Kirik Deniz, Georgievska Biljana, Burger Corinna, Winkler Christian, Muzyczka Nicholas, Mandel Ronald J, Bjorklund Anders
Wallenberg Neuroscience Center, Department of Physiological Sciences, Division of Neurobiology, Lund University, BMC A11, S-221 84, Lund, Sweden.
Proc Natl Acad Sci U S A. 2002 Apr 2;99(7):4708-13. doi: 10.1073/pnas.062047599. Epub 2002 Mar 26.
Intrastriatal delivery of the tyrosine hydroxylase gene by viral vectors is being explored as a tool for local delivery of L-dopa in animals with lesions of the nigrostriatal pathway. The functional effects reported using this approach have been disappointing, probably because the striatal L-dopa levels attained have been too low. In the present study, we have defined a critical threshold level of L-dopa, 1.5 pmol/mg of tissue, that has to be reached to induce any significant functional effects. Using new generation high-titer recombinant adeno-associated virus vectors, we show that levels of striatal L-dopa production exceeding this threshold can be obtained provided that tyrosine hydroxylase is coexpressed with the cofactor synthetic enzyme, GTP-cyclohydrolase-1. After striatal transduction with this combination of vectors, substantial functional improvement in both drug-induced and spontaneous behavior was observed in rats with either complete or partial 6-hydroxydopamine lesions of the nigrostriatal pathway. However, complete reversal of motor deficits occurred only in animals in which part of the striatal dopamine innervation was left intact. Spared nigrostriatal fibers thus may convert L-dopa to dopamine and store and release dopamine in a more physiologically relevant manner in the denervated striatum to mediate better striatal output-dependent motor function. We conclude that intrastriatal L-dopa delivery may be a viable strategy for treatment and control of adverse side effects associated with oral L-dopa therapy such as on-off fluctuations and drug-induced dyskinesias in patients with Parkinson's disease.
通过病毒载体将酪氨酸羟化酶基因纹状体内递送,正作为在黑质纹状体通路受损动物中局部递送左旋多巴的一种工具进行探索。使用这种方法所报道的功能效应并不理想,可能是因为所达到的纹状体左旋多巴水平过低。在本研究中,我们确定了一个关键的左旋多巴阈值水平,即每毫克组织1.5皮摩尔,必须达到该水平才能诱导出任何显著的功能效应。使用新一代高滴度重组腺相关病毒载体,我们表明,只要酪氨酸羟化酶与辅因子合成酶鸟苷三磷酸环化水解酶-1共表达,就可以获得超过该阈值的纹状体左旋多巴产生水平。在用这种载体组合进行纹状体转导后,在黑质纹状体通路完全或部分6-羟基多巴胺损伤的大鼠中,观察到药物诱导行为和自发行为都有显著的功能改善。然而,运动缺陷的完全逆转仅发生在部分纹状体多巴胺神经支配保持完整的动物中。因此,保留的黑质纹状体纤维可能将左旋多巴转化为多巴胺,并以更符合生理的方式在去神经支配的纹状体中储存和释放多巴胺,以介导更好的纹状体输出依赖性运动功能。我们得出结论,纹状体内左旋多巴递送可能是一种可行的策略,用于治疗和控制与帕金森病患者口服左旋多巴治疗相关的不良副作用,如开关波动和药物诱导的运动障碍。