Nishino S, Arrigoni J, Valtier D, Miller J D, Guilleminault C, Dement W C, Mignot E
Stanford Sleep Disorders Research Center, Palo Alto, California 94304.
J Neurosci. 1991 Sep;11(9):2666-71. doi: 10.1523/JNEUROSCI.11-09-02666.1991.
Narcolepsy is a sleep disorder characterized by abnormal manifestations of rapid-eye-movement (REM) sleep and excessive daytime sleepiness. Using a canine model of the disease, we found that central D2 antagonists suppressed cataplexy, a form of REM-sleep atonia occurring in narcolepsy, whereas this symptom was aggravated by D2 agonists. The effect on cataplexy was stereospecific for the S(-) enantiomer of sulpiride (a D2 antagonist) and the R(+) enantiomer of 3-PPP (a D2 agonist). There was also a significant correlation between the in vivo pharmacological potency and in vitro drug affinity for D2 receptors (but not for D1 and alpha 2 receptors) among the seven central D2 antagonists tested. Selective D1 compounds were also tested; however, the results were inconsistent because both antagonists and agonists generally suppressed cataplexy. Our current results demonstrate that central D2-type receptors are critically involved in the control of cataplexy and REM sleep. Furthermore, the finding that small doses of D2 antagonists suppressed cataplexy and induced behavioral excitation, while small doses of D2 agonists aggravated cataplexy and induced sedation, suggests that this effect is mediated presynaptically. However, considering the fact that selective dopamine reuptake inhibitors did not modify cataplexy and that our previous pharmacological results demonstrated a preferential involvement of the noradrenergic system in the control of cataplexy, we believe that the effect of D2 compounds on cataplexy is mediated secondarily via the noradrenergic systems.
发作性睡病是一种睡眠障碍,其特征为快速眼动(REM)睡眠出现异常表现以及日间过度嗜睡。利用该疾病的犬类模型,我们发现中枢D2拮抗剂可抑制猝倒,猝倒是发作性睡病中出现的一种REM睡眠性肌张力缺失形式,而D2激动剂会加重这种症状。对于舒必利(一种D2拮抗剂)的S(-)对映体和3-PPP(一种D2激动剂)的R(+)对映体,对猝倒的作用具有立体特异性。在所测试的七种中枢D2拮抗剂中,体内药理活性与对D2受体(而非D1和α2受体)的体外药物亲和力之间也存在显著相关性。还测试了选择性D1化合物;然而,结果并不一致,因为拮抗剂和激动剂通常都会抑制猝倒。我们目前的结果表明,中枢D2型受体在猝倒和REM睡眠的控制中起关键作用。此外,小剂量D2拮抗剂抑制猝倒并诱导行为兴奋,而小剂量D2激动剂加重猝倒并诱导镇静,这一发现表明这种作用是通过突触前介导的。然而,考虑到选择性多巴胺再摄取抑制剂不会改变猝倒,以及我们之前的药理学结果表明去甲肾上腺素能系统在猝倒控制中起优先作用,我们认为D2化合物对猝倒的作用是通过去甲肾上腺素能系统继发介导的。