Aubert Incarnation, Guigoni Céline, Li Qin, Dovero Sandra, Bioulac Bernard H, Gross Christian E, Crossman Alan R, Bloch Bertrand, Bezard Erwan
Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR) 5541, Bordeaux Cedex, France.
Biol Psychiatry. 2007 Apr 1;61(7):836-44. doi: 10.1016/j.biopsych.2006.06.038. Epub 2006 Sep 1.
A role for enhanced opioid peptide transmission has been suggested in the genesis of levodopa-induced dyskinesia. However, basal ganglia nuclei other than the striatum have not been regarded as potential sources, and the opioid precursors have never been quantified simultaneously with the levels of opioid receptors at the peak of dyskinesia severity.
The levels of messenger RNA (mRNA) encoding the opioid precursors preproenkephalin-A and preproenkephalin-B in the striatum and the subthalamic nucleus and the levels of mu, delta, and kappa opioid receptors were measured within the basal ganglia of four groups of nonhuman primates killed at the peak of effect: normal, parkinsonian, parkinsonian chronically-treated with levodopa without exhibiting dyskinesia, and parkinsonian chronically-treated with levodopa showing overt dyskinesia.
Dyskinesia are associated with reduction in opioid receptor binding and specifically of kappa and mu receptor binding in the globus pallidus internalis (GPi), the main output structure of the basal ganglia. This decrease was correlated with enhancement of the expression of preproenkephalin-B mRNA but not that of preproenkephalin-A in the striatum and the subthalamic nucleus.
Abnormal transmission of preproenkephalin-B-derived opioid coming from the striatum and the subthalamic nucleus converges upon GPi at the peak of dose to induce levodopa-induced dyskinesia.
在左旋多巴诱导的异动症的发生过程中,有人提出增强的阿片肽传递起到了一定作用。然而,除纹状体之外的基底神经节核团并未被视为潜在来源,而且在异动症严重程度达到峰值时,阿片肽前体从未与阿片受体水平同时进行过定量分析。
在四组非人类灵长类动物的基底神经节内,测量了纹状体和丘脑底核中编码阿片肽前体脑啡肽原 -A 和脑啡肽原 -B 的信使核糖核酸(mRNA)水平,以及 μ、δ 和 κ 阿片受体的水平。这四组动物分别为:正常组、帕金森病组、长期接受左旋多巴治疗但未出现异动症的帕金森病组,以及长期接受左旋多巴治疗且出现明显异动症的帕金森病组。这些动物在药效峰值时被处死。
异动症与阿片受体结合减少有关,特别是在基底神经节的主要输出结构苍白球内侧部(GPi)中 κ 和 μ 受体结合减少。这种减少与纹状体和丘脑底核中脑啡肽原 -B mRNA 表达增强相关,但与脑啡肽原 -A 的表达增强无关。
来自纹状体和丘脑底核的脑啡肽原 -B 衍生的阿片肽异常传递在剂量峰值时汇聚于 GPi,从而诱发左旋多巴诱导的异动症。