Department of Pharmacology, College of Medicine, Hanyang University, 133-791, Seoul, Korea.
Cell Mol Neurobiol. 2010 Aug;30(6):817-25. doi: 10.1007/s10571-010-9509-9. Epub 2010 Mar 16.
The administration of L: -DOPA is the standard treatment for Parkinson's disease (PD). However, the symptomatic relief provided by long-term administration may be compromised by L: -DOPA-induced dyskinesia (LID) that presents as adverse fluctuations in motor responsiveness and progressive loss of motor control. In the later stages of PD, raphestriatal serotonin neurons compensate for the loss of nigrostriatal dopamine (DA) neurons by converting and releasing DA derived from exogenous L: -DOPA. Since the serotonin system does not have an autoregulatory mechanism for DA, raphe-mediated striatal DA release may fluctuate dramatically and precede the development of LID. The 6-hydroxydopamine lesioned rats were treated with L: -DOPA (6 mg/kg) and benserazide (15 mg/kg) daily for 3 weeks to allow for the development of abnormal involuntary movement score (AIMs). In rats with LID, chronic treatment with L: -DOPA increased striatal DA levels compared with control rats. We also observed a relative increase in the expression of striatal L: -amino-acid decarboxylase (AADC) in LID rats, even though tyrosine hydroxylase (TH) expression did not increase. The administration of L: -DOPA also increased striatal serotonin immunoreactivity in LID rats compared to control rats. Striatal DA and 5-hydroxytryptamine (5-HT) levels were negatively correlated in L: -DOPA-treated rats. These results of this study reveal that 5-HT contributes to LID. Striatal DA positively influences LID, while 5-HT is negatively associated with LID. Finally, we suggest that by strategic modification of the serotonin system it may be possible to attenuate the adverse effects of chronic L: -DOPA therapy in PD patients.
左旋多巴(L: -DOPA)的给药是治疗帕金森病(PD)的标准方法。然而,长期给药提供的症状缓解可能因 L: -DOPA 诱导的运动障碍(LID)而受到损害,其表现为运动反应的不良波动和运动控制的逐渐丧失。在 PD 的后期阶段,中缝核纹状体 5-羟色胺神经元通过将源自外源性 L: -DOPA 的 DA 转化和释放来补偿黑质纹状体多巴胺(DA)神经元的丧失。由于 5-羟色胺系统没有用于 DA 的自动调节机制,中缝介导的纹状体 DA 释放可能会剧烈波动,并先于 LID 的发展。用 6-羟多巴胺损伤大鼠,每天用 L: -DOPA(6mg/kg)和苄丝肼(15mg/kg)治疗 3 周,以允许出现异常不自主运动评分(AIMs)。在患有 LID 的大鼠中,与对照大鼠相比,L: -DOPA 的慢性治疗增加了纹状体 DA 水平。我们还观察到 LID 大鼠纹状体 L: -氨基酸脱羧酶(AADC)的表达相对增加,尽管酪氨酸羟化酶(TH)表达没有增加。与对照大鼠相比,LID 大鼠的纹状体 5-羟色胺免疫反应性也在 L: -DOPA 治疗后增加。在 L: -DOPA 处理的大鼠中,纹状体 DA 和 5-羟色胺(5-HT)水平呈负相关。这项研究的结果表明 5-HT 有助于 LID。纹状体 DA 对 LID 有积极影响,而 5-HT 与 LID 呈负相关。最后,我们建议通过对 5-羟色胺系统进行策略性修饰,可能会减轻 PD 患者慢性 L: -DOPA 治疗的不良反应。