Neurodegenerative Diseases Research Centre, School of Health and Biomedical Sciences, King's College, London, UK.
Eur J Pharmacol. 2010 Jun 10;635(1-3):109-16. doi: 10.1016/j.ejphar.2010.03.006. Epub 2010 Mar 19.
Dopa decarboxylase inhibitors are routinely used to potentiate the effects of L-DOPA in the treatment of Parkinson's disease. However, neither in clinical use nor in experimental models of Parkinson's disease have the timing and dose of dopa decarboxylase inhibitors been thoroughly explored. We now report on the choice of dopa decarboxylase inhibitors, dose and the time of dosing relationships of carbidopa, benserazide and L-alpha-methyl dopa (L-AMD) in potentiating the effects of L-DOPA in the 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP)-treated common marmoset. Pre-treatment with benserazide for up to 3h did not alter the motor response to L-DOPA compared to simultaneous administration with L-DOPA. There was some evidence of a relationship between carbidopa and benserazide dose and increased locomotor activity and the reversal of motor disability. But in general, commonly used dose levels of dopa decarboxylase inhibitors appeared to produce a maximal motor response to L-DOPA. In contrast, dyskinesia intensity and duration continued to increase with both carbidopa and benserazide dose. The novel dopa decarboxylase inhibitor, L-AMD, increased locomotor activity and improved motor disability to the same extent as carbidopa or benserazide but importantly this was accompanied by significantly less dyskinesia. This study shows that currently, dopa decarboxylase inhibitors may be routinely employed in the MPTP-treated primate at doses which are higher than those necessary to produce a maximal potentiation of the anti-parkinsonian effect of L-DOPA. This may lead to excessive expression of dyskinesia in this model of Parkinson's disease and attention should be given to the dose regimens currently employed.
多巴脱羧酶抑制剂通常用于增强左旋多巴在帕金森病治疗中的作用。然而,无论是在临床应用还是帕金森病的实验模型中,多巴脱羧酶抑制剂的时间和剂量都没有得到彻底的研究。我们现在报告在 1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)处理的普通狨猴中,选择多巴脱羧酶抑制剂、卡比多巴、苯丝肼和 L-α-甲基多巴(L-AMD)的剂量和投药时间与左旋多巴增强作用的关系。与同时给予 L-多巴相比,苯丝肼预处理长达 3 小时并不会改变对 L-多巴的运动反应。卡比多巴和苯丝肼剂量与增加的运动活性和运动障碍的逆转之间存在一定的关系。但是,一般来说,常用剂量的多巴脱羧酶抑制剂似乎对 L-多巴产生最大的运动反应。相比之下,运动障碍的强度和持续时间随着卡比多巴和苯丝肼剂量的增加而持续增加。新型多巴脱羧酶抑制剂 L-AMD 增加了运动活性和改善了运动障碍,与卡比多巴或苯丝肼的程度相同,但重要的是,它伴随着明显较少的运动障碍。这项研究表明,目前,在 MPTP 处理的灵长类动物中,多巴脱羧酶抑制剂可能常规用于剂量高于产生左旋多巴抗帕金森作用最大增强所需的剂量。这可能导致在帕金森病模型中过度表达运动障碍,应注意目前使用的剂量方案。