纹状体中均降低。反复给予L - DOPA伴随着纹状体PPE - B mRNA水平升高以及PPE - A表达在损伤诱导水平之上进一步升高。这种进一步升高仅限于背外侧纹状体。然而,在反复给予溴隐亭或利苏瑞得后,未观察到PPE - B表达增加,且损伤诱导的PPE - A表达增加恢复到损伤前水平。PPE - A和PPE - B水平升高可能分别通过降低基底神经节输出核中的GABA和谷氨酸释放,在帕金森病中L - DOPA和多巴胺激动剂诱导的运动障碍的发生中起作用。这些研究表明,与PPE - B升高和/或使升高的PPE - A前体表达正常化无关的抗帕金森病治疗,如NMDA受体拮抗剂或长效多巴胺D2受体激动剂,例如卡麦角林或罗匹尼罗,可能会减少帕金森病中的运动障碍。