Kornhuber J, Weller M, Schoppmeyer K, Riederer P
Department of Psychiatry, University of Würzburg, Federal Republic of Germany.
J Neural Transm Suppl. 1994;43:91-104.
The pharmacological inhibition of excitatory amino acid neurotransmission has evolved to be a major topic in neuropharmacology since enhanced synaptic action of glutamate and possibly other related neurotransmitters has been suggested to play a role both in acute neurological conditions such as ischemia and epilepsy and in chronic degenerative neurological diseases including Parkinson's disease, Huntington's disease and Alzheimer's disease. While antagonists at N-methyl-D-aspartate (NMDA) type glutamate receptors include psychotomimetic and neurotoxic agents such as phencyclidine and MK-801, the aminoadamantanes represent a class of drugs which may be largely free of such actions and which have already been used clinically as antiviral and antiparkinsonian agents. Multiple in vitro studies have recently delineated the neuroprotective properties of amantadine, and of its more potent congener, memantine, which appear to mediate neuroprotection via inhibition of NMDA receptor-dependent glutamate activity. Thus, neuroprotection targeting glutamate receptors does apparently not have to be associated with prominent psychotogenicity, and the development and evaluation of new neuroprotective drugs will have to performed in consideration both of the relative safety and of the good clinical effect of the already known and established aminoadamantanes.
兴奋性氨基酸神经传递的药理学抑制已成为神经药理学中的一个主要课题,因为谷氨酸以及可能其他相关神经递质的突触作用增强,被认为在急性神经疾病如缺血和癫痫以及慢性退行性神经疾病包括帕金森病、亨廷顿病和阿尔茨海默病中都起作用。虽然N-甲基-D-天冬氨酸(NMDA)型谷氨酸受体拮抗剂包括拟精神病药和神经毒性剂如苯环利定和MK-801,但金刚烷胺类药物可能基本没有此类作用,并且已在临床上用作抗病毒和抗帕金森病药物。最近多项体外研究阐明了金刚烷胺及其更强效的同系物美金刚的神经保护特性,它们似乎通过抑制NMDA受体依赖性谷氨酸活性来介导神经保护作用。因此,针对谷氨酸受体的神经保护显然不一定与显著的致幻性相关,新神经保护药物的研发和评估必须考虑已知和已确立的金刚烷胺类药物的相对安全性和良好临床效果。
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