Department of Neurology, University Hospital and Palacký University Medical School, I. P. Pavlova 6, 77520, Olomouc, Czech Republic.
Neurol Sci. 2010 Oct;31(5):565-9. doi: 10.1007/s10072-010-0262-0. Epub 2010 May 13.
Peripheral metabolism of L-DOPA via enzyme catechol-O-methyltransferase (COMT) is one of the possible sources of homocysteine (HCY). The aim of this study was to assess plasma HCY levels in L-DOPA-treated Parkinson's disease (PD) patients and its influence by adding the inhibitor COMT (entacapone). Patients were divided into two groups: (1) patients long term treated with L-DOPA but were naïve to entacapone, (2) L-DOPA naïve patients, in whom a combined treatment with L-DOPA and entacapone was started. The HCY levels were higher in Group 1 than in Group 2. No statistically significant changes of HCY concentrations were found in both patient groups after adding entacapone to their L-DOPA treatments. Results of this study confirm that patients treated with L-DOPA for a long term have increased plasma HCY concentrations. We believe combined L-DOPA and entacapone therapy could be a possible protective mechanism against hyperhomocysteinemia in early PD.
左旋多巴的外周代谢通过酶儿茶酚-O-甲基转移酶（COMT）进行，这可能是高半胱氨酸（HCY）的来源之一。本研究旨在评估接受左旋多巴治疗的帕金森病（PD）患者的血浆 HCY 水平及其受 COMT 抑制剂（恩他卡朋）的影响。患者分为两组：（1）长期接受左旋多巴治疗但尚未使用恩他卡朋的患者；（2）接受左旋多巴和恩他卡朋联合治疗的左旋多巴初治患者。第 1 组患者的 HCY 水平高于第 2 组。在向两组患者的左旋多巴治疗中添加恩他卡朋后，均未发现 HCY 浓度有统计学意义的变化。本研究结果证实，长期接受左旋多巴治疗的患者血浆 HCY 浓度升高。我们认为，左旋多巴和恩他卡朋联合治疗可能是早期 PD 患者高同型半胱氨酸血症的一种潜在保护机制。
