Leiva C
Servicio de Neurología, Hospital General Universitario de Alicante, España.
Rev Neurol. 1997 Dec;25(148):1957-63.
To review the main landmarks which led to the introduction of levadopa in the the treatment of Parkinson's disease and the impact of levadopatherapy.
The introduction of levadopa was based on the results of basic scientific investigations in neurochemistry and neuropharmacology. In 1959 the possibility of dopamine being a neurotransmissor, and the role it plays in motor control, had been discovered. In 1960, Hornykiewiez and Ehringer published a paper on the existence of a marked deficit of dopamine in the caudate nucleus and putamen of patients with Parkinson's disease. Almost simultaneously, Birkmayer and Barbeau treated their patients with levadopa for the first time. However, levadopa was not introduced into clinical practice until 1967 and 1969 when Cotzias published papers establishing the principles of levadopatherapy as we now know it. Introduction of levadopa produced a markedly beneficial effect on the course and mortality of Parkinson's disease. However, it was soon seen that progression of the disease was not halted and that undesirable side effects appeared in patients on long-term treatment. This has led to the development of strategies to prolong the beneficial effects of levadopa and minimize its side effects.
More than 25 years after the introduction of levadopatherapy, it is still the mainstay of the treatment of Parkinson's disease, in combination with other medical and surgical treatment. Definitive treatment, however, will have to wait until the cause of this illness is fully understood.
回顾导致左旋多巴被引入帕金森病治疗的主要里程碑事件以及左旋多巴治疗的影响。
左旋多巴的引入基于神经化学和神经药理学的基础科学研究成果。1959年，多巴胺作为神经递质的可能性及其在运动控制中的作用被发现。1960年，霍尼基维茨和埃林格发表了一篇关于帕金森病患者尾状核和壳核中多巴胺显著缺乏的论文。几乎与此同时，比尔克迈尔和巴贝au首次用左旋多巴治疗他们的患者。然而，直到1967年和1969年科齐亚斯发表论文确立了我们现在所熟知的左旋多巴治疗原则后，左旋多巴才被引入临床实践。左旋多巴的引入对帕金森病的病程和死亡率产生了显著的有益影响。然而，很快就发现疾病的进展并未停止，并且长期治疗的患者出现了不良副作用。这导致了延长左旋多巴有益作用并将其副作用降至最低的策略的发展。
左旋多巴治疗引入25年多后，它仍然是帕金森病治疗的主要手段，与其他药物和手术治疗相结合。然而，确定性的治疗必须等到这种疾病的病因被完全了解之后。
