Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Cells. 2022 Nov 23;11(23):3736. doi: 10.3390/cells11233736.
The most commonly used treatment for Parkinson's disease (PD) is levodopa, prescribed in conjunction with carbidopa. Virtually all patients with PD undergo dopamine replacement therapy using levodopa during the course of the disease's progression. However, despite the fact that levodopa is the "gold standard" in PD treatments and has the ability to significantly alleviate PD symptoms, it comes with side effects in advanced PD. Levodopa replacement therapy remains the current clinical treatment of choice for Parkinson's patients, but approximately 80% of the treated PD patients develop levodopa-induced dyskinesia (LID) in the advanced stages of the disease. A better understanding of the pathological mechanisms of LID and possible means of improvement would significantly improve the outcome of PD patients, reduce the complexity of medication use, and lower adverse effects, thus, improving the quality of life of patients and prolonging their life cycle. This review assesses the recent advancements in understanding the underlying mechanisms of LID and the therapeutic management options available after the emergence of LID in patients. We summarized the pathogenesis and the new treatments for LID-related PD and concluded that targeting pathways other than the dopaminergic pathway to treat LID has become a new possibility, and, currently, amantadine, drugs targeting 5-hydroxytryptamine receptors, and surgery for PD can target the Parkinson's symptoms caused by LID.
左旋多巴是治疗帕金森病（PD）最常用的方法，常与卡比多巴联合使用。几乎所有 PD 患者在疾病进展过程中都接受左旋多巴的多巴胺替代疗法。然而，尽管左旋多巴是 PD 治疗的“金标准”，并且能够显著缓解 PD 症状，但它在晚期 PD 中也有副作用。左旋多巴替代疗法仍然是目前治疗帕金森病患者的首选临床治疗方法，但大约 80%的接受治疗的 PD 患者在疾病的晚期会出现左旋多巴诱导的运动障碍（LID）。更好地了解 LID 的病理机制和可能的改善方法将显著改善 PD 患者的预后，降低药物使用的复杂性，并降低不良反应，从而提高患者的生活质量并延长其生命周期。这篇综述评估了对 LID 潜在机制的理解的最新进展，以及在患者出现 LID 后可用的治疗管理选择。我们总结了 LID 相关 PD 的发病机制和新的治疗方法，并得出结论，针对除多巴胺能途径以外的途径来治疗 LID 已成为一种新的可能性，目前，金刚烷胺、针对 5-羟色胺受体的药物和 PD 手术都可以针对 LID 引起的帕金森症状。
Zotero 插件
