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(-)去甲丙咪嗪(司来吉兰)对帕金森病和阿尔茨海默病有益作用的药理学基础。

The pharmacological basis of the beneficial effects of (-)deprenyl (selegiline) in Parkinson's and Alzheimer's diseases.

作者信息

Knoll J

机构信息

Department of Pharmacology, Semmelweis University of Medicine, Budapest, Hungary.

出版信息

J Neural Transm Suppl. 1993;40:69-91.

PMID:8294902
Abstract

(-)Deprenyl (Selegiline, Jumex, Eldepryl, Movergan), structurally closely related to phenylethylamine (PEA), is a drug with a unique pharmacological spectrum. It is a highly potent and selective irreversible inhibitor of B-type monoamine oxidase (MAO) and interferes with the uptake of catecholamines and indirectly acting symphathomimetics. In striking contrast to PEA and its relatives, which displace the transmitter from the storage places, (-)deprenyl inhibits the releasing effect of tyramine and is up to the present the only safe MAO inhibitor which can be administered without dietary restrictions. Maintenance on (-)deprenyl enhances selectively superoxide dismutase (SOD) and catalase activities in the striatum. This effect is unrelated to the MAO and uptake inhibitory effects of the drug. Maintenance on (-)deprenyl facilitates the activity of the nigrostriatal dopaminergic neurons with remarkable selectivity and this effect too, is unrelated to either the MAO or the uptake inhibitory effects of the drug. Maintenance on (-)deprenyl prevents the characteristic age-related morphological changes in the neuromelanin granules of the neurocytes in the substantia nigra. As a consequence of its complex spectrum of activity male rats maintained on (-)deprenyl live longer, lose their capacity to ejaculate later, show improved performance in learning tests and maintain this activity for a longer period than their untreated peers. Patients with Parkinson's disease maintained on levodopa plus (-)deprenyl (10 mg daily) live significantly longer than those on levodopa alone. Freshly diagnosed patients treated with (-)deprenyl need levodopa later than their placebo-treated peers. Continuous administration of (-)deprenyl improves the performance of patients with Alzheimer's disease.

摘要

(-)司来吉兰(丙炔苯丙胺、Jumex、Eldepryl、Movergan)在结构上与苯乙胺(PEA)密切相关,是一种具有独特药理谱的药物。它是一种高效且选择性的不可逆B型单胺氧化酶(MAO)抑制剂,可干扰儿茶酚胺的摄取以及间接作用的拟交感神经药。与PEA及其同类物显著不同的是,后者会将递质从储存部位置换出来,而(-)司来吉兰可抑制酪胺的释放作用,并且是目前唯一一种无需饮食限制即可使用的安全MAO抑制剂。持续使用(-)司来吉兰可选择性增强纹状体中超氧化物歧化酶(SOD)和过氧化氢酶的活性。这种作用与该药物的MAO和摄取抑制作用无关。持续使用(-)司来吉兰可显著选择性地促进黑质纹状体多巴胺能神经元的活性,并且这种作用同样与该药物的MAO或摄取抑制作用无关。持续使用(-)司来吉兰可防止黑质神经细胞中神经黑色素颗粒出现与年龄相关的特征性形态变化。由于其复杂的活性谱,持续使用(-)司来吉兰的雄性大鼠寿命更长,射精能力丧失更晚,在学习测试中表现更佳,并且与未治疗的同龄大鼠相比,这种活性可维持更长时间。接受左旋多巴加(-)司来吉兰(每日10毫克)治疗的帕金森病患者的寿命明显长于仅接受左旋多巴治疗的患者。与接受安慰剂治疗的同龄患者相比,刚被诊断出的患者使用(-)司来吉兰后需要左旋多巴的时间更晚。持续使用(-)司来吉兰可改善阿尔茨海默病患者的表现。

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