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腺苷 A 受体在运动控制中的作用:与帕金森病和运动障碍的相关性。

Role of adenosine A receptors in motor control: relevance to Parkinson's disease and dyskinesia.

机构信息

Neuroscience Institute - Cagliari, National Research Council of Italy (CNR), Building A, Cittadella Universitaria di Monserrato, 09042, Monserrato (CA), Italy.

Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Cagliari, Italy.

出版信息

J Neural Transm (Vienna). 2018 Aug;125(8):1273-1286. doi: 10.1007/s00702-018-1848-6. Epub 2018 Feb 2.

Abstract

Adenosine is an endogenous purine nucleoside that regulates several physiological functions, at the central and peripheral levels. Besides, adenosine has emerged as a major player in the regulation of motor behavior. In fact, adenosine receptors of the A subtype are highly enriched in the caudate-putamen, which is richly innervated by dopamine. Moreover, several studies in experimental animals have consistently demonstrated that the pharmacological antagonism of A receptors has a facilitatory influence on motor behavior. Taken together, these findings have envisaged A receptors as a promising target for symptomatic therapies aimed at ameliorating motor deficits. Accordingly, A receptor antagonists have been extensively studied as new agents for the treatment of Parkinson's disease (PD), the epitome of motor disorders. In this review, we provide an overview of the effects that adenosine A receptor antagonists elicit in rodent and primate experimental models of PD, with regard to the counteraction of motor deficits as well as to manifestation of dyskinesia and motor fluctuations. Moreover, we briefly present the results of clinical trials of A receptor antagonists in PD patients experiencing motor fluctuations, with particular regard to dyskinesia. Finally, we discuss the interaction between A receptor antagonists and serotonin receptor agonists, since combined administration of these drugs has recently emerged as a new potential therapeutic strategy in the treatment of dyskinesia.

摘要

腺苷是一种内源性嘌呤核苷,在中枢和外周水平调节多种生理功能。此外,腺苷已成为调节运动行为的主要参与者。事实上,A 亚型的腺苷受体在富含多巴胺的尾壳核中高度丰富。此外,几项实验动物研究一致表明,A 受体的药理学拮抗作用对运动行为具有促进作用。综上所述,这些发现将 A 受体视为一种有前途的治疗靶点,旨在改善运动缺陷的症状治疗。因此,A 受体拮抗剂已被广泛研究作为治疗帕金森病 (PD) 的新型药物,PD 是运动障碍的典型代表。在这篇综述中,我们概述了腺苷 A 受体拮抗剂在 PD 实验动物模型中产生的影响,包括对运动缺陷的对抗以及对运动障碍和运动波动的表现。此外,我们简要介绍了 A 受体拮抗剂在经历运动波动的 PD 患者中的临床试验结果,特别关注运动障碍。最后,我们讨论了 A 受体拮抗剂和 5-羟色胺受体激动剂之间的相互作用,因为这些药物的联合给药最近已成为治疗运动障碍的一种新的潜在治疗策略。

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