Laboratory of Neuroanatomy and Experimental Neurology, Department of Morphological Sciences, Faculty of Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
Brain. 2012 Jan;135(Pt 1):124-38. doi: 10.1093/brain/awr320. Epub 2011 Dec 20.
There is a lack of consensus about the effects of the type of menopause (surgical or natural) and of oestrogen replacement therapy on Parkinson's disease. The effects of the timing of replacement therapy and the female's age may explain the observed differences in such effects. However, the mechanisms involved are poorly understood. The renin-angiotensin system mediates the beneficial effects of oestrogen in several tissues, and we have previously shown that dopaminergic cell loss is enhanced by angiotensin via type 1 receptors, which is activated by ageing. In rats, we compared the effects of oestrogen replacement therapy on 6-hydroxydopamine-induced dopaminergic degeneration, nigral renin-angiotensin system activity, activation of the nicotinamide adenine dinucleotide phosphate oxidase complex and levels of the proinflammatory cytokine interleukin-1β in young (surgical) menopausal rats and aged menopausal rats. In young surgically menopausal rats, the renin-angiotensin system activity was higher (i.e. higher angiotensin converting enzyme activity, higher angiotensin type-1 receptor expression and lower angiotensin type-2 receptor expression) than in surgically menopausal rats treated with oestrogen; the nicotinamide adenine dinucleotide phosphate oxidase activity and interleukin-1β expression were also higher in the first group than in the second group. In aged menopausal rats, the levels of nigral renin-angiotensin and nicotinamide adenine dinucleotide phosphate oxidase activity were similar to those observed in surgically menopausal rats. However, oestrogen replacement therapy significantly reduced 6-hydroxydopamine-induced dopaminergic cell loss in young menopausal rats but not in aged rats. Treatment with oestrogen also led to a more marked reduction in nigral renin-angiotensin and nicotinamide adenine dinucleotide phosphate oxidase activity in young surgically menopausal rats (treated either immediately or after a period of hypo-oestrogenicity) than in aged menopausal rats. Interestingly, treatment with the angiotensin type-1 receptor antagonist candesartan led to remarkable reduction in renin-angiotensin system activity and dopaminergic neuron loss in both groups of menopausal rats. This suggests that manipulation of the brain renin-angiotensin system may be an efficient approach for the prevention or treatment of Parkinson's disease in oestrogen-deficient females, together with or instead of oestrogen replacement therapy.
关于绝经类型(手术或自然)和雌激素替代疗法对帕金森病的影响,目前尚未达成共识。替代疗法的时机和女性年龄的影响可能可以解释观察到的这些差异。但是,相关的机制仍知之甚少。肾素-血管紧张素系统在多种组织中介导雌激素的有益作用,我们之前已经表明,血管紧张素通过 1 型受体增强多巴胺能神经元的丢失,而这种受体的激活与衰老有关。在大鼠中,我们比较了雌激素替代疗法对 6-羟多巴胺诱导的多巴胺能变性、黑质肾素-血管紧张素系统活性、烟酰胺腺嘌呤二核苷酸磷酸氧化酶复合物的激活和促炎细胞因子白细胞介素-1β水平的影响在年轻(手术)绝经大鼠和老年绝经大鼠中。在年轻的手术绝经大鼠中,肾素-血管紧张素系统活性更高(即血管紧张素转换酶活性更高,血管紧张素 1 型受体表达更高,血管紧张素 2 型受体表达更低),而接受雌激素治疗的手术绝经大鼠则更高;第一组的烟酰胺腺嘌呤二核苷酸磷酸氧化酶活性和白细胞介素-1β表达也高于第二组。在老年绝经大鼠中,黑质肾素-血管紧张素和烟酰胺腺嘌呤二核苷酸磷酸氧化酶活性水平与手术绝经大鼠相似。然而,雌激素替代疗法显著减少了年轻绝经大鼠中 6-羟多巴胺诱导的多巴胺能神经元丢失,但对老年大鼠没有作用。雌激素治疗还导致年轻手术绝经大鼠(无论是立即治疗还是在低雌激素期后治疗)中黑质肾素-血管紧张素和烟酰胺腺嘌呤二核苷酸磷酸氧化酶活性的显著降低(与老年绝经大鼠相比)。有趣的是,血管紧张素 1 型受体拮抗剂坎地沙坦的治疗导致两组绝经大鼠的肾素-血管紧张素系统活性和多巴胺能神经元丢失显著减少。这表明,对大脑肾素-血管紧张素系统的操纵可能是一种有效的方法,用于预防或治疗雌激素缺乏的女性中的帕金森病,与雌激素替代疗法一起或代替雌激素替代疗法。