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左旋多巴诱发异动症的研究进展:从动物模型到人类疾病

Research advances on L-DOPA-induced dyskinesia: from animal models to human disease.

作者信息

Chen Xi, Wang Yuanyuan, Wu Haifeng, Cheng Cheng, Le Weidong

机构信息

Liaoning Provincial Center for Clinical Research on Neurological Disease, the First Affiliated Hospital, Dalian Medical University, Dalian, 116021, People's Republic of China.

Liaoning Provincial Key Laboratory for Research on Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian, 116021, People's Republic of China.

出版信息

Neurol Sci. 2020 Aug;41(8):2055-2065. doi: 10.1007/s10072-020-04333-5. Epub 2020 Mar 17.

Abstract

L-3,4-dihydroxyphenylalanine (L-DOPA) was introduced about half a century ago and is still the most effective medicine for the treatment of Parkinson's disease (PD). However, such chronic treatment eventually leads to L-DOPA-induced dyskinesia (LID) on the majority of PD patients. Besides L-DOPA, dopamine agonists are able to induce dyskinesia as well. So far no drug is yet claimed to effectively curb LID, and amantadine has only a modest benefit on LID patients. Thus, understanding the molecular mechanisms behind LID is urgently needed, and developing new antiparkinsonian medications with low dyskinesia potential is necessarily required. In the last decades, several animal models have been generated for these aims. 1-Methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP)-lesioned monkey models always considered as gold standard of PD studies are also applied well for the research of LID. Additionally, several rodent models were developed for such clinical needs. Of them, 6-hydroxydopamine (OHDA)-lesioned rats or mice exhibiting countable abnormal involuntary movements (AIMs) after L-DOPA treatments have becoming widely applicable tools for LID pathogenesis studies. Under investigating these models for years, multiple potential LID-associated genes and pathways have been innovatively identified, which largely advance the therapeutic and preventative strategies for the disease. In this review, we attempt to update the recent findings represented in LID animal models and trial studies, which may facilitate the mechanistic understanding, drug development, and clinical evaluation of this movement disorder.

摘要

左旋3,4-二羟基苯丙氨酸(L-多巴)大约在半个世纪前被引入,至今仍是治疗帕金森病(PD)最有效的药物。然而,这种长期治疗最终会导致大多数PD患者出现左旋多巴诱导的运动障碍(LID)。除了L-多巴,多巴胺激动剂也能够诱发运动障碍。到目前为止,尚无药物被宣称能有效抑制LID,金刚烷胺对LID患者只有一定程度的益处。因此,迫切需要了解LID背后的分子机制,并且必须开发出具有低运动障碍风险的新型抗帕金森病药物。在过去几十年里,为实现这些目标已建立了多种动物模型。1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)损伤的猴子模型一直被视为PD研究的金标准,也很好地应用于LID的研究。此外,还针对此类临床需求开发了几种啮齿动物模型。其中,经6-羟基多巴胺(OHDA)损伤的大鼠或小鼠在接受L-多巴治疗后会出现可计数的异常不自主运动(AIMs),已成为LID发病机制研究中广泛应用的工具。在对这些模型进行多年研究之后,已创新性地鉴定出多个与LID相关的潜在基因和途径,这在很大程度上推动了该疾病的治疗和预防策略。在本综述中,我们试图更新LID动物模型和试验研究中的最新发现,这可能有助于对这种运动障碍的机制理解、药物开发及临床评估。

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