Eaker E Y, Bixler G B, Dunn A J, Moreshead W V, Mathias J R
Department of Medicine, College of Medicine, University of Florida, Gainesville 32610.
Am J Physiol. 1987 Dec;253(6 Pt 1):G809-15. doi: 10.1152/ajpgi.1987.253.6.G809.
Parkinsonian patients may have symptoms consistent with intestinal pseudo-obstruction, but a primary intestinal abnormality has not been shown. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), after conversion to a toxic metabolite via the monoamine oxidase system, can induce Parkinson's disease by destroying dopaminergic neurons in the substantia nigra in humans and primates. Rodents have some catecholamine depletion but much less so than primates. Using chronic bipolar electrodes on the proximal jejunum of Wistar rats, we show significant, chronic migrating myoelectric complex disruption (P less than 0.001) and prolongation of irregular spike activity (P less than 0.001). Pargyline (a monoamine oxidase inhibitor) pretreatment significantly blocked these myoelectric changes. Sinemet (L-dopa and carbidopa), given after MPTP to replete dopamine, decreased the MPTP-induced migrating myoelectric complex disruption. Jejunal myenteric plexus dopamine levels were significantly decreased (to 61% of control) after MPTP but after much higher doses than were required to disrupt migrating myoelectric complex activity (180 mg/kg total vs. 30 mg/kg). Dopamine in the central nervous system was not depleted. We conclude that MPTP causes intestinal myoelectric disruption (which can be blocked by pargyline and decreased by Sinemet) possibly through enteric, but not central, nervous system effects.
帕金森病患者可能出现与假性肠梗阻相符的症状,但尚未发现原发性肠道异常。1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)通过单胺氧化酶系统转化为有毒代谢产物后,可通过破坏人类和灵长类动物黑质中的多巴胺能神经元诱发帕金森病。啮齿动物会出现一些儿茶酚胺耗竭,但程度远低于灵长类动物。我们在Wistar大鼠的空肠近端使用慢性双极电极,发现存在显著的慢性移行性肌电复合波破坏(P<0.001)以及不规则锋电位活动延长(P<0.001)。帕吉林(一种单胺氧化酶抑制剂)预处理可显著阻断这些肌电变化。MPTP给药后给予息宁(左旋多巴和卡比多巴)以补充多巴胺,可减轻MPTP诱导的移行性肌电复合波破坏。MPTP给药后空肠肌间神经丛多巴胺水平显著降低(降至对照的61%),但所需剂量远高于破坏移行性肌电复合波活动所需剂量(总剂量180mg/kg对30mg/kg)。中枢神经系统中的多巴胺未出现耗竭。我们得出结论,MPTP可能通过影响肠神经系统而非中枢神经系统,导致肠道肌电破坏(可被帕吉林阻断,息宁可减轻)。