Laboratorio de Quimica Farmaceutica e Medicinal (PharMedChem), Universidade Federal do Amapa, Macapa, Amapa, Brazil.
Faculdade de Ciencias Farmaceuticas, Universidade Estadual Paulista (UNESP), Campus Araraquara, Departamento de Principios Ativos Naturais e Toxicologia, Araraquara, Sao Paulo, Brazil.
Mini Rev Med Chem. 2020;20(9):754-767. doi: 10.2174/1389557519666191104110908.
Parkinson's Disease (PD) is the second most common neurodegenerative disease in the elderly population, with a higher prevalence in men, independent of race and social class; it affects approximately 1.5 to 2.0% of the elderly population over 60 years and 4% for those over 80 years of age. PD is caused by the necrosis of dopaminergic neurons in the substantia nigra, which is the brain region responsible for the synthesis of the neurotransmitter dopamine (DA), resulting in its decrease in the synaptic cleft. The monoamine oxidase B (MAO-B) degrades dopamine, promoting the glutamate accumulation and oxidative stress with the release of free radicals, causing excitotoxicity. The PD symptoms are progressive physical limitations such as rigidity, bradykinesia, tremor, postural instability and disability in functional performance. Considering that there are no laboratory tests, biomarkers or imaging studies to confirm the disease, the diagnosis of PD is made by analyzing the motor features. There is no cure for PD, and the pharmacological treatment consists of a dopaminergic supplement with levodopa, COMT inhibitors, anticholinergics agents, dopaminergic agonists, and inhibitors of MAO-B, which basically aims to control the symptoms, enabling better functional mobility and increasing life expectancy of the treated PD patients. Due to the importance and increasing prevalence of PD in the world, this study reviews information on the pathophysiology, symptomatology as well as the most current and relevant treatments of PD patients.
帕金森病(PD)是老年人中第二常见的神经退行性疾病,男性患病率高于女性,与种族和社会阶层无关;它影响大约 1.5%至 2.0%的 60 岁以上老年人,4%的 80 岁以上老年人。PD 是由黑质中多巴胺能神经元的坏死引起的,黑质是负责合成神经递质多巴胺(DA)的大脑区域,导致其在突触间隙中减少。单胺氧化酶 B(MAO-B)降解多巴胺,促进谷氨酸的积累和氧化应激,释放自由基,导致兴奋性毒性。PD 的症状是进行性的身体限制,如僵硬、运动迟缓、震颤、姿势不稳和功能表现障碍。由于没有实验室测试、生物标志物或影像学研究来确认疾病,PD 的诊断是通过分析运动特征来做出的。目前还没有治愈 PD 的方法,药物治疗包括用左旋多巴补充多巴胺、儿茶酚-O-甲基转移酶抑制剂、抗胆碱能药物、多巴胺激动剂和 MAO-B 抑制剂,主要目的是控制症状,使治疗后的 PD 患者能够更好地移动并提高预期寿命。由于 PD 在世界上的重要性和日益增加的流行率,本研究综述了 PD 的病理生理学、症状学以及最新和相关的治疗信息。