Maruyama W, Naoi M, Narabayashi H
Department of Neurology, Nagoya University School of Medicine, Japan.
J Neurol Sci. 1996 Jul;139(1):141-8.
The monoamines and their metabolites were analyzed in the intraventricular fluid of parkinsonian patients treated with L-DOPA alone or together with L-threo-3,4-dihydroxyphenylserine (L-threo-DOPS), the precursor amino acids of dopamine and noradrenaline, respectively. In the intraventricular fluid of the patients administered with L-DOPA, the level of dopamine metabolites were higher than control, suggesting enhanced turnover of dopamine in the brain. However, L-DOPA administration increased free noradrenaline only slightly, and did not affect serotonin and its metabolite. On the other hand, by administration of L-DOPA combined with L-threo-DOPS, the levels of monoamines increased in general, whereas the monoamine metabolites by catechol-O-methyltransferase were reduced compared with those in the patients treated with L-DOPA alone. Only a minor part of L-threo-DOPS was metabolized into noradrenaline by aromatic L-amino acid decarboxylase, and it was metabolized mainly by two other enzymes, catechol-O-methyltransferase and DOPS-aldolase in the brain. An overview of the metabolism of neurotransmitters in the brain proved to be useful to evaluate the therapeutic effects of these precursor amino acids.
在单独使用左旋多巴或与左旋苏式-3,4-二羟基苯丝氨酸(L-苏式-DOPS)联合治疗的帕金森病患者的脑室内液中,对单胺类及其代谢产物进行了分析,L-苏式-DOPS分别是多巴胺和去甲肾上腺素的前体氨基酸。在给予左旋多巴的患者的脑室内液中,多巴胺代谢产物的水平高于对照组,这表明脑中多巴胺的周转增强。然而,给予左旋多巴仅使游离去甲肾上腺素略有增加,且不影响血清素及其代谢产物。另一方面,通过给予左旋多巴与L-苏式-DOPS联合用药,单胺类水平总体上有所增加,而与单独使用左旋多巴治疗的患者相比,儿茶酚-O-甲基转移酶作用下的单胺代谢产物减少。只有一小部分L-苏式-DOPS被芳香族L-氨基酸脱羧酶代谢为去甲肾上腺素,它在脑中主要由另外两种酶,即儿茶酚-O-甲基转移酶和DOPS-醛缩酶代谢。事实证明,对脑中神经递质代谢的概述有助于评估这些前体氨基酸的治疗效果。