Muriel M P, Bernard V, Levey A I, Laribi O, Abrous D N, Agid Y, Bloch B, Hirsch E C
Institut National de la Santé et de la Recherche Médicale U289, Hôpital de la Salpêtrière, Paris, France.
Ann Neurol. 1999 Jul;46(1):103-11. doi: 10.1002/1531-8249(199907)46:1<103::aid-ana15>3.0.co;2-z.
Parkinson's disease is characterized by a massive loss of nigral dopamine neurons that results in a reduction of dopamine concentrations in the striatum. The most commonly used treatment for this disease is levodopa therapy to restore striatal dopamine. This treatment is mediated by dopamine receptors, but the effect of treatment and the disease on receptor distribution is unknown. In this study, the distribution of D1 dopamine receptors was analyzed at the cellular and subcellular level in the striatum of 5 patients with Parkinson's disease (all treated with levodopa) and 4 control subjects. In the control brains, D1 dopamine receptors were mostly detected on the plasma membrane of medium-sized spiny neurons. The quantitative analysis performed at the ultrastructural level in patients with Parkinson's disease revealed an increase in immunostaining in the cytoplasm of medium-sized neurons. This effect was likely the result of the treatment rather than the dopaminergic denervation, as such changes were not observed in the striatum of rats with a unilateral 6-hydroxydopamine nigrostriatal lesion, but were present in normal or lesioned rats treated with a D1 dopamine agonist. Altered localization of D1 dopamine receptors may participate in the occurrence of side effects of levodopa therapy such as dyskinesia and fluctuations in motor performances.
帕金森病的特征是黑质多巴胺能神经元大量丧失,导致纹状体中多巴胺浓度降低。该疾病最常用的治疗方法是左旋多巴疗法,以恢复纹状体多巴胺水平。这种治疗由多巴胺受体介导,但治疗和疾病对受体分布的影响尚不清楚。在本研究中,分析了5例帕金森病患者(均接受左旋多巴治疗)和4例对照受试者纹状体中D1多巴胺受体在细胞和亚细胞水平的分布。在对照大脑中,D1多巴胺受体主要在中等大小棘状神经元的质膜上检测到。在帕金森病患者中进行的超微结构水平定量分析显示,中等大小神经元细胞质中的免疫染色增加。这种效应可能是治疗的结果,而非多巴胺能去神经支配的结果,因为在单侧6-羟基多巴胺黑质纹状体损伤的大鼠纹状体中未观察到此类变化,但在用D1多巴胺激动剂治疗的正常或损伤大鼠中存在。D1多巴胺受体定位改变可能参与左旋多巴治疗的副作用,如运动障碍和运动表现波动的发生。