Nomoto M, Iwata S, Kaseda S
Department of Pharmacology, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
Nihon Yakurigaku Zasshi. 2001 Feb;117(2):111-22. doi: 10.1254/fpj.117.111.
Antiparkinsonian agents applied or under the investigation for the treatment of patients with Parkinson's disease were reviewed. Tremor, akinesia, rigidity and postual instability are key signs of Parkinson's disease. The most important one is akinesia, which includes decreased spontaneous locomotor activity, slowness of movement, awkwardness and freezing. The main pathophysiology of Parkinson's disease is neurodegeneration of nigrostriatal dopaminergic neurons. Neurotoxins or oxidative stress to the dopaminergic neurons have been discussed as one of the etiologies of degeneration. Antioxidant or neuroprotective agents will be the future drugs for Parkinson's disease. At present, supplement of dopamine by levodopa administration, retarding the metabolism of levodopa or dopamine by a dopa decarboxylase inhibitor (DCI), MAO-B (monoamine oxidase inhibitor type B) inhibitor or catechol-O-methyltransferase (COMT) inhibitor, dopamine receptor agonists, anticholinergic agents, dopamine release enhancer/uptake inhibitor, N-methyl-D-aspartate (NMDA) receptor antagonists are applied for the treatment of Parkinson's disease. New agents such as adenosine receptor antagonists, serotonergic agents and nicotinic receptor agonists are under investigation. Agents to facilitate the growth of nerves or to inhibit degeneration of nerves are also studied and will be developed for the treatment of Parkinson's disease in the future. In the case of familial Parkinson's disease, abnormal genes were identified. Gene therapy might be another future treatment for these cases.
对已应用或正在研究用于治疗帕金森病患者的抗帕金森病药物进行了综述。震颤、运动不能、强直和姿势不稳是帕金森病的关键体征。其中最重要的是运动不能，它包括自发运动活动减少、运动迟缓、动作笨拙和冻结现象。帕金森病的主要病理生理学是黑质纹状体多巴胺能神经元的神经变性。多巴胺能神经元的神经毒素或氧化应激已被讨论为变性的病因之一。抗氧化剂或神经保护剂将是未来治疗帕金森病的药物。目前，通过给予左旋多巴补充多巴胺，通过多巴脱羧酶抑制剂（DCI）、单胺氧化酶B型（MAO-B）抑制剂或儿茶酚-O-甲基转移酶（COMT）抑制剂延缓左旋多巴或多巴胺的代谢，使用多巴胺受体激动剂、抗胆碱能药物、多巴胺释放增强剂/摄取抑制剂、N-甲基-D-天冬氨酸（NMDA）受体拮抗剂来治疗帕金森病。腺苷受体拮抗剂、5-羟色胺能药物和烟碱受体激动剂等新型药物正在研究中。促进神经生长或抑制神经变性的药物也在研究中，未来将开发用于治疗帕金森病。在家族性帕金森病的情况下，已鉴定出异常基因。基因治疗可能是这些病例未来的另一种治疗方法。
