Paquette Melanie A, Foley Katherine, Brudney Elizabeth G, Meshul Charles K, Johnson Steven W, Berger S Paul
Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA.
Psychopharmacology (Berl). 2009 Jul;204(4):743-54. doi: 10.1007/s00213-009-1505-8. Epub 2009 Mar 13.
Levodopa (L-DOPA), the gold standard treatment for Parkinson's disease (PD), eventually causes L-DOPA-induced dyskinesia (LID) in up to 80% of patients. In the 6-hydroxydopamine (6-OHDA) rat model of PD, L-DOPA induces a similar phenomenon, which has been termed abnormal involuntary movement (AIM). We previously demonstrated that BMY-14802 suppresses AIM expression in this model.
Although BMY-14802 is widely used as a sigma-1 antagonist, it is also an agonist at serotonin (5-HT) 1A and adrenergic alpha-1 receptors. The current study was conducted to determine which of these mechanisms underlies BMY-14802's AIM-suppressing effect. This characterization included testing the 5-HT1A agonist buspirone and multiple sigma agents. When these studies implicated a 5-HT1A mechanism, we subsequently undertook a pharmacological reversal study, evaluating whether the 5-HT1A antagonist WAY-100635 counteracted BMY-14802's AIM-suppressing effects.
Buspirone dose-dependently suppressed AIM, supporting past findings. However, no AIM-suppressing effects were produced by drugs with effects at sigma receptors, including BD-1047, finasteride, SM-21, DTG, trans-dehydroandrosterone (DHEA), carbetapentane, and opipramol. Finally, we show for the first time that the AIM-suppressing effect of BMY-14802 was dose-dependently prevented by WAY-100635 but not by the alpha-1 antagonist prazosin.
BMY-14802 exerts its AIM-suppressing effects via a 5-HT1A agonist mechanism, similar to buspirone. Other 5-HT1A agonists have failed clinical trials, possibly due to submicromolar affinity at other receptors, including D2, which may exacerbate PD symptoms. BMY-14802 is a promising candidate for clinical trials due to its extremely low affinity for the D2 receptor and lack of extrapyramidal effects during prior clinical trials for schizophrenia.
左旋多巴(L-DOPA)是帕金森病(PD)的金标准治疗药物,但最终会导致高达80%的患者出现左旋多巴诱导的异动症(LID)。在帕金森病的6-羟基多巴胺(6-OHDA)大鼠模型中,左旋多巴会诱发类似现象,即异常不自主运动(AIM)。我们之前证明BMY-14802可抑制该模型中的AIM表达。
尽管BMY-14802被广泛用作西格玛-1拮抗剂,但它也是5-羟色胺(5-HT)1A和肾上腺素α-1受体的激动剂。本研究旨在确定这些机制中哪一种是BMY-14802抑制AIM作用的基础。该特性研究包括测试5-HT1A激动剂丁螺环酮和多种西格玛药物。当这些研究暗示存在5-HT1A机制时,我们随后进行了一项药理学逆转研究,评估5-HT1A拮抗剂WAY-100635是否能抵消BMY-14802的AIM抑制作用。
丁螺环酮剂量依赖性地抑制AIM,支持既往研究结果。然而,对西格玛受体有作用的药物,包括BD-1047、非那雄胺、SM-21、DTG、反式脱氢表雄酮(DHEA)、卡比戊烷和奥匹哌醇,均未产生AIM抑制作用。最后,我们首次表明,WAY-100635可剂量依赖性地阻止BMY-14802的AIM抑制作用,而α-1拮抗剂哌唑嗪则不能。
BMY-14802通过5-HT1A激动剂机制发挥其AIM抑制作用,类似于丁螺环酮。其他5-HT1A激动剂在临床试验中失败,可能是由于它们对包括D2受体在内的其他受体具有亚微摩尔亲和力,这可能会加重帕金森病症状。BMY-14802对D2受体的亲和力极低,且在既往精神分裂症临床试验中无锥体外系反应,因此是一个有前景的临床试验候选药物。