Cassani Erica, Cilia Roberto, Laguna Janeth, Barichella Michela, Contin Manuela, Cereda Emanuele, Isaias Ioannis U, Sparvoli Francesca, Akpalu Albert, Budu Kwabena Ofosu, Scarpa Maria Teresa, Pezzoli Gianni
Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
J Neurol Sci. 2016 Jun 15;365:175-80. doi: 10.1016/j.jns.2016.04.001. Epub 2016 Apr 16.
Parkinson's disease (PD) is a progressive neurological condition. Levodopa (LD) is the gold standard therapy for PD patients. Most PD patients in low-income areas cannot afford long-term daily Levodopa therapy. The aim of our study was to investigate if Mucuna pruriens (MP), a legume with high LD content that grows in tropical regions worldwide, might be potential alternative for poor PD patients.
We analyzed 25 samples of MP from Africa, Latin America and Asia. We measured the content in LD in various MP preparations (dried, roasted, boiled). LD pharmacokinetics and motor response were recorded in four PD patients, comparing MP vs. LD+Dopa-Decarboxylase Inhibitor (DDCI) formulations.
Median LD concentration in dried MP seeds was 5.29%; similar results were obtained in roasted powder samples (5.3%), while boiling reduced LD content up to 70%. Compared to LD+DDCI, MP extract at similar LD dose provided less clinical benefit, with a 3.5-fold lower median AUC.
Considering the lack of a DDCI, MP therapy may provide clinical benefit only when content of LD is at least 3.5-fold the standard LD+DDCI. If long-term MP proves to be safe and effective in controlled clinical trials, it may be a sustainable alternative therapy for PD in low-income countries.
帕金森病(PD)是一种进行性神经疾病。左旋多巴(LD)是治疗PD患者的金标准疗法。大多数低收入地区的PD患者负担不起长期每日左旋多巴治疗。我们研究的目的是调查刺蒺藜豆(MP),一种在全球热带地区生长且左旋多巴含量高的豆科植物,是否可能成为贫困PD患者的潜在替代疗法。
我们分析了来自非洲、拉丁美洲和亚洲的25份MP样本。我们测量了各种MP制剂(干燥、烘烤、煮沸)中的左旋多巴含量。记录了4例PD患者的左旋多巴药代动力学和运动反应,比较了MP与左旋多巴+多巴脱羧酶抑制剂(DDCI)制剂。
干燥MP种子中的左旋多巴浓度中位数为5.29%;烘烤粉末样本中得到了类似结果(5.3%),而煮沸使左旋多巴含量降低了70%。与左旋多巴+DDCI相比,在相似左旋多巴剂量下的MP提取物提供的临床益处较少,中位数AUC低3.5倍。
考虑到缺乏DDCI,仅当左旋多巴含量至少是标准左旋多巴+DDCI的3.5倍时,MP疗法才可能提供临床益处。如果长期MP在对照临床试验中被证明是安全有效的,它可能成为低收入国家PD的一种可持续替代疗法。