1
|
Ayuso P, Jiménez-Jiménez FJ, Gómez-Tabales J, Alonso-Navarro H, García-Martín E, Agúndez JAG. An update on the pharmacogenetic considerations when prescribing dopamine receptor agonists for Parkinson's disease. Expert Opin Drug Metab Toxicol 2023; 19:447-460. [PMID: 37599424 DOI: 10.1080/17425255.2023.2249404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/31/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Parkinson's disease is a chronic neurodegenerative multisystemic disorder that affects approximately 2% of the population over 65 years old. This disorder is characterized by motor symptoms which are frequently accompanied by non-motor symptoms such as cognitive disorders. Current drug therapies aim to reduce the symptoms and increase the patient's life expectancy. Nevertheless, there is heterogeneity in therapy response in terms of efficacy and adverse effects. This wide range in response may be linked to genetic variability. Thus, it has been suggested that pharmacogenomics may help to tailor and personalize drug therapy for Parkinson's disease. AREAS COVERED This review describes and updates the clinical impact of genetic factors associated with the efficacy and adverse drug reactions related to common medications used to treat Parkinson's disease. Additionally, we highlight current informative recommendations for the drug treatment of Parkinson's disease. EXPERT OPINION The pharmacokinetic, pharmacodynamic, and safety profiles of Parkinson's disease drugs do not favor the development of pharmacogenetic tests with a high probability of success. The chances of obtaining ground-breaking pharmacogenetics biomarkers for Parkinson's disease therapy are limited. Nevertheless, additional information on the metabolism of certain drugs, and an analysis of the potential of pharmacogenetics in novel drugs could be of interest.
Collapse
Affiliation(s)
- Pedro Ayuso
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
| | | | - Javier Gómez-Tabales
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
| | | | - Elena García-Martín
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
| | - José A G Agúndez
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
| |
Collapse
|
2
|
Vuletić V, Rački V, Papić E, Peterlin B. A Systematic Review of Parkinson's Disease Pharmacogenomics: Is There Time for Translation into the Clinics? Int J Mol Sci 2021; 22:ijms22137213. [PMID: 34281267 PMCID: PMC8268929 DOI: 10.3390/ijms22137213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/26/2021] [Accepted: 06/29/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most frequent neurodegenerative disease, which creates a significant public health burden. There is a challenge for the optimization of therapies since patients not only respond differently to current treatment options but also develop different side effects to the treatment. Genetic variability in the human genome can serve as a biomarker for the metabolism, availability of drugs and stratification of patients for suitable therapies. The goal of this systematic review is to assess the current evidence for the clinical translation of pharmacogenomics in the personalization of treatment for Parkinson's disease. METHODS We performed a systematic search of Medline database for publications covering the topic of pharmacogenomics and genotype specific mutations in Parkinson's disease treatment, along with a manual search, and finally included a total of 116 publications in the review. RESULTS We analyzed 75 studies and 41 reviews published up to December of 2020. Most research is focused on levodopa pharmacogenomic properties and catechol-O-methyltransferase (COMT) enzymatic pathway polymorphisms, which have potential for clinical implementation due to changes in treatment response and side-effects. Likewise, there is some consistent evidence in the heritability of impulse control disorder via Opioid Receptor Kappa 1 (OPRK1), 5-Hydroxytryptamine Receptor 2A (HTR2a) and Dopa decarboxylase (DDC) genotypes, and hyperhomocysteinemia via the Methylenetetrahydrofolate reductase (MTHFR) gene. On the other hand, many available studies vary in design and methodology and lack in sample size, leading to inconsistent findings. CONCLUSIONS This systematic review demonstrated that the evidence for implementation of pharmacogenomics in clinical practice is still lacking and that further research needs to be done to enable a more personalized approach to therapy for each patient.
Collapse
Affiliation(s)
- Vladimira Vuletić
- Clinic of Neurology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia; (V.R.); (E.P.)
- Department of Neurology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Correspondence:
| | - Valentino Rački
- Clinic of Neurology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia; (V.R.); (E.P.)
- Department of Neurology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Eliša Papić
- Clinic of Neurology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia; (V.R.); (E.P.)
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia;
| |
Collapse
|
3
|
Salles PA, Mata IF, Fernandez HH. Should we start integrating genetic data in decision-making on device-aided therapies in Parkinson disease? A point of view. Parkinsonism Relat Disord 2021; 88:51-57. [PMID: 34119931 DOI: 10.1016/j.parkreldis.2021.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/26/2021] [Accepted: 05/12/2021] [Indexed: 12/14/2022]
Abstract
Parkinson disease (PD) is a complex heterogeneous neurodegenerative disorder. Association studies have revealed numerous genetic risk loci and variants, and about 5-10% suffer from a monogenic form. Because the presentation and course of PD is unique to each patient, personalized symptomatic treatment should ideally be offered to treat the most disabling motor and non-motor symptoms. Indeed, clinical milestones and treatment complications that appear during disease progression are influenced by the genetic imprint. With recent advances in PD, more patients live longer to become eligible for device-aided therapies, such as apomorphine continuous subcutaneous infusion, levodopa duodenal gel infusion, and deep brain stimulation surgery, each with its own inclusion and exclusion criteria, advantages and disadvantages. Because genetic variants influence the expression of particular clinical profiles, factors for better or worse outcomes for device-aided therapies may then be proactively identified. For example, mutations in PRKN, LRRK2 and GBA express phenotypes that favor suitability for different device therapies, although with marked differences in the therapeutic window; whereas multiplications of SNCA express phenotypes that make them less desirable for device therapies.
Collapse
Affiliation(s)
- Philippe A Salles
- Center for Neurological Restoration, Cleveland Clinic Neurological Institute, OH, USA; Movement Disorders Center, CETRAM, Santiago, Chile.
| | - Ignacio F Mata
- Lerner Research Institute, Genomic Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
| | - Hubert H Fernandez
- Center for Neurological Restoration, Cleveland Clinic Neurological Institute, OH, USA.
| |
Collapse
|
4
|
Magistrelli L, Ferrari M, Furgiuele A, Milner AV, Contaldi E, Comi C, Cosentino M, Marino F. Polymorphisms of Dopamine Receptor Genes and Parkinson's Disease: Clinical Relevance and Future Perspectives. Int J Mol Sci 2021; 22:ijms22073781. [PMID: 33917417 PMCID: PMC8038729 DOI: 10.3390/ijms22073781] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/26/2021] [Accepted: 04/01/2021] [Indexed: 12/20/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disease caused by loss of dopaminergic neurons in the midbrain. PD is clinically characterized by a variety of motor and nonmotor symptoms, and treatment relies on dopaminergic replacement. Beyond a common pathological hallmark, PD patients may present differences in both clinical progression and response to drug therapy that are partly affected by genetic factors. Despite extensive knowledge on genetic variability of dopaminergic receptors (DR), few studies have addressed their relevance as possible influencers of clinical heterogeneity in PD patients. In this review, we summarized available evidence regarding the role of genetic polymorphisms in DR as possible determinants of PD development, progression and treatment response. Moreover, we examined the role of DR in the modulation of peripheral immunity, in light of the emerging role of the peripheral immune system in PD pathophysiology. A better understanding of all these aspects represents an important step towards the development of precise and personalized disease-modifying therapies for PD.
Collapse
Affiliation(s)
- Luca Magistrelli
- PhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, 21100 Varese, Italy; (L.M.); (A.F.)
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (A.V.M.); (E.C.)
| | - Marco Ferrari
- Centre of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy; (M.F.); (M.C.); (F.M.)
| | - Alessia Furgiuele
- PhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, 21100 Varese, Italy; (L.M.); (A.F.)
- Centre of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy; (M.F.); (M.C.); (F.M.)
| | - Anna Vera Milner
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (A.V.M.); (E.C.)
| | - Elena Contaldi
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (A.V.M.); (E.C.)
- PhD Program in Medical Sciences and Biotechnology, University of Piemonte Orientale, 28100 Novara, Italy
| | - Cristoforo Comi
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (A.V.M.); (E.C.)
- Centre of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy; (M.F.); (M.C.); (F.M.)
- Correspondence:
| | - Marco Cosentino
- Centre of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy; (M.F.); (M.C.); (F.M.)
- Center of Research in Neuroscience, University of Insubria, 21100 Varese, Italy
| | - Franca Marino
- Centre of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy; (M.F.); (M.C.); (F.M.)
- Center of Research in Neuroscience, University of Insubria, 21100 Varese, Italy
| |
Collapse
|
5
|
Dopamine Receptor D2 Gene (DRD2) Polymorphisms, Job Stress, and Their Interaction on Sleep Dysfunction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218174. [PMID: 33167416 PMCID: PMC7663844 DOI: 10.3390/ijerph17218174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/03/2020] [Indexed: 01/03/2023]
Abstract
Recent studies have shown that incessant job stress could eventually result in sleep dysfunction (SD), and most importantly, the essential role dopamine receptor D2 (DRD2) gene polymorphisms play in the psychopathological mechanism of SD. The Effort-Reward Imbalance scale and the Pittsburgh Sleep Quality Index were both used to access SD and job stress (JS). A significant negative correlation was observed between the sDA levels and SD subscale scores (sleep efficiency, daytime dysfunction). The findings revealed that high levels of JS were linked to a higher SD score (OR = 2.13, 95% CI: 1.46–3.12). Likewise, the homozygous A1A1 genotype of DRD2 rs1800497 was more likely to be associated with SD (OR = 2.90, 95% CI: 1.75–4.82). Compared to participants with low JS and heterozygous A1A2/A2A2 genotype, those with both high JS and homozygous A1A1 genotype had a higher SD score (OR = 5.40, 95% CI: 2.89–10.11). The A1 allele of the DRD2 rs1800497 polymorphism also enhances the likelihood of SD when undergoing JS. Besides, subjects with low JS and the homozygous A1A1 genotype also showed an increased possibility for sleep dysfunction (OR = 2.05, 95% CI: 1.03–4.11). Our results suggest that the DA system may interrelate with JS to affect sleep.
Collapse
|
6
|
Redenšek S, Dolžan V. The role of pharmacogenomics in the personalization of Parkinson's disease treatment. Pharmacogenomics 2020; 21:1033-1043. [PMID: 32893736 DOI: 10.2217/pgs-2020-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Parkinson's disease (PD)-related phenotypes can vary among patients substantially, including response to dopaminergic treatment in terms of efficacy and occurrence of adverse events. Many pharmacogenetic studies have already been conducted to find genetic markers of response to dopaminergic treatment. Integration of genetic and clinical data has already resulted in construction of clinical pharmacogenetic models for prediction of adverse events. However, the results of pharmacogenetic studies are inconsistent. More comprehensive genome-wide approaches are needed to find genetic biomarkers of PD-related phenotypes to better explain the variability in response to treatment. These genetic markers should be integrated with clinical, environmental, imaging, and other omics data to build clinically useful algorithms for personalization of PD management.
Collapse
Affiliation(s)
- Sara Redenšek
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| |
Collapse
|
7
|
Redenšek S, Flisar D, Kojović M, Gregorič Kramberger M, Georgiev D, Pirtošek Z, Trošt M, Dolžan V. Dopaminergic Pathway Genes Influence Adverse Events Related to Dopaminergic Treatment in Parkinson's Disease. Front Pharmacol 2019; 10:8. [PMID: 30745869 PMCID: PMC6360186 DOI: 10.3389/fphar.2019.00008] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/07/2019] [Indexed: 11/13/2022] Open
Abstract
Dopaminergic pathway is the most disrupted pathway in the pathogenesis of Parkinson's disease. Several studies reported associations of dopaminergic genes with the occurrence of adverse events of dopaminergic treatment. However, none of these studies adopted a pathway based approach. The aim of this study was to comprehensively evaluate the influence of selected single nucleotide polymorphisms of key dopaminergic pathway genes on the occurrence of motor and non-motor adverse events of dopaminergic treatment in Parkinson's disease. In total, 231 Parkinson's disease patients were enrolled. Demographic and clinical data were collected. Genotyping was performed for 16 single nucleotide polymorphisms from key dopaminergic pathway genes. Logistic and Cox regression analyses were used for evaluation. Results were adjusted for significant clinical data. We observed that carriers of at least one COMT rs165815 C allele had lower odds for developing visual hallucinations (OR = 0.34; 95% CI = 0.16-0.72; p = 0.004), while carriers of at least one DRD3 rs6280 C allele and CC homozygotes had higher odds for this adverse event (OR = 1.88; 95% CI = 1.00-3.54; p = 0.049 and OR = 3.31; 95% CI = 1.37-8.03; p = 0.008, respectively). Carriers of at least one DDC rs921451 C allele and CT heterozygotes had higher odds for orthostatic hypotension (OR = 1.86; 95% CI = 1.07-3.23; p = 0.028 and OR = 2.30; 95% CI = 1.26-4.20; p = 0.007, respectively). Heterozygotes for DDC rs3837091 and SLC22A1 rs628031 AA carriers also had higher odds for orthostatic hypotension (OR = 1.94; 95% CI = 1.07-3.51; p = 0.028 and OR = 2.57; 95% CI = 1.11-5.95; p = 0.028, respectively). Carriers of the SLC22A1 rs628031 AA genotype had higher odds for peripheral edema and impulse control disorders (OR = 4.00; 95% CI = 1.62-9.88; p = 0.003 and OR = 3.16; 95% CI = 1.03-9.72; p = 0.045, respectively). Finally, heterozygotes for SLC22A1 rs628031 and carriers of at least one SLC22A1 rs628031 A allele had lower odds for dyskinesia (OR = 0.48; 95% CI = 0.24-0.98, p = 0.043 and OR = 0.48; 95% CI = 0.25-0.92; p = 0.027, respectively). Gene-gene interactions, more specifically DDC-COMT, SLC18A2-SV2C, and SLC18A2-SLC6A3, also significantly influenced the occurrence of some adverse events. Additionally, haplotypes of COMT and SLC6A3 were associated with the occurrence of visual hallucinations (AT vs. GC: OR = 0.34; 95% CI = 0.16-0.72; p = 0.005) and orthostatic hypotension (ATG vs. ACG: OR = 2.48; 95% CI: 1.01-6.07; p = 0.047), respectively. Pathway based approach allowed us to identify new potential candidates for predictive biomarkers of adverse events of dopaminergic treatment in Parkinson's disease, which could contribute to treatment personalization.
Collapse
Affiliation(s)
- Sara Redenšek
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Dušan Flisar
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Maja Kojović
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Dejan Georgiev
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Zvezdan Pirtošek
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Maja Trošt
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
8
|
Ciccacci C, Borgiani P. Pharmacogenomics in Parkinson's disease: which perspective for developing a personalized medicine? Neural Regen Res 2019; 14:75-76. [PMID: 30531077 PMCID: PMC6263000 DOI: 10.4103/1673-5374.243706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Cinzia Ciccacci
- Department of Biomedicine and Prevention, Section of Genetics, School of Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Paola Borgiani
- Department of Biomedicine and Prevention, Section of Genetics, School of Medicine, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
9
|
Politi C, Ciccacci C, Novelli G, Borgiani P. Genetics and Treatment Response in Parkinson's Disease: An Update on Pharmacogenetic Studies. Neuromolecular Med 2018; 20:1-17. [PMID: 29305687 DOI: 10.1007/s12017-017-8473-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 12/29/2017] [Indexed: 01/11/2023]
Abstract
Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by a progressive loss of dopamine neurons of the central nervous system. The disease determines a significant disability due to a combination of motor symptoms such as bradykinesia, rigidity and rest tremor and non-motor symptoms such as sleep disorders, hallucinations, psychosis and compulsive behaviors. The current therapies consist in combination of drugs acting to control only the symptoms of the illness by the replacement of the dopamine lost. Although patients generally receive benefits from this symptomatic pharmacological management, they also show great variability in drug response in terms of both efficacy and adverse effects. Pharmacogenetic studies highlighted that genetic factors play a relevant influence in this drug response variability. In this review, we tried to give an overview of the recent progresses in the pharmacogenetics of PD, reporting the major genetic factors identified as involved in the response to drugs and highlighting the potential use of some of these genomic variants in the clinical practice. Many genes have been investigated and several associations have been reported especially with adverse drug reactions. However, only polymorphisms in few genes, including DRD2, COMT and SLC6A3, have been confirmed as associated in different populations and in large cohorts. The identification of genomic biomarkers involved in drug response variability represents an important step in PD treatment, opening the prospective of more personalized therapies in order to identify, for each person, the better therapy in terms of efficacy and toxicity and to improve the PD patients' quality of life.
Collapse
Affiliation(s)
- Cristina Politi
- Department of Biomedicine and Prevention, Genetics Section, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Cinzia Ciccacci
- Department of Biomedicine and Prevention, Genetics Section, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
| | - Giuseppe Novelli
- Department of Biomedicine and Prevention, Genetics Section, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Paola Borgiani
- Department of Biomedicine and Prevention, Genetics Section, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| |
Collapse
|
10
|
Lahut S, Gispert S, Ömür Ö, Depboylu C, Seidel K, Domínguez-Bautista JA, Brehm N, Tireli H, Hackmann K, Pirkevi C, Leube B, Ries V, Reim K, Brose N, den Dunnen WF, Johnson M, Wolf Z, Schindewolf M, Schrempf W, Reetz K, Young P, Vadasz D, Frangakis AS, Schröck E, Steinmetz H, Jendrach M, Rüb U, Başak AN, Oertel W, Auburger G. Blood RNA biomarkers in prodromal PARK4 and rapid eye movement sleep behavior disorder show role of complexin 1 loss for risk of Parkinson's disease. Dis Model Mech 2017; 10:619-631. [PMID: 28108469 PMCID: PMC5451169 DOI: 10.1242/dmm.028035] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/12/2017] [Indexed: 12/30/2022] Open
Abstract
Parkinson's disease (PD) is a frequent neurodegenerative process in old age. Accumulation and aggregation of the lipid-binding SNARE complex component α-synuclein (SNCA) underlies this vulnerability and defines stages of disease progression. Determinants of SNCA levels and mechanisms of SNCA neurotoxicity have been intensely investigated. In view of the physiological roles of SNCA in blood to modulate vesicle release, we studied blood samples from a new large pedigree with SNCA gene duplication (PARK4 mutation) to identify effects of SNCA gain of function as potential disease biomarkers. Downregulation of complexin 1 (CPLX1) mRNA was correlated with genotype, but the expression of other Parkinson's disease genes was not. In global RNA-seq profiling of blood from presymptomatic PARK4 indviduals, bioinformatics detected significant upregulations for platelet activation, hemostasis, lipoproteins, endocytosis, lysosome, cytokine, Toll-like receptor signaling and extracellular pathways. In PARK4 platelets, stimulus-triggered degranulation was impaired. Strong SPP1, GZMH and PLTP mRNA upregulations were validated in PARK4. When analysing individuals with rapid eye movement sleep behavior disorder, the most specific known prodromal stage of general PD, only blood CPLX1 levels were altered. Validation experiments confirmed an inverse mutual regulation of SNCA and CPLX1 mRNA levels. In the 3'-UTR of the CPLX1 gene we identified a single nucleotide polymorphism that is significantly associated with PD risk. In summary, our data define CPLX1 as a PD risk factor and provide functional insights into the role and regulation of blood SNCA levels. The new blood biomarkers of PARK4 in this Turkish family might become useful for PD prediction.
Collapse
Affiliation(s)
- Suna Lahut
- Experimental Neurology, Goethe University Medical School, Frankfurt/Main 60590, Germany
- NDAL, Boğaziçi University, Istanbul 34342, Turkey
| | - Suzana Gispert
- Experimental Neurology, Goethe University Medical School, Frankfurt/Main 60590, Germany
| | - Özgür Ömür
- Experimental Neurology, Goethe University Medical School, Frankfurt/Main 60590, Germany
- NDAL, Boğaziçi University, Istanbul 34342, Turkey
| | - Candan Depboylu
- Department of Neurology, Philipps University, Baldingerstrasse, Marburg 35043, Germany
| | - Kay Seidel
- Dr Senckenberg Chronomedical Institute, Goethe University, Frankfurt/Main 60590, Germany
| | | | - Nadine Brehm
- Experimental Neurology, Goethe University Medical School, Frankfurt/Main 60590, Germany
| | - Hülya Tireli
- Department of Neurology, Haydarpaşa Numune Training and Research Hospital, Istanbul 34668, Turkey
| | - Karl Hackmann
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, Dresden 01307, Germany
| | | | - Barbara Leube
- Institute of Human Genetics, Heinrich Heine University, Düsseldorf 40225, Germany
| | - Vincent Ries
- Department of Neurology, Philipps University, Baldingerstrasse, Marburg 35043, Germany
| | - Kerstin Reim
- Department of Molecular Neurobiology and Center for the Molecular Physiology of the Brain, Max Planck Institute of Experimental Medicine, Göttingen 37075, Germany
| | - Nils Brose
- Department of Molecular Neurobiology and Center for the Molecular Physiology of the Brain, Max Planck Institute of Experimental Medicine, Göttingen 37075, Germany
| | - Wilfred F den Dunnen
- Department of Pathology and Medical Biology, Medical Center, University, Groningen 9700 RB, The Netherlands
| | - Madrid Johnson
- Buchmann Institute for Molecular Life Sciences and Institute for Biophysics, Goethe University, Frankfurt/Main 60438, Germany
| | - Zsuzsanna Wolf
- Haemophilia Centre, Medical Clinic III, Institute of Immunohaematology and Transfusion Medicine, Goethe University, Frankfurt/Main 60590, Germany
| | - Marc Schindewolf
- Department of Internal Medicine, Division of Vascular Medicine and Hemostaseology, Goethe University, Frankfurt 60590, Germany
| | - Wiebke Schrempf
- Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität, Dresden 01307, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University Hospital, Aachen 52074, Germany
| | - Peter Young
- Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Münster, Münster 48149, Germany
| | - David Vadasz
- Department of Neurology, Philipps University, Baldingerstrasse, Marburg 35043, Germany
| | - Achilleas S Frangakis
- Buchmann Institute for Molecular Life Sciences and Institute for Biophysics, Goethe University, Frankfurt/Main 60438, Germany
| | - Evelin Schröck
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, Dresden 01307, Germany
| | - Helmuth Steinmetz
- Experimental Neurology, Goethe University Medical School, Frankfurt/Main 60590, Germany
| | - Marina Jendrach
- Experimental Neurology, Goethe University Medical School, Frankfurt/Main 60590, Germany
| | - Udo Rüb
- Dr Senckenberg Chronomedical Institute, Goethe University, Frankfurt/Main 60590, Germany
| | | | - Wolfgang Oertel
- Department of Neurology, Philipps University, Baldingerstrasse, Marburg 35043, Germany
| | - Georg Auburger
- Experimental Neurology, Goethe University Medical School, Frankfurt/Main 60590, Germany
| |
Collapse
|
11
|
Lim EW, Tan EK. Genes and Nonmotor Symptoms in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:111-127. [DOI: 10.1016/bs.irn.2017.05.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
12
|
Corvol JC, Poewe W. Pharmacogenetics of Parkinson's Disease in Clinical Practice. Mov Disord Clin Pract 2016; 4:173-180. [PMID: 30363349 DOI: 10.1002/mdc3.12444] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 08/12/2016] [Accepted: 08/29/2016] [Indexed: 12/13/2022] Open
Abstract
Background Pharmacogenetics aims to identify the genetic factors participating in the heterogeneity of drug response. The ultimate goal is to provide personalized treatment by identifying responders and non-responders, individuals at risk of developing drug adverse effects, and by adjusting dosage. Several studies have been performed in Parkinson's disease (PD), to investigate drug response variability according to genetic factors for dopamine replacement therapies. Methods We performed a systematic literature search of articles related to pharmacogenetic studies in PD, and found 47 studies. Findings Motor response and adverse reactions to dopaminergic drugs were associated with genes encoding enzymes of their metabolism as well as their receptors or targets. Despite some interesting results, considerable work remains to be done to replicate and validate their clinical relevance before translation into clinical practice. Conclusions There are currently no guidelines published for pharmacogenetic factors related to PD drugs. More research is need in this field in order to improve our knowledge in drug response variability in PD. Algorithms taking into account clinical, pharmacological, and genetic factors are probably the most promising way to help for a personalized medicine in PD.
Collapse
Affiliation(s)
- Jean-Christophe Corvol
- Sorbonne Universités UPMC Univ Paris 06 UMR_S1127 ICM Paris France.,INSERM UMR_S1127 and CIC-1422 ICM Paris France.,CNRS UMR_7225 ICM Paris France.,Département des maladies du système nerveux AP-HP Hôpital Pitié-Salpêtrière Paris France
| | - Werner Poewe
- Department of Neurology Medical University Innsbruck Innsbruck Austria
| |
Collapse
|
13
|
Kim HJ, Jeon B. How close are we to individualized medicine for Parkinson's disease? Expert Rev Neurother 2016; 16:815-30. [PMID: 27105072 DOI: 10.1080/14737175.2016.1182021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION There is a considerable inter-individual heterogeneity in clinical features, disease course, and treatment response in Parkinson's disease (PD), which can be explained not only by disease process and clinical variables, but also by an impact from genetic factors. Evidence-based medicine relies on large randomized control trials and meta-analysis-average medicine, which ignores individual differences. However, we are now in the early phases of a paradigm shift in medicine relating to individuality and variability. The purpose of individualized medicine is to predict patients' responses to targeted therapy using diagnostic tests based on genetics or other molecular mechanisms, thus providing the right drug at the right dose at the right time. AREAS COVERED In this article, we outline current state of individualized medicine for PD. Expert Commentary: Pharmacogenomics, an important element of individualized medicine, is just beginning to be considered in PD. To advance the clinical use of pharmacogenomics, big data cohort for genomic research and multidisciplinary team approaches are necessary.
Collapse
Affiliation(s)
- Hee Jin Kim
- a Department of Neurology , Konkuk University Medical Center , Seoul , South Korea.,b Parkinson Disease Study Group , Seoul National University Hospital , Seoul , South Korea
| | - Beomseok Jeon
- a Department of Neurology , Konkuk University Medical Center , Seoul , South Korea.,c Department of Neurology and Movement Disorder Center, College of Medicine , Seoul National University , Seoul , South Korea
| |
Collapse
|
14
|
Kurzawski M, Białecka M, Droździk M. Pharmacogenetic considerations in the treatment of Parkinson's disease. Neurodegener Dis Manag 2016; 5:27-35. [PMID: 25711452 DOI: 10.2217/nmt.14.38] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Recently, a lot of progress has been made in the identification of genetic biomarkers of drug response. Efforts to define the role of genetic polymorphisms in optimizing pharmacotherapy of Parkinson's disease were also undertaken. This report presents the current state of knowledge on pharmacogenetics of PD, including genes encoding enzymes involved in drug metabolism, drug transporters and direct targets of antiparkinsonian drugs. In most of cases, available data on pharmacogenetic factors that could turn out to be significant modifiers of therapy with anti-PD drugs is still very incomplete and makes it impossible to reach final conclusion about their usefulness in the clinic. More extensive studies, in more uniform, large patient groups, including genome-wide association studies, should be undertaken to finally confirm or deny the value of genetic tests in PD therapy individualization.
Collapse
Affiliation(s)
- Mateusz Kurzawski
- Department of Experimental & Clinical Pharmacology, Pomeranian Medical University, Szczecin, Poland
| | | | | |
Collapse
|
15
|
Qiu C, Frederick IO, Sorensen T, Aurora SK, Gelaye B, Enquobahrie DA, Williams MA. Sleep disturbances among pregnant women with history of migraines: A cross-sectional study. Cephalalgia 2015; 35:1092-102. [PMID: 25633375 PMCID: PMC4519425 DOI: 10.1177/0333102415570493] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 12/26/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Migraine is associated with sleep disturbances in men and non-pregnant women. However, relatively little is known about sleep disturbances among pregnant migraineurs. We investigated sleep disturbances among pregnant women with and without history of migraine. METHODS This cross-sectional study was conducted among 1324 women who were recruited during early pregnancy. Migraine diagnoses were based on the International Classification of Headache Disorders-II criteria. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to evaluate sleep-related characteristics including sleep duration, sleep quality, excessive daytime sleepiness, and other sleep traits. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS Migraineurs were more likely than non-migraineurs to report short sleep duration (<6.5 hours) (AOR = 1.47, 95% CI 1.07-2.02), poor sleep quality (PSQI>5) (AOR = 1.73, 95% CI 1.35-2.23), and daytime dysfunction due to sleepiness (AOR = 1.51, 95% CI 1.12-2.02). Migraineurs were also more likely than non-migraineurs to report taking sleep medication during pregnancy (AOR = 1.71, 95% CI 1.20-2.42). Associations were generally similar for migraine with or without aura. The odds of sleep disturbances were particularly elevated among pre-pregnancy overweight migraineurs. CONCLUSION Migraine headache and sleep disturbances are common comorbid conditions among pregnant women.
Collapse
Affiliation(s)
- Chunfang Qiu
- Center for Perinatal Studies, Swedish Medical Center, USA
| | | | - Tanya Sorensen
- Center for Perinatal Studies, Swedish Medical Center, USA
| | | | - Bizu Gelaye
- Department of Epidemiology, Harvard School of Public Health, USA
| | - Daniel A Enquobahrie
- Center for Perinatal Studies, Swedish Medical Center, USA Department of Epidemiology, University of Washington School of Public Health, USA
| | - Michelle A Williams
- Center for Perinatal Studies, Swedish Medical Center, USA Department of Epidemiology, Harvard School of Public Health, USA
| |
Collapse
|
16
|
Schumacher-Schuh AF, Rieder CRM, Hutz MH. Parkinson's disease pharmacogenomics: new findings and perspectives. Pharmacogenomics 2015; 15:1253-71. [PMID: 25141900 DOI: 10.2217/pgs.14.93] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Parkinson's disease (PD) is unique among neurodegenerative disorders because a highly effective pharmacological symptomatic treatment is available. The marked variability in drug response and in adverse profiles associated with this treatment led to the search of genetic markers associated with these features. We present a review of the literature on PD pharmacogenetics to provide a critical discussion of the current findings, new approaches, limitations and recommendations for future research. Pharmacogenetics studies in this field have assessed several outcomes and genes, with special focus on dopaminergic genes, mainly DRD2, which is the most important receptor in nigrostriatal pathway. The heterogeneity in methodological strategies employed by different studies is impressive. The question of whether PD pharmacogenetics studies will improve clinical management by causing a shift from a trial-and-error approach to a pharmacological regimen that takes into account the individual variability remains an open question. Collaborative longitudinal studies with larger sample sizes, better outcome definitions and replication studies are required.
Collapse
Affiliation(s)
- Artur F Schumacher-Schuh
- Departamento de Genética, Instituto de Biociências, UFRGS, Caixa Postal 15053, 91501-970, Porto Alegre, RS, Brazil
| | | | | |
Collapse
|
17
|
McDonald MP. Methods and Models of the Nonmotor Symptoms of Parkinson Disease. Mov Disord 2015. [DOI: 10.1016/b978-0-12-405195-9.00023-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
18
|
Yeung EYH, Cavanna AE. Sleep Attacks in Patients With Parkinson's Disease on Dopaminergic Medications: A Systematic Review. Mov Disord Clin Pract 2014; 1:307-316. [PMID: 30363881 DOI: 10.1002/mdc3.12063] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/05/2014] [Accepted: 05/25/2014] [Indexed: 11/05/2022] Open
Abstract
Dopaminergic medications are used as first-line treatment for Parkinson's disease (PD). In 1999, a case series was published describing 9 patients who took dopamine agonists (pramipexole or ropinirole) and experienced sudden irresistible sleep attacks. Sleep attacks have subsequently been reported with other dopaminergic medications, including levodopa. Because these symptoms might not be rare and can affect health-related quality of life, we set out to review the prevalence and clinical characteristics of sleep attacks in patients with PD on dopaminergic medications. We conducted a systematic literature review using the terms parkinson* AND dopamine* AND narcolep* OR sleep attack in multiple databases (PubMed, Embase, and PsycINFO). The systematic literature review yielded 23 relevant articles, including nine case reports or case series and 14 original studies. According to the pooled data from the five studies reporting prevalence figures (n = 10,084), sleep attacks occur in 13.0% of patients with PD on dopaminergic medications. Our analysis failed to show significant differences in the Epworth Sleepiness scores between patients with and without sleep attacks (mean difference: 2.92; 95% confidence interval: -0.47-6.31). The I2 value of 76% indicated high heterogeneity among the studies. Sleep attacks are not a rare occurrence in patients with PD on dopamine agonist treatment. We found conflicting results on whether sleep attacks in PD resemble narcolepsy. The pathophysiology of these symptoms might be related to dopamine D2 and D4 receptor gene polymorphisms. The most effective management strategies were dose reduction and discontinuation of the offending drugs.
Collapse
Affiliation(s)
- Eugene Y H Yeung
- College of Medical and Dental Sciences University of Birmingham Birmingham United Kingdom
| | - Andrea E Cavanna
- College of Medical and Dental Sciences University of Birmingham Birmingham United Kingdom.,Department of Neuropsychiatry Birmingham and Solihull Mental Health NHS Foundation Trust Birmingham United Kingdom.,School of Life and Health Sciences Aston University Birmingham United Kingdom.,Sobell Department of Motor Neuroscience and Movement Disorders University College London and Institute of Neurology London United Kingdom
| |
Collapse
|
19
|
Sleep/wake problems in Parkinson’s disease: pathophysiology and clinicopathologic correlations. J Neural Transm (Vienna) 2014; 121 Suppl 1:S3-13. [DOI: 10.1007/s00702-014-1239-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 05/06/2014] [Indexed: 11/25/2022]
|
20
|
Droździk M, Białecka M, Kurzawski M. Pharmacogenetics of Parkinson's disease - through mechanisms of drug actions. Curr Genomics 2014; 14:568-77. [PMID: 24532988 PMCID: PMC3924251 DOI: 10.2174/1389202914666131210212521] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 08/26/2013] [Accepted: 10/30/2013] [Indexed: 01/05/2023] Open
Abstract
In the last years due to development of molecular methods a substantial progress in understanding of genetic
associations with drug effects in many clinical disciplines has been observed. The efforts to define the role of genetic polymorphisms
in optimizing pharmacotherapy of Parkinson’s disease (PD) were also undertaken. So far, some promising
genetic loci for PD treatment were determined. In the review pharmacogenetic aspects of levodopa, dopamine agonists
and COMT inhibitors are discussed.
Collapse
Affiliation(s)
- Marek Droździk
- Department of Pharmacology, Pomeranian Medical University, Szczecin, Poland
| | - Monika Białecka
- Department of Pharmacology, Pomeranian Medical University, Szczecin, Poland
| | - Mateusz Kurzawski
- Department of Pharmacology, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
21
|
Calandrella D, Antonini A. Pathological gambling in Parkinson’s disease: disease related or drug related? Expert Rev Neurother 2014; 11:809-14. [DOI: 10.1586/ern.11.70] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
22
|
Chan A, Pirmohamed M, Comabella M. Pharmacogenomics in neurology: current state and future steps. Ann Neurol 2012; 70:684-97. [PMID: 22162054 DOI: 10.1002/ana.22502] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In neurology, as in any other clinical specialty, there is a need to develop treatment strategies that allow stratification of therapies to optimize efficacy and minimize toxicity. Pharmacogenomics is one such method for therapy optimization: it aims to elucidate the relationship between human genome sequence variation and differential drug responses. Approaches have focused on candidate approaches investigating absorption-, distribution-, metabolism, and elimination (ADME)-related genes (pharmacokinetic pathways), and potential drug targets (pharmacodynamic pathways). To date, however, only few genetic variants have been incorporated into clinical algorithms. Unfortunately, a large number of studies have thrown up contradictory results due to a number of deficiencies, including small sample sizes, inadequate phenotyping, and genotyping strategies. Thus, there still exists an urgent need to establish biomarkers that could help to select for patients with an optimal benefit to risk relationship. Here we review recent advances, and limitations, in pharmacogenomics for agents used in neuroimmunology, neurodegenerative diseases, ischemic stroke, epilepsy, and primary headaches. Further work is still required in all of these areas, which really needs to progress on several fronts, including better standardized phenotyping, appropriate sample sizes through multicenter collaborations and judicious use of new technological advances such as genome-wide approaches, next generation sequencing and systems biology. In time, this is likely to lead to improvements in the benefit-harm balance of neurological therapies, cost efficiency, and identification of new drugs.
Collapse
Affiliation(s)
- Andrew Chan
- Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Germany.
| | | | | |
Collapse
|
23
|
Güzey C, Allard P, Brännström T, Spigset O. Radioligand Binding to Brain Dopamine and Serotonin Receptors and Transporters in Parkinson's Disease: Relation to Gene Polymorphisms. Int J Neurosci 2011; 122:124-32. [DOI: 10.3109/00207454.2011.631716] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
24
|
Kalinderi K, Fidani L, Katsarou Z, Bostantjopoulou S. Pharmacological treatment and the prospect of pharmacogenetics in Parkinson's disease. Int J Clin Pract 2011; 65:1289-94. [PMID: 22093536 DOI: 10.1111/j.1742-1241.2011.02793.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Parkinson disease (PD) is a progressive movement disorder marked by tremor, rigidity, bradykinesia and postural instability. Levodopa (l-dopa), usually combined with a peripheral dopa decarboxylase inhibitor, has been proved to provide the best symptomatic benefit for PD. However, its long-term efficacy is limited because of motor complications and drug-induced dyskinesia. Dopamine agonists, catechol-O-methyltransferase inhibitors and monoamine oxidase-B inhibitors are anti-parkinsonian (anti-PD) drugs that have been found to further improve the potency of l-dopa and prevent the onset of motor complications. However, as PD is a progressive disorder, all the drugs used for its therapy, manifest reduced efficacy and adverse effects with time. Research on the field of pharmacogenetics has pointed out that the genetic variability of each individual determines to a large extent the inter-individual variability in response to anti-PD drugs. Clinicogenetic trials show that drug efficacy or toxicity or susceptibility to side effects are features governed by genetic principles. This article is a review of the present pharmacological treatment of PD and current pharmacogenetic data for PD.
Collapse
Affiliation(s)
- K Kalinderi
- Department of General Biology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | |
Collapse
|
25
|
Abstract
SUMMARY Parkinson’s disease (PD) patients demonstrate a variety of sleep/wake complaints. Some of these are associated with dopaminergic dysfunction, some presumed to arise from nondopaminergic PD pathology, some from PD treatments and, in some, the etiologies are multifactorial or unknown. Optimal management of sleep/wake problems requires a good understanding of sleep/wake principals in the PD population, as there are few controlled trials to dictate therapy. In this article, we review the main causes of sleep/wake disorders in PD patients, namely sleep fragmentation, excessive daytime sleepiness, restless legs syndrome, periodic limb movement of sleep, rapid eye movement sleep behavioral disorder and sleep apnea. Available therapies and management recommendations for each disorder are given particular emphasis.
Collapse
Affiliation(s)
- Raja Mehanna
- Parkinson’s Disease Center & Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | | |
Collapse
|
26
|
Güzey C, Lopez-Rodriguez R, Myhre R, Spigset O. Allele and genotype frequencies of serotonin and dopamine transporter and receptor polymorphisms in a Norwegian population. Genet Test Mol Biomarkers 2011; 15:557-63. [PMID: 21453053 DOI: 10.1089/gtmb.2010.0210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Polymorphisms in genes coding for dopaminergic and serotonergic receptors and transporters have been associated with the clinical effects and adverse drug reactions of antipsychotic and antidepressant drugs. The objective of this study was to investigate the frequency and combinations of common polymorphisms in the dopamine transporter (DAT1), dopamine D(2) receptor (DRD2), dopamine D(3) receptor (DRD3), serotonin transporter (5HTT), and serotonin 2A receptor (5HTR2A) genes in a Norwegian population. To determine the background frequency in the population, 250 blood samples were consecutively collected from healthy Norwegian blood donors (125 men and 125 women; mean age: 48±11 years). Samples were tested for DAT1 VNTR, DRD2 Taq1A, DRD3 Ser9Gly, 5HTTLPR, and four polymorphisms (102 T>C, His452Tyr, 516 C>T, and Thr25Asn) in the 5HTR2A, using polymerase chain reaction and real-time polymerase chain reaction. We observed the frequency of the nine-repeat allele of DAT1 VNTR polymorphism as 20% (95% confidence interval [CI]: 0.18-0.23), the A1 allele of DRD2 Taq1A polymorphism as 21% (95% CI: 0.19-0.23), the A1 allele of DRD3 Ser9Gly polymorphism as 68% (95% CI: 0.66-0.70), the short allele of 5HTTLPR as 38% (95% CI: 0.36-0.40), and the T allele of 5HTR2A 102 T>C polymorphism as 41% (95% CI: 0.39-0.41), and the frequencies of 5HTR2A His452Tyr and 5HTR2A Thr25Asn were 93% and 95%, respectively. The tested polymorphisms showed differences compared with other European populations. Further studies are necessary to better understand the effect of these alleles and their combinations on personality, mental disorders, drug response, and adverse reactions of psychotropic drugs.
Collapse
Affiliation(s)
- Cüneyt Güzey
- Division of Psychiatry, Department of Research and Development, St. Olav University Hospital, Trondheim, Norway.
| | | | | | | |
Collapse
|
27
|
Abstract
Excessive daytime sleepiness (EDS) is described as inappropriate and undesirable sleepiness during waking hours and is a common non-motor symptom in Parkinson's disease, affecting up to 50% of patients. EDS has a large impact on the quality of life of Parkinson's disease patients as well as of their caregivers, in some cases even more than the motor symptoms of the disease. Drug-induced EDS is a particular problem as many dopamine agonists used for the treatment of Parkinson's disease have EDS as an adverse effect. Dopaminergic treatment may also render a subset of Parkinson's disease patients at risk for sudden-onset sleep attacks that occur without warning and can be particularly hazardous if the patient is driving. This demonstrates the need for early recognition and management not only to increase health-related quality of life but also to ensure patient safety. There are many assessment tools for EDS, including the Epworth Sleepiness Scale (ESS) and the Multiple Sleep Latency Test (MSLT), although only the Parkinson's Disease Sleep Scale (PDSS) and the SCales for Outcomes in PArkinson's Disease-Sleep (SCOPA-S) are specifically validated for Parkinson's disease. Polysomnography can be used when necessary. Management comprises non-pharmacological and pharmacological approaches. Non-pharmacological approaches can be the mainstay of treatment for mild to moderate EDS. Advice on good sleep hygiene is instrumental, as pharmacological approaches have yet to provide consistent and reliable results without significant adverse effects. The efficacy of pharmacological treatment of EDS in Parkinson's disease using wakefulness-promoting drugs such as modafinil remains controversial. Further areas of research are now also focusing on adenosine A(2A) receptor antagonists, sodium oxybate and caffeine to promote wakefulness. A definitive treatment for the highly prevalent drug-induced EDS has not yet been found.
Collapse
Affiliation(s)
- Bettina Knie
- Charit Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | |
Collapse
|
28
|
Ceravolo R, Rossi C, Kiferle L, Bonuccelli U. Nonmotor symptoms in Parkinson’s disease: the dark side of the moon. FUTURE NEUROLOGY 2010. [DOI: 10.2217/fnl.10.69] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Nonmotor symptoms may appear during the course of Parkinson’s disease, complicating the advanced phase in particular, but are also common in the premotor phase of Parkinson’s disease. The appearance of nonmotor manifestations represents a milestone, determining a worse prognosis and lower quality of life; however, they are often misdiagnosed and untreated. The spectrum of nonmotor symptoms encompasses mood disorders, psychosis, dementia, sleep disorders, impulse-control disorders and autonomic dysfunctions. This article describes these nonmotor symptoms and their management.
Collapse
Affiliation(s)
- Roberto Ceravolo
- Department of Neurosciences, Section of Neurology, University of Pisa, via Roma 67, 56126 Pisa, Italy
| | - Carlo Rossi
- Department of Neurosciences, Section of Neurology, University of Pisa, via Roma 67, 56126 Pisa, Italy
| | - Lorenzo Kiferle
- Department of Neurosciences, Section of Neurology, University of Pisa, via Roma 67, 56126 Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Neurosciences, Section of Neurology, University of Pisa, via Roma 67, 56126 Pisa, Italy
| |
Collapse
|
29
|
Burgess CR, Tse G, Gillis L, Peever JH. Dopaminergic regulation of sleep and cataplexy in a murine model of narcolepsy. Sleep 2010; 33:1295-304. [PMID: 21061851 PMCID: PMC2941415 DOI: 10.1093/sleep/33.10.1295] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES To determine if the dopaminergic system modulates cataplexy, sleep attacks and sleep-wake behavior in narcoleptic mice. DESIGN Hypocretin/orexin knockout (i.e., narcoleptic) and wild-type mice were administered amphetamine and specific dopamine receptor modulators to determine their effects on sleep, cataplexy and sleep attacks. PATIENTS OR PARTICIPANTS Hypocretin knockout (n = 17) and wild-type mice (n = 21). INTERVENTIONS Cataplexy, sleep attacks and sleep-wake behavior were identified using electroencephalogram, electromyogram and videography. These behaviors were monitored for 4 hours after an i.p. injection of saline, amphetamine and specific dopamine receptor modulators (D1- and D2-like receptor modulators). MEASUREMENTS AND RESULTS Amphetamine (2 mg/kg), which increases brain dopamine levels, decreased sleep attacks and cataplexy by 61% and 67%, suggesting that dopamine transmission modulates such behaviors. Dopamine receptor modulation also had powerful effects on sleep attacks and cataplexy. Activation (SKF 38393; 20 mg/kg) and blockade (SCH 23390; 1 mg/kg) of D1-like receptors decreased and increased sleep attacks by 77% and 88%, without affecting cataplexy. Pharmacological activation of D2-like receptors (quinpirole; 0.5 mg/kg) increased cataplectic attacks by 172% and blockade of these receptors (eticlopride; 1 mg/kg) potently suppressed them by 97%. Manipulation of D2-like receptors did not affect sleep attacks. CONCLUSIONS We show that the dopaminergic system plays a role in regulating both cataplexy and sleep attacks in narcoleptic mice. We found that cataplexy is modulated by a D2-like receptor mechanism, whereas dopamine modulates sleep attacks by a D1-like receptor mechanism. These results support a role for the dopamine system in regulating sleep attacks and cataplexy in a murine model of narcolepsy.
Collapse
Affiliation(s)
| | - Gavin Tse
- Department of Cell and Systems Biology, University of Toronto, Toronto, Canada
| | - Lauren Gillis
- Department of Cell and Systems Biology, University of Toronto, Toronto, Canada
| | - John H. Peever
- Department of Cell and Systems Biology, University of Toronto, Toronto, Canada
- Department of Physiology, University of Toronto, Toronto, Canada
| |
Collapse
|
30
|
Vautier S, Fernandez C. ABCB1: the role in Parkinson's disease and pharmacokinetics of antiparkinsonian drugs. Expert Opin Drug Metab Toxicol 2010; 5:1349-58. [PMID: 19663741 DOI: 10.1517/17425250903193079] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
ABCB1/P-glycoprotein (P-gp) is an ATP-dependant transmembrane efflux protein widely expressed in human organs and plays a protective role against endogenous and exogenous substances. It is involved in drug pharmacokinetics affecting drug absorption, disposition and elimination. At the BBB level, due to its luminal localisation, ABCB1 limits drug transport and is important in central detoxification. Inter-individual variability has been described in ABCB1 expression and functionality. Recent work suggests that variability may play a role in the pathogenesis of neurological diseases. Furthermore, ABCB1 expression and/or functionality may modify drug efficacy or increase central adverse events. This paper reviews ABCB1 implication in the pathophysiology of Parkinson's disease and its role in the cerebral distribution of drugs.
Collapse
Affiliation(s)
- Sarah Vautier
- University Paris-Sud XI, Department of Clinical Pharmacy, Chatenay-Malabry, France.
| | | |
Collapse
|
31
|
Tolosa E, Santamaria J, Gaig C, Compta Y. Nonmotor Aspects of Parkinson's Disease. MOVEMENT DISORDERS 4 2010. [DOI: 10.1016/b978-1-4160-6641-5.00014-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
32
|
|
33
|
Bonuccelli U, Ceravolo R. The safety of dopamine agonists in the treatment of Parkinson's disease. Expert Opin Drug Saf 2008; 7:111-27. [PMID: 18324875 DOI: 10.1517/14740338.7.2.111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Dopamine agonists are highly effective as adjunctive therapy to levodopa in advanced Parkinson's disease. These drugs have rapidly gained popularity as a monotherapy in the early stages of Parkinson's disease for patients < 65-70 years old, because they are about as effective as levodopa, but patients demonstrate a lower tendency to develop motor complications. However, dopamine agonists could have peripheral and central side effects, which are often the reason for the discontinuation of the treatment. This review focuses on the potential negative effects related to the use of dopamine agonists in the treatment of Parkinson's disease.
Collapse
Affiliation(s)
- Ubaldo Bonuccelli
- University of Pisa, Department of Neuroscience, Via Roma, 67 56100 Pisa, Italy.
| | | |
Collapse
|
34
|
Arbouw MEL, van Vugt JPP, Egberts TCG, Guchelaar HJ. Pharmacogenetics of antiparkinsonian drug treatment: a systematic review. Pharmacogenomics 2007; 8:159-76. [PMID: 17286539 DOI: 10.2217/14622416.8.2.159] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pharmacotherapy is the mainstay in the treatment of Parkinson's disease and the armamentarium of drugs available for the therapy of this disease is still expanding. Anti-Parkinson's disease drugs are effective in reducing the physical symptoms, such as hypokinesia, bradykinesia, rigidity and tremor. However, there is a large interindividual variability in response to anti-Parkinson's disease drugs with respect to both drug efficacy and toxicity. It is thought that genetic variability in genes encoding drug-metabolizing enzymes, drug receptors and proteins involved in pathway signaling is an important factor in determining interindividual variability in drug response. Pharmacogenetics aims at identifying genetic markers associated with drug response. Ideally, knowledge of these genetic markers will enable us to predict an individual's drug response in terms of both efficacy and toxicity. The role of pharmacogenetics in the treatment of Parkinson's disease is relatively unexplored. Therefore, we aim to present a systematic review of the published pharmacogenetic studies in Parkinson's disease and to describe polymorphic genes of interest for future research.
Collapse
Affiliation(s)
- Maurits E L Arbouw
- Utrecht University, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Sciences, Utrecht, The Netherlands
| | | | | | | |
Collapse
|
35
|
Bartrés-Faz D, Martí MJ, Junqué C, Solé-Padullés C, Ezquerra M, Bralten LBC, Gaig C, Campdelacreu J, Mercader JM, Tolosa E. Increased cerebral activity in Parkinson?s disease patients carrying the DRD2 TaqIA A1 allele during a demanding motor task: a compensatory mechanism? GENES BRAIN AND BEHAVIOR 2007; 6:588-92. [PMID: 17147698 DOI: 10.1111/j.1601-183x.2006.00290.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previous studies suggest that neuroimaging techniques are useful for detecting the effects of functional genetic polymorphisms on brain function in healthy subjects or in patients presenting with psychiatric or neurodegenerative conditions. Former evidence showed that individuals carrying risk alleles displayed broader patterns of brain activity during behavioural and cognitive tasks, despite being clinically comparable to non-carriers. This suggests the presence of compensatory brain mechanisms. In the present study, we investigated this effect in Parkinson's disease (PD) patients carrying the DRD2 TaqIA A1 allelic variant. This variant may confer an increased risk of developing the disease and/or influence the clinical presentation. During a complex sequential motor task, we evidenced by functional magnetic resonance imaging that A1 allele carriers activated a larger network of bilateral cerebral areas than non-carriers, including cerebellar and premotor regions. Both groups had similar clinical and demographic measures. In addition, their motor performance during the functional magnetic resonance experiment was comparable. Therefore, our conclusions, pending replication in a larger sample, seem to reflect the recruitment of compensatory cerebral resources during motor processing in PD patients carrying the A1 allele.
Collapse
Affiliation(s)
- D Bartrés-Faz
- Department de Psiquiatria i Psicobiologia Clinica, Facultat de Medicina, Universitat de Barcelona, and Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Güzey C, Scordo MG, Spina E, Landsem VM, Spigset O. Antipsychotic-induced extrapyramidal symptoms in patients with schizophrenia: associations with dopamine and serotonin receptor and transporter polymorphisms. Eur J Clin Pharmacol 2007; 63:233-41. [PMID: 17225991 DOI: 10.1007/s00228-006-0234-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2006] [Accepted: 11/06/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the influence of polymorphisms of the dopamine and serotonin system on the risk for extrapyramidal symptoms (EPS) during treatment with antipsychotic drugs. METHODS Of 119 subjects with schizophrenia treated with antipsychotics, 63 had current or previous EPS (acute dystonia, parkinsonism, tardive dyskinesia), and 56 had no such symptoms. All subjects were genotyped for a total of eight dopamine and serotonin receptor and transporter polymorphisms: the Taq1A polymorphism of the dopamine D(2) receptor (DRD2) gene, the Msc1 polymorphism of the dopamine D(3) receptor (DRD3) gene, the variable number of tandem repeat (VNTR) polymorphism of the dopamine transporter (DAT1) gene, four polymorphisms (102T/C, His452Tyr, 516 C/T, and Thr25Asn) of the serotonin 5-HT(2A) receptor (5HTR2A) gene, and the 5HTTLPR polymorphism of the serotonin transporter (5HTT) gene. RESULTS The frequency of the A1 allele of the DRD2 Taq1A polymorphism was significantly higher in the EPS group than in the control group [16% vs. 7%, P = 0.040; odds ratio (OR) 2.4; 95% confidence interval (CI) 1.1-5.7]. Also, the 9 repeat allele of the DAT1 VNTR polymorphism was significantly more common in the EPS group (42% vs. 28%, P = 0.030; OR 1.9; 95% CI 1.1-3.3). Being a carrier of both DRD2 Taq1A A1 and DAT1 VNTR 9 repeat alleles was also significantly associated with the occurrence of EPS (19% vs. 6%, P = 0.040; OR 4.0; 95% CI 1.05-15.2) No significant differences in allele frequencies were found for the other polymorphisms. CONCLUSION Presence of the Taq1A A1 allele of the DRD2 and the 9 repeat allele of the DAT1 VNTR polymorphisms might be risk factors for EPS caused by antipsychotic drugs.
Collapse
Affiliation(s)
- Cüneyt Güzey
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.
| | | | | | | | | |
Collapse
|
37
|
Skipper L, Liu JJ, Tan EK. Polymorphisms in candidate genes: implications for the current treatment of Parkinson's disease. Expert Opin Pharmacother 2006; 7:849-55. [PMID: 16634708 DOI: 10.1517/14656566.7.7.849] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pharmacological treatment remains the cornerstone of therapy in Parkinson's disease. A number of clinical and genetic factors may influence the therapeutic response and treatment-related complications. Some exploratory studies have suggested that genetic polymorphisms may influence an individual's response to dopaminergic therapy and susceptibility to drug-related complications, such as hallucinations, dyskinesias, motor fluctuations and sudden onset of sleep episodes. This article provides a concise summary and discussion of the potential utility and limitation of studies that have examined the influence of genetic polymorphisms on drug-related response and complications in Parkinson's disease.
Collapse
Affiliation(s)
- Lisa Skipper
- Population Genetics, Genome Institute of Singapore, Singapore
| | | | | |
Collapse
|
38
|
Gruber R, Grizenko N, Schwartz G, Ben Amor L, Gauthier J, de Guzman R, Joober R. Sleep and COMT polymorphism in ADHD children: preliminary actigraphic data. J Am Acad Child Adolesc Psychiatry 2006; 45:982-989. [PMID: 16865041 DOI: 10.1097/01.chi.0000220848.48650.10] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine whether COMT (catechol-O-methyltransferase) polymorphism modulates aspects of sleep in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). METHOD Nightly sleep actigraphic recordings during a double-blind, placebo-controlled, crossover clinical study (1 week of 0.5 mg/kg MPH; 1 week of placebo) were obtained for 34 children, 7.4 to 12 years old, diagnosed with ADHD (DSM-IV). Diagnosis was generated by the Diagnostic Interview Schedule for Children and was confirmed by multidisciplinary consensus. RESULTS Children who were Val allele carriers had poorer sleep continuity compared with children with the Met-Met genotype while receiving a placebo and while receiving methylphenidate. CONCLUSIONS The findings of the present study support the hypothesis that sleep disturbances in children with ADHD are related to the underlying pathophysiology of the disorder.
Collapse
Affiliation(s)
- Reut Gruber
- Drs. Gruber, Grizenko, and Joober, Mr. Schwartz, Ms. Gauthier, and Ms. de Guzman are with the Douglas Hospital Research Centre and McGill University, Montreal; and Dr. Amor is with the Laval University and Hôpital Hôtel Dieu de Lévis, Quebec City, Canada..
| | - Natalie Grizenko
- Drs. Gruber, Grizenko, and Joober, Mr. Schwartz, Ms. Gauthier, and Ms. de Guzman are with the Douglas Hospital Research Centre and McGill University, Montreal; and Dr. Amor is with the Laval University and Hôpital Hôtel Dieu de Lévis, Quebec City, Canada
| | - George Schwartz
- Drs. Gruber, Grizenko, and Joober, Mr. Schwartz, Ms. Gauthier, and Ms. de Guzman are with the Douglas Hospital Research Centre and McGill University, Montreal; and Dr. Amor is with the Laval University and Hôpital Hôtel Dieu de Lévis, Quebec City, Canada
| | - Leila Ben Amor
- Drs. Gruber, Grizenko, and Joober, Mr. Schwartz, Ms. Gauthier, and Ms. de Guzman are with the Douglas Hospital Research Centre and McGill University, Montreal; and Dr. Amor is with the Laval University and Hôpital Hôtel Dieu de Lévis, Quebec City, Canada
| | - Julie Gauthier
- Drs. Gruber, Grizenko, and Joober, Mr. Schwartz, Ms. Gauthier, and Ms. de Guzman are with the Douglas Hospital Research Centre and McGill University, Montreal; and Dr. Amor is with the Laval University and Hôpital Hôtel Dieu de Lévis, Quebec City, Canada
| | - Rosherrie de Guzman
- Drs. Gruber, Grizenko, and Joober, Mr. Schwartz, Ms. Gauthier, and Ms. de Guzman are with the Douglas Hospital Research Centre and McGill University, Montreal; and Dr. Amor is with the Laval University and Hôpital Hôtel Dieu de Lévis, Quebec City, Canada
| | - Ridha Joober
- Drs. Gruber, Grizenko, and Joober, Mr. Schwartz, Ms. Gauthier, and Ms. de Guzman are with the Douglas Hospital Research Centre and McGill University, Montreal; and Dr. Amor is with the Laval University and Hôpital Hôtel Dieu de Lévis, Quebec City, Canada
| |
Collapse
|
39
|
|