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溴隐亭:这种帕金森病药物在心血管疾病管理中发挥作用吗?

Bromocriptine: does this drug of Parkinson's disease have a role in managing cardiovascular diseases?

作者信息

Kutikuppala Lakshmi Venkata Simhachalam, Sharma Sushil, Chavan Madhavrao, Rangari Gaurav, Misra Arup Kumar, Innamuri Sai Ram, Vijayakumar Tejus, Varshitha Golla

机构信息

Department of Pharamacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, India.

Department of General Medicine, International School of Medicine (ISM), Bishkek, Kyrgyzstan.

出版信息

Ann Med Surg (Lond). 2023 Dec 19;86(2):926-929. doi: 10.1097/MS9.0000000000001642. eCollection 2024 Feb.

Abstract

Cardiovascular disease (CVD) is the most common cause of morbidity and mortality worldwide. Bromocriptine is a partial antagonist for D1 dopamine receptors while also serving as a selective agonist on D2 dopamine receptors as a dopamine receptor agonist. Apart from prolactin inhibiting action, bromocriptine has some beneficial effects on the blood pressure, plasma norepinephrine levels and vascular resistance. Dopamine D2 receptor activation of bromocriptine is associated with the antihypertensive effect, which lowers blood pressure via inhibiting sympathetic nerve activity and Na/K ATPase activity. Plasma levels of the pro-inflammatory cytokines such as interleukin (IL)-1B and IL-18, chemokine CCL2/ MCP-1/, and the pro-inflammatory hormone prolactin, all of which are elevated and linked to accelerated cardiometabolic illness, were decreased because of bromocriptine therapy. The most common side effects of Bromocriptine use are dizziness, nausea, headache, vomiting and hypotension. Bromocriptine is mainly contraindicated in patients with syncope with hypotension, psychosis, and type I diabetes mellitus. The authors suggest that developing therapies directed to increase D2 receptor expression and function by drugs like Bromocriptine can provide practical and novelistic approaches to prevent and manage myocardial and renal injury in the cardiovascular disease patients.

摘要

心血管疾病(CVD)是全球发病和死亡的最常见原因。溴隐亭是D1多巴胺受体的部分拮抗剂,同时作为多巴胺受体激动剂对D2多巴胺受体起选择性激动作用。除抑制催乳素作用外,溴隐亭对血压、血浆去甲肾上腺素水平和血管阻力有一些有益作用。溴隐亭的多巴胺D2受体激活与降压作用相关,其通过抑制交感神经活动和钠钾ATP酶活性来降低血压。由于溴隐亭治疗,促炎细胞因子如白细胞介素(IL)-1β和IL-18、趋化因子CCL2/MCP-1/以及促炎激素催乳素的血浆水平均降低,所有这些均升高并与加速的心脏代谢疾病相关。使用溴隐亭最常见的副作用是头晕、恶心、头痛、呕吐和低血压。溴隐亭主要禁用于伴有低血压的晕厥、精神病和I型糖尿病患者。作者建议,开发像溴隐亭这样的药物来增加D2受体表达和功能的疗法,可以为预防和管理心血管疾病患者的心肌和肾损伤提供实用且新颖的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ec0/10849299/feb62bf245d0/ms9-86-0926-g001.jpg

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