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在帕金森病中获得神经保护的尝试。

Attempts to obtain neuroprotection in Parkinson's disease.

作者信息

Olanow C W

机构信息

Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA.

出版信息

Neurology. 1997 Jul;49(1 Suppl 1):S26-33. doi: 10.1212/wnl.49.1_suppl_1.s26.

Abstract

It is suggested that oxidant stress is a contributing factor in the pathogenesis of Parkinson's disease (PD). Oxidant stress may contribute to cell death in PD because oxidative metabolism of dopamine has the potential to yield highly reactive and cytotoxic free radicals. Evidence for this hypothesis includes: (1) increased dopamine turnover with increased hydrogen peroxide formation; (2) decreased glutathione availability; and (3) increased reactive iron in the brains of patients with PD. Antioxidant therapies might be neuroprotective and could slow the clinical progression of the disease whereas metabolites of levodopa therapy may accelerate the rate of neuronal degeneration. Laboratory studies demonstrate that both selegiline and dopamine agonists can provide neuroprotective benefits. Selegiline-treated patients require less levodopa and have a delay in the progression of parkinsonian signs and symptoms. Dopamine agonists provide antiparkinson benefits and also diminish the need for levodopa.

摘要

有人认为氧化应激是帕金森病(PD)发病机制中的一个促成因素。氧化应激可能导致PD中的细胞死亡,因为多巴胺的氧化代谢有可能产生高反应性和细胞毒性的自由基。这一假说的证据包括:(1)多巴胺周转增加,过氧化氢生成增加;(2)谷胱甘肽可用性降低;(3)PD患者大脑中的反应性铁增加。抗氧化疗法可能具有神经保护作用,并可减缓疾病的临床进展,而左旋多巴治疗的代谢产物可能会加速神经元变性的速度。实验室研究表明,司来吉兰和多巴胺激动剂都能提供神经保护益处。接受司来吉兰治疗的患者需要的左旋多巴较少,帕金森病体征和症状的进展会延迟。多巴胺激动剂具有抗帕金森病的益处,也减少了对左旋多巴的需求。

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