Department of Neurology, Xinhua Hospital, Medical School of Shanghai Jiaotong University, Shanghai 200092, P.R. China.
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, P.R. China.
Mol Med Rep. 2018 Jan;17(1):1118-1124. doi: 10.3892/mmr.2017.7974. Epub 2017 Nov 6.
Levodopa (L‑DOPA) is the gold standard for symptomatic treatment of Parkinson's disease (PD); however, long‑term therapy is associated with the emergence of L‑DOPA‑induced dyskinesia (LID). Nigral dopaminergic cell loss determines the degree of drug exposure and time required for the initial onset of LID. Accumulating evidence indicates that α‑lipoic acid (ALA) decreases this nigral dopaminergic cell loss. However, until now, the precise mechanisms of ALA have only been partially understood in LID. Chronic L‑DOPA treatment was demonstrated to develop intense AIM scores to assess dyskinetic symptoms. Rats in the LID group were administrated twice daily with L‑DOPA + benserazide for 3 weeks to induce a rat model of dyskinesia. Moreover, other 6‑OHDA‑lesioned rats were treatment with ALA (31.5 mg/kg or 63 mg/kg) in combination with L‑DOPA treatment. Furthermore, the authors investigated the level of malondialdehyde (MDA) and glutathione (GSH) activity, as well as IBa‑1, caspase‑3 and poly (ADP-ribose) polymerase (PARP) in substantia nigra by the way of western blotting and immunofluorescence. ALA reduced LID in a dose‑dependent manner without compromising the anti‑PD effect of L‑DOPA. Moreover, ALA reduced the level of MDA and upregulated the GSH activity, as well as ameliorated IBa‑1 positive neurons in the substantia nigra. Finally, it was identified that ALA could reduce L‑DOPA‑induced cleaved‑caspase‑3 and PARP overexpression in the substantia nigra. Based on the present findings, ALA could be recommended as a promising disease‑modifying therapy when administered with L‑DOPA early in the course of PD. The exact mechanism for this action, although incompletely understood, appears to relate to anti‑oxidative stress and anti‑apoptosis.
左旋多巴(L-DOPA)是治疗帕金森病(PD)的金标准;然而,长期治疗与 L-DOPA 诱导的运动障碍(LID)的出现有关。黑质多巴胺能神经元的丧失决定了药物暴露的程度和 LID 初始发作所需的时间。越来越多的证据表明,α-硫辛酸(ALA)可减少这种黑质多巴胺能神经元的丧失。然而,到目前为止,ALA 在 LID 中的确切机制仅部分得到理解。慢性 L-DOPA 治疗被证明会发展出强烈的 AIMS 评分来评估运动障碍症状。LID 组的大鼠每天两次接受 L-DOPA+benserazide 治疗 3 周,以诱导运动障碍大鼠模型。此外,其他 6-OHDA 损伤的大鼠用 ALA(31.5mg/kg 或 63mg/kg)与 L-DOPA 联合治疗。此外,作者通过 Western blot 和免疫荧光法研究了黑质中丙二醛(MDA)和谷胱甘肽(GSH)活性以及 IBa-1、caspase-3 和多聚(ADP-核糖)聚合酶(PARP)的水平。ALA 以剂量依赖性方式减轻 LID,而不影响 L-DOPA 的抗 PD 作用。此外,ALA 降低 MDA 水平,上调 GSH 活性,并改善黑质中 IBa-1 阳性神经元。最后,确定 ALA 可减少黑质中 L-DOPA 诱导的裂解 caspase-3 和 PARP 过表达。基于目前的发现,ALA 可作为一种有前途的疾病修饰疗法,与 L-DOPA 联合用于 PD 早期。虽然其确切机制尚不完全清楚,但似乎与抗氧化应激和抗细胞凋亡有关。