Pearce R K, Jackson M, Britton D R, Shiosaki K, Jenner P, Marsden C D
University Department of Clinical Neurology, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK.
Psychopharmacology (Berl). 1999 Feb;142(1):51-60. doi: 10.1007/s002130050861.
Common marmosets show parkinsonian motor deficits following 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) administration and develop dyskinesias during chronic L-dopa exposure. The D1 agonists A-77636 [(1R, 3S) 3-(1'-adamantyl)-1-aminomethyl-3, 4-dihydro-5, 6-dihydroxy-1H-2-benzopyran HCl] and A-86929 [(-)-trans 9, 10-hydroxy-2-propyl-4, 5, 5a, 6, 7, 11b-hexahydro-3-thia-5-azacyclopent-1-ena[c]phenanthrene hydrochloride] possess potent antiparkinsonian activity in the MPTP-treated marmoset and we now assess their influence on L-dopa-induced dyskinesias. MPTP-treated marmosets with stable motor deficits were treated with L-dopa plus carbidopa for 28 days to induce dyskinesias. Subsequently, they received A-86929 for 10 days, initially at 0.5 micromol/kg and then at 1.0 micromol/kg for a further 5 days. Several months later, L-dopa 12.5 mg/kg plus carbidopa 12.5 mg/kg was given orally twice daily for 7 days, followed by A-77636 1 micromol/kg for 10 days, and then both A-77636 and L-dopa plus carbidopa were given concurrently for 3 further days. In these L-dopa-primed animals, A-86929 effectively reversed akinesia and produced dose-dependent dyskinesias which were significantly less intense than those produced by L-dopa administration. A degree of behavioral tolerance was encountered, but antiparkinsonian activity was preserved and elicited behaviour was free of hyperkinesis and stereotypy and more naturalistic than that seen with L-dopa. After a week of twice-daily L-dopa dosing, administration of the long-acting D1 agonist A-77636 initially dramatically enhanced locomotion and reproduced dyskinesia with prominent dystonia, but after repeated administration of A-77636, dyskinesia and in particular chorea, gradually disappeared. Tolerance to locomotor stimulation greater than with A-86929 occurred, although activity remained significantly above baseline levels. There was a marked reduction in L-dopa-induced climbing, stereotypy and hyperkinesis and behaviour more closely resembled that of normal unlesioned marmosets. Upon reintroduction of L-dopa concurrently with continued A-77636 administration, dystonic, but virtually no choreic dyskinesias appeared and behaviour was once again free of stereotypy and hyperkinesis, contrasting dramatically with the presence of these behaviours along with abundant chorea when L-dopa is given alone. These results show a lesser liability of A-86929 and A-77636 to reproduce dyskinesia in L-dopa-primed MPTP-lesioned subjects while maintaining effective antiparkinsonian activity and producing a more naturalistic motor response. The differential effects of A-77636 on chorea and dystonia, with suppression of chorea and stereotypy on co-administration with L-dopa, may reflect an altered balance of activity in the direct and indirect striatofugal pathways. These results suggest a possible role for D1 agonists in the treatment of Parkinson's disease.
普通狨猴在给予1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)后会出现帕金森病样运动缺陷,并在长期左旋多巴暴露期间出现运动障碍。D1激动剂A-77636 [(1R, 3S) 3-(1'-金刚烷基)-1-氨甲基-3, 4-二氢-5, 6-二羟基-1H-2-苯并吡喃盐酸盐] 和A-86929 [(-)-反式9, 10-二羟基-2-丙基-4, 5, 5a, 6, 7, 11b-六氢-3-硫杂-5-氮杂环戊-1-烯并[c]菲盐酸盐] 在MPTP处理的狨猴中具有强大的抗帕金森病活性,我们现在评估它们对左旋多巴诱导的运动障碍的影响。对具有稳定运动缺陷的MPTP处理的狨猴给予左旋多巴加卡比多巴28天以诱导运动障碍。随后,它们接受A-86929治疗10天,最初剂量为0.5微摩尔/千克,然后在接下来的5天内剂量为1.0微摩尔/千克。几个月后,每天两次口服给予左旋多巴12.5毫克/千克加卡比多巴12.5毫克/千克,持续7天,随后给予A-77636 1微摩尔/千克,持续10天,然后同时给予A-77636和左旋多巴加卡比多巴,再持续3天。在这些预先用左旋多巴处理的动物中,A-86929有效地逆转了运动不能,并产生了剂量依赖性运动障碍,其严重程度明显低于左旋多巴给药所产生的运动障碍。出现了一定程度的行为耐受性,但抗帕金森病活性得以保留,引发的行为没有运动亢进和刻板行为,比左旋多巴引起的行为更自然。在每天两次给予左旋多巴一周后,给予长效D1激动剂A-77636最初显著增强了运动能力,并再现了伴有明显肌张力障碍的运动障碍,但在重复给予A-77636后,运动障碍尤其是舞蹈症逐渐消失。对运动刺激的耐受性比A-86929时更高,尽管活性仍显著高于基线水平。左旋多巴诱导的攀爬、刻板行为和运动亢进明显减少,行为更类似于正常未损伤的狨猴。在继续给予A-77636的同时重新引入左旋多巴时,出现了肌张力障碍性运动障碍,但几乎没有舞蹈症样运动障碍,行为再次没有刻板行为和运动亢进,这与单独给予左旋多巴时这些行为以及大量舞蹈症的出现形成了鲜明对比。这些结果表明,在预先用左旋多巴处理的MPTP损伤的受试者中,A-86929和A-77636产生运动障碍的倾向较小,同时保持有效的抗帕金森病活性并产生更自然的运动反应。A-77636对舞蹈症和肌张力障碍的不同作用,即与左旋多巴联合给药时对舞蹈症和刻板行为的抑制,可能反映了直接和间接纹状体传出通路中活动平衡的改变。这些结果提示D1激动剂在帕金森病治疗中可能具有一定作用。