Ciarrocchi Davide, Pecoraro Pasquale Maria, Zompanti Alessandro, Pennazza Giorgio, Santonico Marco, di Biase Lazzaro
Unit of Electronics for Sensor Systems, Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
Operative Research Unit of Neurology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Rome, Italy.
J Clin Med. 2024 Dec 7;13(23):7458. doi: 10.3390/jcm13237458.
Since its first introduction, levodopa has remained the cornerstone treatment for Parkinson's disease. However, as the disease advances, the therapeutic window for levodopa narrows, leading to motor complications like fluctuations and dyskinesias. Clinicians face challenges in optimizing daily therapeutic regimens, particularly in advanced stages, due to the lack of quantitative biomarkers for continuous motor monitoring. Biochemical sensing of levodopa offers a promising approach for real-time therapeutic feedback, potentially sustaining an optimal motor state throughout the day. These sensors vary in invasiveness, encompassing techniques like microdialysis, electrochemical non-enzymatic sensing, and enzymatic approaches. Electrochemical sensing, including wearable solutions that utilize reverse iontophoresis and microneedles, is notable for its potential in non-invasive or minimally invasive monitoring. Point-of-care devices and standard electrochemical cells demonstrate superior performance compared to wearable solutions; however, this comes at the cost of wearability. As a result, they are better suited for clinical use. The integration of nanomaterials such as carbon nanotubes, metal-organic frameworks, and graphene has significantly enhanced sensor sensitivity, selectivity, and detection performance. This framework paves the way for accurate, continuous monitoring of levodopa and its metabolites in biofluids such as sweat and interstitial fluid, aiding real-time motor performance assessment in Parkinson's disease. This review highlights recent advancements in biochemical sensing for levodopa and catecholamine monitoring, exploring emerging technologies and their potential role in developing closed-loop therapy for Parkinson's disease.
自首次引入以来，左旋多巴一直是帕金森病的基石治疗药物。然而，随着疾病进展，左旋多巴的治疗窗口变窄，导致诸如波动和异动症等运动并发症。由于缺乏用于持续运动监测的定量生物标志物，临床医生在优化每日治疗方案时面临挑战，尤其是在疾病晚期。左旋多巴的生化传感为实时治疗反馈提供了一种有前景的方法，有可能全天维持最佳运动状态。这些传感器的侵入性各不相同，包括微透析、电化学非酶传感和酶法等技术。电化学传感，包括利用反向离子电渗疗法和微针的可穿戴解决方案，因其在非侵入性或微创监测方面的潜力而备受关注。即时检测设备和标准电化学电池相比可穿戴解决方案具有更优越的性能；然而，这是以牺牲可穿戴性为代价的。因此，它们更适合临床使用。碳纳米管、金属有机框架和石墨烯等纳米材料的整合显著提高了传感器的灵敏度、选择性和检测性能。该框架为准确、持续监测汗液和组织间液等生物流体中的左旋多巴及其代谢物铺平了道路，有助于帕金森病的实时运动性能评估。本综述重点介绍了左旋多巴和儿茶酚胺监测的生化传感方面的最新进展，探讨了新兴技术及其在开发帕金森病闭环治疗中的潜在作用。
