School of Health and Biomedical Sciences, Neurodegenerative Diseases Research Centre, King's College, London, SE1 1UL, UK.
J Neural Transm (Vienna). 2010 Jan;117(1):55-67. doi: 10.1007/s00702-009-0323-9. Epub 2009 Oct 7.
Dopamine replacement therapy in Parkinson's disease (PD) using L-dopa is invariably associated with a loss of drug efficacy ("wearing off") and the onset of dyskinesia. The use of dopamine receptor partial agonists might improve therapeutic benefit without increased dyskinesia expression but may antagonise the effects of L-dopa. We now examine the effects of the novel high affinity, dopamine D(2) receptor partial agonist, aplindore alone and in combination with L-dopa in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated common marmoset. In non-dyskinetic MPTP treated animals, aplindore (0.05-1.0 mg/kg p.o.) produced a dose-dependent reversal of motor disability and an increase in locomotor activity that was maximal at doses of 0.2 mg/kg and above. In animals previously exposed to L: -dopa to induce dyskinesia, escalating and repeated dosing of aplindore (0.05-0.5 mg/kg p.o.) produced a sustained, dose-related improvement in motor disability and an increase in locomotor activity. The effects were maximal at a dose of 0.1 mg/kg and above and not different from those produced by L-dopa (12.5 mg/kg plus carbidopa 12.5 mg/kg p.o.). Aplindore administration also led to dose-dependent expression of dyskinesia but at 0.1 mg/kg, this was significantly less intense than that produced by L-dopa. Administration of aplindore (1.0 mg/kg p.o.) in combination with L-dopa (2.5 mg/kg plus carbidopa 12.5 mg/kg p.o.) did not inhibit the reversal of motor deficits but improved motor disability and increased both locomotor activity and dyskinesia expression equivalent to that produced by L-dopa (12.5 mg/kg plus carbidopa 12.5 mg/kg p.o.). These data suggest that dopamine receptor partial agonists would be effective in the treatment of Parkinson's disease and would not inhibit the beneficial actions of L-dopa.
在帕金森病(PD)中使用左旋多巴进行多巴胺替代治疗,不可避免地会导致药物疗效丧失(“失效”)和运动障碍的发生。使用多巴胺受体部分激动剂可能会提高治疗效果,而不会增加运动障碍的表达,但可能会拮抗左旋多巴的作用。我们现在研究新型高亲和力多巴胺 D2 受体部分激动剂阿普林多单独使用以及与左旋多巴联合使用对 1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)处理的普通狨猴的影响。在非运动障碍性 MPTP 治疗的动物中,阿普林多(0.05-1.0 mg/kg 口服)剂量依赖性地逆转运动障碍,并增加运动活动,最大剂量为 0.2 mg/kg 及以上。在先前暴露于 L-多巴以诱导运动障碍的动物中,递增和重复给予阿普林多(0.05-0.5 mg/kg 口服)可使运动障碍持续、剂量相关地改善,并增加运动活动。最大剂量为 0.1 mg/kg 及以上,与 L-多巴(12.5 mg/kg 加卡比多巴 12.5 mg/kg 口服)产生的效果相同。阿普林多给药还导致运动障碍的剂量依赖性表达,但在 0.1 mg/kg 时,其强度明显低于 L-多巴产生的运动障碍。阿普林多(1.0 mg/kg 口服)与左旋多巴(2.5 mg/kg 加卡比多巴 12.5 mg/kg 口服)联合给药不会抑制运动缺陷的逆转,但改善运动障碍,并增加运动活动和运动障碍表达,与 L-多巴(12.5 mg/kg 加卡比多巴 12.5 mg/kg 口服)产生的效果相同。这些数据表明,多巴胺受体部分激动剂将在治疗帕金森病方面有效,并且不会抑制左旋多巴的有益作用。