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Thirunavukarasu S, Ramanan BBV, Suresh SK, Antonisamy VJ, Varadharaj D, Shanmugam P, Verma K, Elumalai C, Selvakumar G, Elumalai A, Prabahar L, Janardhanan HA, Ur A. The Administration of Levodopa in a Patient With Parkinson's Disease Using a Novel Maxillofacial Route: A First-in-Human Report. Cureus 2023; 15:e48011. [PMID: 38034171 PMCID: PMC10687491 DOI: 10.7759/cureus.48011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Parkinson's disease is characterized by the loss of nigrostriatal dopaminergic neurons in the brain. Dopamine cannot be administered systemically because it does not cross the blood-brain barrier. Oral levodopa remains the gold standard to date. Currently, for patients who show a poor response to oral levodopa and for those who cannot take it orally, the alternate routes available are inhalation and continuous administration via intestinal and subcutaneous routes. In this report, a novel maxillofacial route was used for the first time in the world to administer levodopa to a Parkinson's patient. Furthermore, the efficacy of maxillofacial administration was compared with the oral route of administration.
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Affiliation(s)
- Suresh Thirunavukarasu
- Neurology, Indira Gandhi Government General Hospital and Post Graduate Institute, Puducherry, IND
| | | | | | | | - Devi Varadharaj
- Neurology, Indira Gandhi Government General Hospital and Post Graduate Institute, Puducherry, IND
| | - Paranjothi Shanmugam
- Neurology, Indira Gandhi Government General Hospital and Post Graduate Institute, Puducherry, IND
| | - Kavita Verma
- Research and Development, UR Anoop Research Group, Puducherry, IND
| | - Canmany Elumalai
- Orthodontics and Dentofacial Orthopaedics, UR Anoop Research Group, Puducherry, IND
| | - Gladson Selvakumar
- Conservative Dentistry and Endodontics, UR Anoop Research Group, Puducherry, IND
| | | | | | | | - Anoop Ur
- Research and Development, UR Anoop Research Group, Puducherry, IND
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2
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Liu Y, Li J, Xiao S, Liu Y, Bai M, Gong L, Zhao J, Chen D. Revolutionizing Precision Medicine: Exploring Wearable Sensors for Therapeutic Drug Monitoring and Personalized Therapy. BIOSENSORS 2023; 13:726. [PMID: 37504123 PMCID: PMC10377150 DOI: 10.3390/bios13070726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/02/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
Precision medicine, particularly therapeutic drug monitoring (TDM), is essential for optimizing drug dosage and minimizing toxicity. However, current TDM methods have limitations, including the need for skilled operators, patient discomfort, and the inability to monitor dynamic drug level changes. In recent years, wearable sensors have emerged as a promising solution for drug monitoring. These sensors offer real-time and continuous measurement of drug concentrations in biofluids, enabling personalized medicine and reducing the risk of toxicity. This review provides an overview of drugs detectable by wearable sensors and explores biosensing technologies that can enable drug monitoring in the future. It presents a comparative analysis of multiple biosensing technologies and evaluates their strengths and limitations for integration into wearable detection systems. The promising capabilities of wearable sensors for real-time and continuous drug monitoring offer revolutionary advancements in diagnostic tools, supporting personalized medicine and optimal therapeutic effects. Wearable sensors are poised to become essential components of healthcare systems, catering to the diverse needs of patients and reducing healthcare costs.
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Affiliation(s)
- Yuqiao Liu
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Junmin Li
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Shenghao Xiao
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Yanhui Liu
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Mingxia Bai
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Lixiu Gong
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Jiaqian Zhao
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Dajing Chen
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310007, China
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3
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Nakmode DD, Day CM, Song Y, Garg S. The Management of Parkinson's Disease: An Overview of the Current Advancements in Drug Delivery Systems. Pharmaceutics 2023; 15:pharmaceutics15051503. [PMID: 37242745 DOI: 10.3390/pharmaceutics15051503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/31/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Parkinson's disease (PD) has significantly affected a large proportion of the elderly population worldwide. According to the World Health Organization, approximately 8.5 million people worldwide are living with PD. In the United States, an estimated one million people are living with PD, with approximately 60,000 new cases diagnosed every year. Conventional therapies available for Parkinson's disease are associated with limitations such as the wearing-off effect, on-off period, episodes of motor freezing, and dyskinesia. In this review, a comprehensive overview of the latest advances in DDSs used to reduce the limitations of current therapies will be presented, and both their promising features and drawbacks will be discussed. We are also particularly interested in the technical properties, mechanism, and release patterns of incorporated drugs, as well as nanoscale delivery strategies to overcome the blood-brain barrier.
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Affiliation(s)
- Deepa D Nakmode
- Centre for Pharmaceutical Innovation, University of South Australia, North Terrace, Adelaide, SA 5000, Australia
| | - Candace M Day
- Centre for Pharmaceutical Innovation, University of South Australia, North Terrace, Adelaide, SA 5000, Australia
| | - Yunmei Song
- Centre for Pharmaceutical Innovation, University of South Australia, North Terrace, Adelaide, SA 5000, Australia
| | - Sanjay Garg
- Centre for Pharmaceutical Innovation, University of South Australia, North Terrace, Adelaide, SA 5000, Australia
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4
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Fabbri M, Barbosa R, Rascol O. Off-time Treatment Options for Parkinson's Disease. Neurol Ther 2023; 12:391-424. [PMID: 36633762 PMCID: PMC10043092 DOI: 10.1007/s40120-022-00435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
Motor fluctuations (MF) are deemed by patients with Parkinson's disease (PD) as the most troublesome disease feature resulting from the increasing impairment in responsiveness to dopaminergic drug treatments. MF are characterized by the loss of a stable response to levodopa over the nychthemeron with the reappearance of motor (and non-motor) parkinsonian clinical signs at various moments during the day and night. They normally appear after a few years of levodopa treatment and with a variable, though overall increasing severity, over the disease course. The armamentarium of first-line treatment options has widened in the last decade with new once-a-daily compounds, including a catechol O-methyltransferase inhibitor - Opicapone-, two MAO-B inhibitors plus channel blocker - Zonisamide and Safinamide and one amantadine extended-release formulation - ADS5012. In addition to apomorphine injection or oral levodopa dispersible tablets, which have been available for a long time, new on-demand therapies such as apomorphine sublingual or levodopa inhaled formulations have recently shown efficacy as rescue therapies for Off-time treatment. When the management of MF becomes difficult in spite of oral/on-demand options, more complex therapies should be considered, including surgical, i.e. deep brain stimulation, or device-aided therapies with pump systems delivering continuous subcutaneous or intestinal levodopa or subcutaneous apomorphine formulation. Older and less commonly used ablative techniques (radiofrequency pallidotomy) may also be effective while there is still scarce data regarding Off-time reduction using a new lesional approach, i.e. magnetic resonance-guided focused ultrasound. The choice between the different advanced therapies options is a shared decision that should consider physician opinion on contraindication/main target symptom, patients' preference, caregiver's availability together with public health systems and socio-economic environment. The choice of the right/first add-on treatment is still a matter of debate as well as the proper time for an advanced therapy to be considered. In this narrative review, we discuss all the above cited aspects of MF in patients with PD, including their phenomenology, management, by means of pharmacological and advanced therapies, on-going clinical trials and future research and treatment perspectives.
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Affiliation(s)
- Margherita Fabbri
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France.
| | - Raquel Barbosa
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France.,Department of Neurology, Hospital de Egas Moniz Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.,NOVA Medical School, Faculdade de Ciências Médicas Universidade Nova de Lisboa, Lisbon, Portugal
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France
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5
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Yuan H, Zhang Z, Hu L. Development and characterization of gastro-floating sustained-release capsule with improved bioavailability of levodopa. Drug Deliv Transl Res 2023; 13:9-17. [PMID: 35661106 DOI: 10.1007/s13346-022-01188-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 12/13/2022]
Abstract
In this study, a new gastro-floating sustained-release capsule (GFC) with levodopa (LD) and benserazide hydrochloride (BH) was successfully developed. GFCs were prepared by filling the LD and BH granules into hard capsules and coated with cellulose acetate (CA) solution as a controlled-release layer. The effects of formulation factors on the release of GFCs were conducted. The AUC0~24 (µg h/mL) of LD were 69.31 ± 3.61 (μg h/mL) and 28.87 ± 2.58 (μg h/mL) and the Cmax were 7.84 ± 0.34 (μg/mL) and 9.21 ± 1.04 (μg/mL) in the GFCs and commercial tablets respectively. The relative bioavailability of LD was 267.55 ± 34.54%. Compared with commercial tablets, the pharmacokinetic study indicated that the developed GFCs provided a better sustained-release effect and higher bioavailability than commercial tablets.
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Affiliation(s)
- Hao Yuan
- Key Laboratory of Pharmaceutical Quality Control of Hebei Province, College of Pharmaceutical Sciences, Institute of Life Science and Green Development, Hebei University, Baoding, 071002, China
| | - Zhengyu Zhang
- Key Laboratory of Pharmaceutical Quality Control of Hebei Province, College of Pharmaceutical Sciences, Institute of Life Science and Green Development, Hebei University, Baoding, 071002, China
| | - Liandong Hu
- Key Laboratory of Pharmaceutical Quality Control of Hebei Province, College of Pharmaceutical Sciences, Institute of Life Science and Green Development, Hebei University, Baoding, 071002, China.
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6
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Levodopa-Induced Dyskinesia in Parkinson's Disease: Pathogenesis and Emerging Treatment Strategies. Cells 2022; 11:cells11233736. [PMID: 36496996 PMCID: PMC9736114 DOI: 10.3390/cells11233736] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
The most commonly used treatment for Parkinson's disease (PD) is levodopa, prescribed in conjunction with carbidopa. Virtually all patients with PD undergo dopamine replacement therapy using levodopa during the course of the disease's progression. However, despite the fact that levodopa is the "gold standard" in PD treatments and has the ability to significantly alleviate PD symptoms, it comes with side effects in advanced PD. Levodopa replacement therapy remains the current clinical treatment of choice for Parkinson's patients, but approximately 80% of the treated PD patients develop levodopa-induced dyskinesia (LID) in the advanced stages of the disease. A better understanding of the pathological mechanisms of LID and possible means of improvement would significantly improve the outcome of PD patients, reduce the complexity of medication use, and lower adverse effects, thus, improving the quality of life of patients and prolonging their life cycle. This review assesses the recent advancements in understanding the underlying mechanisms of LID and the therapeutic management options available after the emergence of LID in patients. We summarized the pathogenesis and the new treatments for LID-related PD and concluded that targeting pathways other than the dopaminergic pathway to treat LID has become a new possibility, and, currently, amantadine, drugs targeting 5-hydroxytryptamine receptors, and surgery for PD can target the Parkinson's symptoms caused by LID.
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7
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Liu WY, Tung TH, Zhang C, Shi L. Systematic review for the prevention and management of falls and fear of falling in patients with Parkinson's disease. Brain Behav 2022; 12:e2690. [PMID: 35837986 PMCID: PMC9392538 DOI: 10.1002/brb3.2690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/17/2022] [Accepted: 04/24/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To synthesize recent empirical evidence for the prevention and management of falls and fear of falling in patients with Parkinson's disease (PD). DATA SOURCE Database from PubMed, Cochrane Library, and EMBASE. STUDY DESIGN Systematic review. DATA COLLECTION We searched the PubMed, Cochrane Library, and EMBASE databases for studies published from inception to February 27, 2021. Inclusion criteria were nonreview articles on prevention and management measures related to falls and fall prevention in Parkinson's disease patients. PRINCIPAL FINDINGS We selected 45 articles and conducted in-depth research and discussion. According to the causes of falls in PD patients, they were divided into five directions, namely physical status, pre-existing conditions, environment, medical care, and cognition. In the cognitive domain, we focused on the fear of falling. On the above basis, we constructed a fall prevention model, which is a tertiary prevention health care network, based on The Johns Hopkins Fall Risk Assessment Tool to provide ideas for the prevention and management of falling and fear of falling in PD patients in clinical practice CONCLUSIONS: Falls and fear of falls in patients with Parkinson's disease can be reduced by effective clinical prevention and management. Future studies are needed to explore the efficacy of treatment and prevention of falls and fear of falls.
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Affiliation(s)
- Wen-Yi Liu
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,Shanghai Bluecross Medical Science Institute, Shanghai, China.,Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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8
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Rezaeisadat M, Salehi N, Bordbar AK. Inclusion of Levodopa into β-Cyclodextrin: A Comprehensive Computational Study. ACS OMEGA 2021; 6:23814-23825. [PMID: 34568661 PMCID: PMC8459354 DOI: 10.1021/acsomega.1c02637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
This study focused on the inclusion of levodopa (LVDP) into β-cyclodextrin (BCD) using various computational methods such as quantum mechanics (QM), molecular dynamics/steered molecular dynamics (MD/SMD), and QM/molecular mechanics/Poison-Boltzmann surface area (QM/MM/PBSA). The QM results assigned the most significant charge-transfer atoms and the higher stability of LVDP in the aqueous phase. The MD results indicate the formation of a 1:1 complex with a reasonable estimation of the effective radius of the complex, the significant contribution of hydrogen bonding in the binding energy, and the enhancement of the water solubility of LVDP. By accounting for the water hydrogen bonds and their dipolar effects, QM/MM calculations lead to the more accurate IR spectrum and binding energy of the BCD-LVDP complex. By considering carboxylic and amine functional groups' more precise arrangement, QM/MM assigns stronger hydrogen bonds between LVDP and BCD. While all the methods provide a reasonable estimation of the binding energy, the most accurate value (-4.14 kcal/mol) is obtained from QM/MM/PBSA.
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Affiliation(s)
| | - Nafiseh Salehi
- Department of Chemistry, University
of Isfahan, Isfahan 8174673441, Iran
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9
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Bahrainian S, Mirmoeini MS, Gilani Z, Gilani K. Engineering of levodopa inhalable microparticles in combination with leucine and dipalmitoylphosphatidylcholine by spray drying technique. Eur J Pharm Sci 2021; 167:106008. [PMID: 34530077 DOI: 10.1016/j.ejps.2021.106008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/05/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
The aim of this work was to study the effect of concomitant use of leucine and dipalmitoylphosphatidylcholine, in different ratios, on aerosolization performance of levodopa. Three-component formulations were selected based on a central composite design using percentages of leucine and dipalmitoylphosphatidylcholine as the independent variables. Particle size, surface roughness index, surface phosphorus and fine particle fraction were considered as dependent variables in the model. The spray dried samples were also characterized to determine their particle shape and solid state nature. levodopa was spray dried with 10-40% w/w of the excipients to prepare two- or three-component formulations. A crystalline nature was determined for levodopa in all samples spray dried from water:ethanol (30:70 v/v). Roughness in surface of the processed particles increased with increasing total concentration of the excipients, specially above 25% w/w. Analysis of phosphorus on the surface demonstrated that three-component formulations prepared with combination of 12.5% w/w leucine had the highest amount of dipalmitoylphosphatidylcholine in the surface, regardless of its percentage used in the initial feed. A combination of 12.43% w/w of leucine and 9.80% w/w of dipalmitoylphosphatidylcholine used in formulation exhibited the highest fine particle fraction (72.63%). It can be concluded that spray drying of levodopa with a suitable combination of both excipients leads to production of a three-component formulation of crystalline levodopa, with an aerosolization performance which is significantly higher than two-component formulations composed of the drug with either leucine or dipalmitoylphosphatidylcholine.
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Affiliation(s)
- Sara Bahrainian
- Aerosol Research Laboratory, Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sadat Mirmoeini
- Aerosol Research Laboratory, Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Gilani
- Aerosol Research Laboratory, Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Gilani
- Aerosol Research Laboratory, Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Medicinal Plants Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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10
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de Beer J, Petzer JP, Lourens ACU, Petzer A. Design, synthesis and evaluation of 3-hydroxypyridin-4-ones as inhibitors of catechol-O-methyltransferase. Mol Divers 2021; 25:753-762. [PMID: 32108308 PMCID: PMC7224104 DOI: 10.1007/s11030-020-10053-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 02/13/2020] [Indexed: 11/30/2022]
Abstract
The most effective treatment of Parkinson's disease is restoring central dopamine levels with levodopa, the metabolic precursor of dopamine. However, due to extensive peripheral metabolism by aromatic L-amino acid decarboxylase and catechol-O-methyltransferase (COMT), only a fraction of the levodopa dose reaches the brain unchanged. Thus, by preventing levodopa metabolism and increasing the availability of levodopa for uptake into the brain, the inhibition of COMT would be beneficial in Parkinson's disease. Although nitrocatechol COMT inhibitors have been used in the treatment of Parkinson's disease, efforts have been made to discover non-nitrocatechol inhibitors. In the present study, the 3-hydroxypyridin-4-one scaffold was selected for the design and synthesis of non-nitrocatechol COMT inhibitors since the COMT inhibitory potential of this class has been illustrated. Using COMT obtained from porcine liver, it was shown that a synthetic series of ten 3-hydroxypyridin-4-ones are in vitro inhibitors with IC50 values ranging from 4.55 to 19.8 µM. Although these compounds are not highly potent inhibitors, they may act as leads for the development of non-nitrocatechol COMT inhibitors. Such compounds would be appropriate for the treatment of Parkinson's disease. 3-Hydroxypyridin-4-ones have been synthesised and evaluated as non-nitrocatechol COMT inhibitors. In vitro, the IC50 values ranged from 4.55 to 19.8 μM.
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Affiliation(s)
- Johannie de Beer
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - Jacobus P Petzer
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- Pharmaceutical Chemistry, School of Pharmacy, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - Anna C U Lourens
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- Pharmaceutical Chemistry, School of Pharmacy, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - Anél Petzer
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
- Pharmaceutical Chemistry, School of Pharmacy, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
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11
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Anastassova N, Aluani D, Kostadinov A, Rangelov M, Todorova N, Hristova-Avakumova N, Argirova M, Lumov N, Kondeva-Burdina M, Tzankova V, Yancheva D. Evaluation of the combined activity of benzimidazole arylhydrazones as new anti-Parkinsonian agents: monoamine oxidase-B inhibition, neuroprotection and oxidative stress modulation. Neural Regen Res 2021; 16:2299-2309. [PMID: 33818516 PMCID: PMC8354139 DOI: 10.4103/1673-5374.309843] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Neuroprotective drugs and selective monoamine oxidase inhibitors can slow down the progression and improve symptoms of Parkinson’s disease (PD). Since there is an implication of oxidative stress in the pathophysiological mechanisms of the disease, the compounds possessing an ability to reduce the oxidative stress are prime candidates for neuroprotection. Thereby our current study is focused on the development of new multi-target PD drugs capable of inhibiting the activity of monoamine oxidase-B while exerting neuroprotective and antioxidant properties. A small series of benzimidazole derivatives containing hydroxy and methoxy arylhydrazone fragments has been synthesized and the neurotoxicity of the compounds has been evaluated in vitro on neuroblastoma SH-SY5Y cells and on isolated rat brain synaptosomes by measuring the cell viability and the levels of reduced glutathione and a good safety profile has been shown. The 2-hydroxy-4-methoxy substituted arylhydrazone 7 was the least toxic on neuronal SH-SY5Y cells and showed the lowest neurotoxicity in rat brain synaptosomes. The neuroprotective properties of the test compounds were further assessed using two models: H2O2 -induced oxidative stress on SH-SY5Y cells and 6-hydroxydopamine-induced neurotoxicity in rat brain synaptosomes. Compound 7 showed more pronounced neuroprotective activity on SH-SY5Y cells, compared to the referent melatonin and rasagiline. It also preserved the synaptosomal viability and the reduced glutathione levels; the effects were stronger than those of rasagiline and comparable to melatonin. All the tested compounds were capable to inhibit human monoamine oxidase-B enzyme to a significant extent, however, compound 7 exerted the most prominent inhibitory activity, similar to selegiline and rasagiline. The carried out molecular docking studies revealed that the activity is related to the appropriate molecular structure enabling the ligand to enter deeper in the narrow and highly lipophylic active site pocket of the human monoamine oxidase-B and has a favoring interaction with the key amino acid residues Tyr326 and Cys172. Since much scientific evidence points out the implication of iron dyshomeostasis in PD, the compounds were tested to reduce the ferrous iron induced oxidative molecular damage on biologically important molecules in an in vitro lecithin containing model system. All the investigated compounds denoted protection effect, stronger than the one of the referent melatonin. In order to support the assignments of the significant neuroprotective and antioxidant pharmacological activities, the radical-scavenging mechanisms of the most promising compound 7 were evaluated using DFT methods. It was found that the most probable free radicals scavenging mechanism in nonpolar phase is the hydrogen atom transfer from the amide group of compound 7, while in polar medium the process is expected to occur by a proton transfer. The current study outlines a perspective leading structure, bearing the potential for a new anti-PD drug. All performed procedures were approved by the Institutional Animal Care Committee of the Medical University of Sofia (Bulgarian Agency for Food Safety with Permission № 190, approved on February 6, 2020).
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Affiliation(s)
- Neda Anastassova
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Denitsa Aluani
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Anton Kostadinov
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Miroslav Rangelov
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Nadezhda Todorova
- Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Nadya Hristova-Avakumova
- Department of Medical Physics and Biophysics, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Argirova
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Nikolay Lumov
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Magdalena Kondeva-Burdina
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Virginia Tzankova
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Denitsa Yancheva
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Sofia, Bulgaria
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12
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Zhang CL, Han QW, Chen NH, Yuan YH. Research on developing drugs for Parkinson's disease. Brain Res Bull 2020; 168:100-109. [PMID: 33387636 DOI: 10.1016/j.brainresbull.2020.12.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/22/2020] [Accepted: 12/26/2020] [Indexed: 12/28/2022]
Abstract
Current treatments for Parkinson's disease (PD) are mainly dopaminergic drugs. However, dopaminergic drugs are only symptomatic treatments and limited by several side effects. Recent studies into drug development focused on emerging new molecular mechanisms, including nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, nuclear receptor-related 1 (Nurr1), adenosine receptor A2, nicotine receptor, metabotropic glutamate receptors (mGluRs), and glucocerebrosidase (GCase). Also, immunotherapy and common pathological mechanisms shared with Alzheimer's Disease (AD) and diabetes have attracted much attention. In this review, we summarized the development of preclinical and clinical studies of novel drugs and the improvement of dopaminergic drugs to provide a prospect for PD treatment.
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Affiliation(s)
- Cheng-Lu Zhang
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica& Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Qi-Wen Han
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica& Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Nai-Hong Chen
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica& Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
| | - Yu-He Yuan
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica& Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
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13
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Abstract
Levodopa is the most effective medication for the treatment of the motor symptoms of Parkinson's disease. However, over time, the clinical response to levodopa becomes complicated by a reduction in the duration and reliability of motor improvement (motor fluctuations) and the emergence of involuntary movements (levodopa-induced dyskinesia). Strategies that have been attempted in an effort to delay the development of these motor complications include levodopa sparing and continuous dopaminergic therapy. Once motor complications occur, a wide array of medical treatments is available to maximize motor function through the day while limiting dyskinesia. Here, we review the clinical features, epidemiology, and risk factors for the development of motor complications, as well as strategies for their prevention and medical management.
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Affiliation(s)
- Stephen D Aradi
- Department of Neurology, Parkinson's Foundation Center of Excellence, University of South Florida, Tampa, FL, USA.
| | - Robert A Hauser
- Department of Neurology, Parkinson's Foundation Center of Excellence, University of South Florida, Tampa, FL, USA
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14
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Müller T. An evaluation of subcutaneous apomorphine for the treatment of Parkinson's disease. Expert Opin Pharmacother 2020; 21:1659-1665. [PMID: 32640853 DOI: 10.1080/14656566.2020.1787379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Heterogeneity of symptoms and individual variability of progression characterizes Parkinson's disease. Unmet therapeutic needs include a cure, disease modification, and improvement of available marketed dopamine-substituting compounds. Personalized treatment, tailored to the patients' needs and symptoms, aims to ameliorate impaired motor behavior and non-motor features. Injection or infusion of apomorphine is a therapeutic option for more advanced patients with severe levodopa associated motor complications. AREAS COVERED This narrative review summarizes the subcutaneous administration, efficacy, and side effects of the non-ergot derivative dopamine agonist apomorphine following a non-systematic literature research. EXPERT OPINION Subcutaneous apomorphine hydrochloride application rapidly terminates intervals with severe motor impairment with bolus injections. Oscillation of motor behavior well responds to continuous apomorphine infusions. Long-term application of the commercially available apomorphine hydrochloride solution sooner or later affects skin and oral mucosa. Onset of skin nodules associated with subcutaneous tissue inflammation probably results from the antioxidant preservative sodium metabisulfite in the apomorphine solution. Addition of another better tolerated and safer antioxidant instead of sodium metabisulphite or use of an already available concentrated apomorphine-free base formulation will enhance its future use, its tolerability, safety, and acceptance of subcutaneous and sublingual application.
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Affiliation(s)
- Thomas Müller
- Department of Neurology, St. Joseph Hospital Berlin-Weißensee , Berlin, Germany
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15
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Coulson J. Optimising the absorption of medicines. Nurs Stand 2020; 35:61-66. [PMID: 32638572 DOI: 10.7748/ns.2020.e11479] [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] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
The speed and extent of medicine absorption in the human body are affected by numerous interrelated pharmacokinetic factors. To maximise therapeutic benefit and ensure patient safety, nurses require an optimal understanding of these factors. The Royal Pharmaceutical Society has established four principles of medicines optimisation that healthcare professionals should follow. This article discusses the pharmacokinetic factors that affect medicine absorption. It also examines the four principles of medicines optimisation and how nurses can use these to ensure the safe and effective use of medicines.
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Affiliation(s)
- Jodie Coulson
- Department of Health Sciences, University of York, York, England
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16
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Paul M, Lau R. Potentials and challenges of Levodopa particle formulation for treatment of Parkinson’s disease through intranasal and pulmonary delivery. ADV POWDER TECHNOL 2020. [DOI: 10.1016/j.apt.2020.03.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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17
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Timpe C, Stegemann S, Barrett A, Mujumdar S. Challenges and opportunities to include patient-centric product design in industrial medicines development to improve therapeutic goals. Br J Clin Pharmacol 2020; 86:2020-2027. [PMID: 32441052 DOI: 10.1111/bcp.14388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/09/2023] Open
Abstract
In the past, drug developers in industry chose approaches mainly focusing on the drug product's efficacy, safety and quality according to the level required by regulatory expectations stipulated in guidelines, pharmacopoeia and other regulatory provisions. By putting more focus on the patient perspective, regulatory authorities are currently raising their requirements regarding successful product submissions. The increasing involvement of patients in the product development process (e.g. conduction of human factor use tests, integration of feedback from patient and patient advisory groups into clinical programmes) requires adaptations to the existing and established industrial drug development processes without compromising fast patient access to innovative therapies. This review provides an expert opinion on the emerging challenges and opportunities to implement a patient-centric approach into new drug development programmes. The aim is to better understand the challenge of finding the right balance between bringing innovative drugs fast to the patients and to develop these in parallel in a patient-centric product form as well as why this is an opportunity and how stakeholder parties (e.g. patients, clinicians, pharmacists, caregivers, regulators) can provide support to achieve desired outcomes.
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Affiliation(s)
| | - Sven Stegemann
- TU Graz, Institute for Process and Particle Engineering, Graz, Austria
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18
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Pfeiffer RF, Isaacson SH, Pahwa R. Clinical implications of gastric complications on levodopa treatment in Parkinson's disease. Parkinsonism Relat Disord 2020; 76:63-71. [PMID: 32461054 DOI: 10.1016/j.parkreldis.2020.05.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/09/2020] [Accepted: 05/01/2020] [Indexed: 12/16/2022]
Abstract
Disorders of the gastrointestinal (GI) tract are common and distressing nonmotor symptoms of Parkinson's disease (PD) that can adversely affect levodopa absorption and lead to OFF periods, also known as motor fluctuations. Gastroparesis, which is primarily defined as delayed gastric emptying (DGE), and Helicobacter pylori infection, which is present with increased frequency in PD, are among the most common and important GI disorders reported in PD that may impair oral levodopa absorption and increase OFF time. Symptoms of gastroparesis include nausea, vomiting, postprandial bloating, fullness, early satiety, abdominal pain, and weight loss. DGE has been reported in a substantial fraction of individuals with PD. Symptoms of H. pylori infection include gastritis and peptic ulcers. Studies have found that DGE and H. pylori infection are correlated with delayed peak levodopa plasma levels and increased incidence of motor fluctuations. Therapeutic strategies devised to minimize the potential that gastric complications will impair oral levodopa absorption and efficacy in PD patients include treatments that circumvent the GI tract, such as apomorphine injection, levodopa intestinal gel delivery, levodopa inhalation powder, and deep brain stimulation. Other strategies aim at improving gastric emptying in PD patients, primarily including prokinetic agents.
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Affiliation(s)
- Ronald F Pfeiffer
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
| | - Stuart H Isaacson
- Parkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA
| | - Rajesh Pahwa
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
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19
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Hitge R, Smit S, Petzer A, Petzer JP. Evaluation of nitrocatechol chalcone and pyrazoline derivatives as inhibitors of catechol-O-methyltransferase and monoamine oxidase. Bioorg Med Chem Lett 2020; 30:127188. [PMID: 32299731 DOI: 10.1016/j.bmcl.2020.127188] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/27/2022]
Abstract
Literature reports that chalcones inhibit the monoamine oxidase (MAO) enzymes, mostly with specificity for the MAO-B isoform, while nitrocatechol compounds are established inhibitors of catechol-O-methyltransferase (COMT). Based on this, nitrocatechol derivatives of chalcone have been proposed to represent dual-target-directed compounds that may inhibit both MAO-B and COMT. Both these enzymes play key roles in the metabolism of dopamine and levodopa, and inhibitors are thus relevant to the treatment of Parkinson's disease. The present study expands on the discovery of dual MAO-B/COMT inhibitors by synthesising additional nitrocatechol derivatives of chalcones which include heterocyclic derivatives, and converting them to the corresponding pyrazoline derivatives. The newly synthesised chalcone and pyrazoline compounds were evaluated as inhibitors of human MAO and rat COMT, and the inhibition potencies were expressed as IC50 values. A pyrazoline derivative, compound 8b, was the most potent COMT inhibitor with an IC50 value of 0.048 μM. This is more potent than the reference COMT inhibitor, entacapone, which has an IC50 value of 0.23 μM. The results indicated that the pyrazoline derivatives (IC50 = 0.048-0.21 µM) are more potent COMT inhibitors than the chalcones (IC50 = 0.14-0.29 µM). Unfortunately, the chalcone and pyrazoline derivatives were weak MAO inhibitors with IC50 values > 41.4 µM. This study concludes that the nitrocatechol derivatives investigated here are promising COMT inhibitors, while not being suitable as MAO inhibitors. Using molecular docking, potential binding modes and interactions of selected inhibitors with COMT are proposed.
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Affiliation(s)
- Rialette Hitge
- Pharmaceutical Chemistry, School of Pharmacy and Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom 2520, South Africa
| | - Sharissa Smit
- Pharmaceutical Chemistry, School of Pharmacy and Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom 2520, South Africa
| | - Anél Petzer
- Pharmaceutical Chemistry, School of Pharmacy and Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom 2520, South Africa.
| | - Jacobus P Petzer
- Pharmaceutical Chemistry, School of Pharmacy and Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom 2520, South Africa.
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20
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Ghanta MK, Elango P, L V K S B. Current Therapeutic Strategies and Perspectives for Neuroprotection in Parkinson's Disease. Curr Pharm Des 2020; 26:4738-4746. [PMID: 32065086 DOI: 10.2174/1381612826666200217114658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/10/2020] [Indexed: 02/04/2023]
Abstract
Parkinson's disease is a progressive neurodegenerative disorder of dopaminergic striatal neurons in basal ganglia. Treatment of Parkinson's disease (PD) through dopamine replacement strategies may provide improvement in early stages and this treatment response is related to dopaminergic neuronal mass which decreases in advanced stages. This treatment failure was revealed by many studies and levodopa treatment became ineffective or toxic in chronic stages of PD. Early diagnosis and neuroprotective agents may be a suitable approach for the treatment of PD. The essentials required for early diagnosis are biomarkers. Characterising the striatal neurons, understanding the status of dopaminergic pathways in different PD stages may reveal the effects of the drugs used in the treatment. This review updates on characterisation of striatal neurons, electrophysiology of dopaminergic pathways in PD, biomarkers of PD, approaches for success of neuroprotective agents in clinical trials. The literature was collected from the articles in database of PubMed, MedLine and other available literature resources.
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Affiliation(s)
- Mohan K Ghanta
- Department of Pharmacology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai-600116, Tamil Nadu, India
| | - P Elango
- Department of Pharmacology, Panimalar Medical College Hospital & Research Institute, Poonamallee, Chennai-600123, Tamil Nadu, India
| | - Bhaskar L V K S
- Department of Zoology, Guru Ghasidas University, Bilaspur, 495009 (CG), India
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21
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22
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Carrarini C, Russo M, Dono F, Di Pietro M, Rispoli MG, Di Stefano V, Ferri L, Barbone F, Vitale M, Thomas A, Sensi SL, Onofrj M, Bonanni L. A Stage-Based Approach to Therapy in Parkinson's Disease. Biomolecules 2019; 9:biom9080388. [PMID: 31434341 PMCID: PMC6723065 DOI: 10.3390/biom9080388] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/31/2019] [Accepted: 08/14/2019] [Indexed: 12/11/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder that features progressive, disabling motor symptoms, such as bradykinesia, rigidity, and resting tremor. Nevertheless, some non-motor symptoms, including depression, REM sleep behavior disorder, and olfactive impairment, are even earlier features of PD. At later stages, apathy, impulse control disorder, neuropsychiatric disturbances, and cognitive impairment can present, and they often become a heavy burden for both patients and caregivers. Indeed, PD increasingly compromises activities of daily life, even though a high variability in clinical presentation can be observed among people affected. Nowadays, symptomatic drugs and non-pharmaceutical treatments represent the best therapeutic options to improve quality of life in PD patients. The aim of the present review is to provide a practical, stage-based guide to pharmacological management of both motor and non-motor symptoms of PD. Furthermore, warning about drug side effects, contraindications, as well as dosage and methods of administration, are highlighted here, to help the physician in yielding the best therapeutic strategies for each symptom and condition in patients with PD.
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Affiliation(s)
- Claudia Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Martina Di Pietro
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Marianna G Rispoli
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Vincenzo Di Stefano
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Laura Ferri
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Filomena Barbone
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Michela Vitale
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Stefano Luca Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy.
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23
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Engelbrecht I, Petzer JP, Petzer A. Evaluation of Selected Natural Compounds as Dual Inhibitors of Catechol-O-Methyltransferase and Monoamine Oxidase. Cent Nerv Syst Agents Med Chem 2019; 19:133-145. [PMID: 31258092 DOI: 10.2174/1871524919666190619090852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 05/23/2019] [Accepted: 06/03/2019] [Indexed: 12/15/2022]
Abstract
Background:
The most effective symptomatic treatment of Parkinson’s disease remains
the metabolic precursor of dopamine, L-dopa. To enhance the efficacy of L-dopa, it is often combined
with inhibitors of the enzymes, catechol-O-methyltransferase (COMT) and monoamine oxidase
(MAO) B, key metabolic enzymes of L-dopa and dopamine.
Objective:
This study attempted to discover compounds that exhibit dual inhibition of COMT and
MAO-B among a library of 40 structurally diverse natural compounds. Such dual acting inhibitors
may be effective as adjuncts to L-dopa and offer enhanced value in the management of Parkinson’s
disease.
Methods:
Selected natural compounds were evaluated as in vitro inhibitors of rat liver COMT and
recombinant human MAO. Reversibility of MAO inhibition was investigated by dialysis.
Results:
Among the natural compounds morin (IC50 = 1.32 µM), chlorogenic acid (IC50 = 6.17 µM),
(+)-catechin (IC50 = 0.86 µM), alizarin (IC50 = 0.88 µM), fisetin (IC50 = 5.78 µM) and rutin (IC50 =
25.3 µM) exhibited COMT inhibition. Among these active COMT inhibitors only morin (IC50 = 16.2
µM), alizarin (IC50 = 8.16 µM) and fisetin (IC50 = 7.33 µM) were noteworthy MAO inhibitors, with
specificity for MAO-A.
Conclusion:
None of the natural products investigated here are dual COMT/MAO-B inhibitors.
However, good potency COMT inhibitors have been identified, which may serve as leads for future
development of COMT inhibitors.
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Affiliation(s)
- Idalet Engelbrecht
- Pharmaceutical Chemistry, School of Pharmacy and Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Jacobus P. Petzer
- Pharmaceutical Chemistry, School of Pharmacy and Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Anél Petzer
- Pharmaceutical Chemistry, School of Pharmacy and Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
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24
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LeWitt PA, Giladi N, Navon N. Pharmacokinetics and efficacy of a novel formulation of carbidopa-levodopa (Accordion Pill®) in Parkinson's disease. Parkinsonism Relat Disord 2019; 65:131-138. [DOI: 10.1016/j.parkreldis.2019.05.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
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25
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Hayes MW, Fung VSC, Kimber TE, O'Sullivan JD. Updates and advances in the treatment of Parkinson disease. Med J Aust 2019; 211:277-283. [DOI: 10.5694/mja2.50224] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Michael W Hayes
- Concord Repatriation General Hospital Sydney NSW
- Sydney Medical SchoolUniversity of Sydney Sydney NSW
| | - Victor SC Fung
- Sydney Medical SchoolUniversity of Sydney Sydney NSW
- Westmead Hospital Sydney NSW
| | - Thomas E Kimber
- Royal Adelaide Hospital Adelaide SA
- University of Adelaide Adelaide SA
| | - John D O'Sullivan
- Royal Brisbane and Women's Hospital Brisbane QLD
- University of QueenslandBrisbaneQLD
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26
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Shpiner DS, Bette S, Di Luca DG, Margolesky J. CVT-301 for the treatment of Parkinson’s disease. Expert Rev Neurother 2019; 19:603-611. [DOI: 10.1080/14737175.2019.1621748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Danielle S. Shpiner
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sagari Bette
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel G. Di Luca
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jason Margolesky
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
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27
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The next chapter in symptomatic Parkinson disease treatments. Parkinsonism Relat Disord 2019; 59:39-48. [DOI: 10.1016/j.parkreldis.2019.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/01/2018] [Accepted: 01/02/2019] [Indexed: 01/19/2023]
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28
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Cyclodextrins in Parkinson's Disease. Biomolecules 2018; 9:biom9010003. [PMID: 30583478 PMCID: PMC6359444 DOI: 10.3390/biom9010003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/17/2022] Open
Abstract
: Parkinson's disease is a movement disorder characterized by a progressive degeneration of dopaminergic neurons that has been object of study by the scientific community through the last decades. However, nowadays there is still no treatment to cure it, although there are drugs available, with limited efficacy, to relieve the symptoms or replenish the cells with dopamine to supply the lack of dopaminergic neurons. This work was structured in two parts. In the first one, binary aqueous solutions of L-dopa and cyclodextrins were studied. In the second part, ternary aqueous solutions of L-dopa were studied with each of the selected cyclodextrins. In all cases, thermodynamic properties (density, partial molar volume and thermodynamic transfer functions for temperatures between 294.15 ± 0.01 K and 312.15 ± 0.01 K) and transport properties (mutual diffusion coefficients, viscosity, transfer viscosity at 298.15 ± 0.01 K and 310.15 ± 0.01 K) were studied. Using theoretical models to adjust the experimental data obtained for the diffusion coefficients and for the apparent molar volumes, in the ternary aqueous solutions, it was possible to estimate the values to the L-dopa-cyclodextrin association constant. For the aqueous ternary solutes, the partial molar volume of transfer of levodopa in the presence of the cyclodextrins, the partial molar expansibility at infinite dilution and from this, the Hepler constant, were determined. Also, the values of Gibbs free energy (ΔG⁰), enthalpy (ΔH⁰) and entropy (ΔS⁰) were determined. From the obtained information, it was possible to characterize the molecular interactions, as well as to identify some structural characteristics of the controlled drug delivery systems under study and to estimate the influence of the cyclodextrin substituent groups, and, also, the temperature effect in the interaction levodopa-cyclodextrin. It is our intent to attain information about the mechanism of possible new systems for controlled drug delivery systems, throughout an alternative perspective, which could allow to increase its effectiveness in the Parkinson's treatment.
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Espay AJ, Morgante F, Merola A, Fasano A, Marsili L, Fox SH, Bezard E, Picconi B, Calabresi P, Lang AE. Levodopa-induced dyskinesia in Parkinson disease: Current and evolving concepts. Ann Neurol 2018; 84:797-811. [DOI: 10.1002/ana.25364] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Alberto J. Espay
- UC Gardner Neuroscience Institute and Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology; University of Cincinnati; Cincinnati OH
| | - Francesca Morgante
- Institute of Molecular and Clinical Sciences; St George's University of London; London United Kingdom
| | - Aristide Merola
- UC Gardner Neuroscience Institute and Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology; University of Cincinnati; Cincinnati OH
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology; University of Toronto; Toronto Ontario Canada
- Krembil Brain Institute; Toronto Ontario Canada
| | - Luca Marsili
- UC Gardner Neuroscience Institute and Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology; University of Cincinnati; Cincinnati OH
| | - Susan H. Fox
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology; University of Toronto; Toronto Ontario Canada
- Krembil Brain Institute; Toronto Ontario Canada
| | - Erwan Bezard
- University of Bordeaux, Institute of Neurodegenerative Diseases; Bordeaux France
- National Center for Scientific Research, Institute of Neurodegenerative Diseases; Bordeaux France
| | - Barbara Picconi
- Experimental Neurophysiology Laboratory; IRCCS San Raffaele Pisana, University San Raffaele; Rome Italy
| | - Paolo Calabresi
- Neurological Clinic; University of Perugia, Santa Maria della Misericordia Hospital; Perugia Italy
| | - Anthony E. Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology; University of Toronto; Toronto Ontario Canada
- Krembil Brain Institute; Toronto Ontario Canada
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30
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Khan AU, Akram M, Daniyal M, Zainab R. Awareness and current knowledge of Parkinson’s disease: a neurodegenerative disorder. Int J Neurosci 2018; 129:55-93. [DOI: 10.1080/00207454.2018.1486837] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Asmat Ullah Khan
- Department of Pharmacology, Laboratory of Neuroanatomy and Neuropsychobiology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), São Paulo, Brazil
- Department of Eastern Medicine and Surgery, School of Medical and Health Sciences, The University of Poonch Rawalakot, Rawalakot, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine and Surgery, Directorate of Medical Sciences, Old Campus, Allama Iqbal Road, Government College University, Faisalabad, Pakistan
| | - Muhammad Daniyal
- TCM and Ethnomedicine Innovation and Development Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
- College of Biology, Hunan Province Key Laboratory of Plant Functional Genomics and Developmental Regulation, State Key Laboratory of Hunan University, Changsha, China
| | - Rida Zainab
- Department of Eastern Medicine and Surgery, Directorate of Medical Sciences, Old Campus, Allama Iqbal Road, Government College University, Faisalabad, Pakistan
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31
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Fox SH, Brotchie JM. Viewpoint: Developing drugs for levodopa-induced dyskinesia in PD: Lessons learnt, what does the future hold? Eur J Neurosci 2018; 49:399-409. [PMID: 30269407 DOI: 10.1111/ejn.14173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/27/2018] [Accepted: 08/01/2018] [Indexed: 12/21/2022]
Abstract
The drive to develop drugs to treat PD starts and ends with the patient. Herein, we discuss how the experience with drug development for LID has led the field in translational studies in PD with advancing ground-breaking science via rigorous clinical trial design, to deliver clinical proof-of-concepts across multiple therapeutic targets. However, issues remain in advancing drugs efficacious preclinically to the clinic, and future studies need to learn from past successes and failures. Such lessons include implementing better early indicators of tolerability, for instance evaluating non-motor symptoms in preclinical models; improving patient-related outcome measures in clinical trials, as well as considering the unique nature of dyskinesia in an individual patient. The field of translational studies needs to become more patient focused to improve successful outcomes.
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Affiliation(s)
- Susan H Fox
- The Edmond J Safra Program in Parkinson Disease and Movement Disorder Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Jonathan M Brotchie
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada.,Atuka Inc, Toronto, Ontario, Canada
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Müller T, Möhr JD. Efficacy of carbidopa-levodopa extended-release capsules (IPX066) in the treatment of Parkinson Disease. Expert Opin Pharmacother 2018; 19:2063-2071. [DOI: 10.1080/14656566.2018.1538355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Thomas Müller
- Department of Neurology, St. Joseph Hospital Berlin-Weißensee , Berlin, Germany
| | - Jan-Dominique Möhr
- Department of Neurology, St. Joseph Hospital Berlin-Weißensee , Berlin, Germany
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Lane EL. L-DOPA for Parkinson's disease-a bittersweet pill. Eur J Neurosci 2018; 49:384-398. [PMID: 30118169 DOI: 10.1111/ejn.14119] [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: 05/15/2018] [Revised: 07/23/2018] [Accepted: 07/30/2018] [Indexed: 01/02/2023]
Abstract
3,4-dihydroxy-L-phenylalanine (L-DOPA) is the gold standard treatment for Parkinson's disease. It has earned that title through its highly effective treatment of some of the motor symptoms in the early stages of the disease but it is a far from perfect drug. The inevitable long-term treatment that comes with this chronic neurodegenerative condition raises the risk significantly of the development of motor fluctuations including disabling L-DOPA-induced dyskinesia. Being unsurpassed as a therapy means that understanding the mechanisms of dyskinesia priming and induction is vital to the search for therapies to treat these side effects and allow optimal use of L-DOPA. However, L-DOPA use may also have consequences (positive or negative) for the development of other interventions, such as cell transplantation, which are designed to treat or repair the ailing brain. This review looks at the issues around the use of L-DOPA with a focus on its potential impact on advanced reparative interventions.
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Affiliation(s)
- Emma L Lane
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
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Müller T, Möhr JD. Long-term management of Parkinson’s disease using levodopa combinations. Expert Opin Pharmacother 2018; 19:1003-1011. [DOI: 10.1080/14656566.2018.1484108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Thomas Müller
- Department of Neurology, St. Joseph Hospital Berlin-Weißensee, Berlin, Germany
| | - Jan-Dominique Möhr
- Department of Neurology, St. Joseph Hospital Berlin-Weißensee, Berlin, Germany
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Lu L, Jia H, Gao G, Duan C, Ren J, Li Y, Yang H. Pink1 Regulates Tyrosine Hydroxylase Expression and Dopamine Synthesis. J Alzheimers Dis 2018; 63:1361-1371. [DOI: 10.3233/jad-170832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Lingling Lu
- Department of Neurobiology, Capital Medical University, Center of Parkinson’s Disease, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, China
| | - Huanzhen Jia
- Department of Neurobiology, Capital Medical University, Center of Parkinson’s Disease, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, China
| | - Ge Gao
- Department of Neurobiology, Capital Medical University, Center of Parkinson’s Disease, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, China
| | - Chunli Duan
- Department of Neurobiology, Capital Medical University, Center of Parkinson’s Disease, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, China
| | - Jing Ren
- Department of Neurobiology, Capital Medical University, Center of Parkinson’s Disease, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, China
| | - Yi Li
- Department of Neurobiology, Capital Medical University, Center of Parkinson’s Disease, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, China
| | - Hui Yang
- Department of Neurobiology, Capital Medical University, Center of Parkinson’s Disease, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, China
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Tambasco N, Romoli M, Calabresi P. Levodopa in Parkinson's Disease: Current Status and Future Developments. Curr Neuropharmacol 2018; 16:1239-1252. [PMID: 28494719 PMCID: PMC6187751 DOI: 10.2174/1570159x15666170510143821] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/25/2017] [Accepted: 05/09/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Ever since the pioneering reports in the 60s, L-3,4-Dioxyphenylalanine (levodopa) has represented the gold standard for the treatment of Parkinson's Disease (PD). However, long-term levodopa (LD) treatment is frequently associated with fluctuations in motor response with serious impact on patient quality of life. The pharmacokinetic and pharmacodynamic properties of LD are pivotal to such motor fluctuations: discontinuous drug delivery, short half-life, poor bioavailability, and narrow therapeutic window are all crucial for such fluctuations. During the last 60 years, several attempts have been made to improve LD treatment and avoid long-term complications. METHODS Research and trials to improve the LD pharmacokinetic since 1960s are reviewed, summarizing the progressive improvements of LD treatment. RESULTS Inhibitors of peripheral amino acid decarboxylase (AADC) have been introduced to achieve proper LD concentration in the central nervous system reducing systemic adverse events. Inhibitors of catechol-O-methyltransferase (COMT) increased LD half-life and bioavailability. Efforts are still being made to achieve a continuous dopaminergic stimulation, with the combination of oral LD with an AADC inhibitor and a COMT inhibitor, or the intra-duodenal water-based LD/ carbidopa gel. Further approaches to enhance LD efficacy are focused on new non-oral administration routes, including nasal, intra-duodenal, intrapulmonary (CVT-301) and subcutaneous (ND0612), as well as on novel ER formulations, including IPX066, which recently concluded phase III trial. CONCLUSION New LD formulations, oral compounds as well as routes have been tested in the last years, with two main targets: achieve continuous dopaminergic stimulation and find an instant deliver route for LD.
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Affiliation(s)
- Nicola Tambasco
- Address correspondence to this author at the Clinica Neurologica, Azienda Ospedaliera e Universitaria di Perugia, Loc. S.Andrea delle Fratte 06156, Perugia, Italy; Tel: +39-075-5783830; Fax: +39-075-5784229;, E-mail:
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Haddad F, Sawalha M, Khawaja Y, Najjar A, Karaman R. Dopamine and Levodopa Prodrugs for the Treatment of Parkinson's Disease. Molecules 2017; 23:E40. [PMID: 29295587 PMCID: PMC5943940 DOI: 10.3390/molecules23010040] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 12/12/2022] Open
Abstract
Background: Parkinson's disease is an aggressive and progressive neurodegenerative disorder that depletes dopamine (DA) in the central nervous system. Dopamine replacement therapy, mainly through actual dopamine and its original prodrug l-dopa (LD), faces many challenges such as poor blood brain barrier penetration and decreased response to therapy with time. Methods: The prodrugs described herein are ester, amide, dimeric amide, carrier-mediated, peptide transport-mediated, cyclic, chemical delivery systems and enzyme-models prodrugs designed and made by chemical means, and their bioavailability was studied in animals. Results: A promising ester prodrug for intranasal delivery has been developed. LD methyl ester is currently in Phase III clinical trials. A series of amide prodrugs were synthesized with better stability than ester prodrugs. Both amide and dimeric amide prodrugs offer enhanced blood brain barrier (BBB) penetration and better pharmacokinetics. Attaching LD to sugars has been used to exploit glucose transport mechanisms into the brain. Conclusions: Till now, no DA prodrug has reached the pharmaceutical market, nevertheless, the future of utilizing prodrugs for the treatment of PD seems to be bright. For instance, LD ester prodrugs have demonstrated an adequate intranasal delivery of LD, thus enabling the absorption of therapeutic agents to the brain. Most of the amide, cyclic, peptidyl or chemical delivery systems of DA prodrugs demonstrated enhanced pharmacokinetic properties.
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Affiliation(s)
- Fatma Haddad
- Department of Bioorganic & Pharmaceutical Chemistry, Faculty of Pharmacy, Al-Quds University, Jerusalem P.O. Box 20002, Palestine.
| | - Maryam Sawalha
- Department of Bioorganic & Pharmaceutical Chemistry, Faculty of Pharmacy, Al-Quds University, Jerusalem P.O. Box 20002, Palestine.
| | - Yahya Khawaja
- Department of Bioorganic & Pharmaceutical Chemistry, Faculty of Pharmacy, Al-Quds University, Jerusalem P.O. Box 20002, Palestine.
| | - Anas Najjar
- Department of Bioorganic & Pharmaceutical Chemistry, Faculty of Pharmacy, Al-Quds University, Jerusalem P.O. Box 20002, Palestine.
| | - Rafik Karaman
- Department of Bioorganic & Pharmaceutical Chemistry, Faculty of Pharmacy, Al-Quds University, Jerusalem P.O. Box 20002, Palestine.
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Perez-Pardo P, Kliest T, Dodiya HB, Broersen LM, Garssen J, Keshavarzian A, Kraneveld AD. The gut-brain axis in Parkinson's disease: Possibilities for food-based therapies. Eur J Pharmacol 2017; 817:86-95. [DOI: 10.1016/j.ejphar.2017.05.042] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/31/2017] [Accepted: 05/22/2017] [Indexed: 12/18/2022]
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The Design and Evaluation of an l-Dopa-Lazabemide Prodrug for the Treatment of Parkinson's Disease. Molecules 2017; 22:molecules22122076. [PMID: 29186917 PMCID: PMC6150007 DOI: 10.3390/molecules22122076] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/22/2017] [Accepted: 11/23/2017] [Indexed: 11/28/2022] Open
Abstract
l-Dopa, the metabolic precursor of dopamine, is the treatment of choice for the symptomatic relief of the advanced stages of Parkinson’s disease. The oral bioavailability of l-dopa, however, is only about 10% to 30%, and less than 1% of the oral dose is estimated to reach the brain unchanged. l-Dopa’s physicochemical properties are responsible for its poor bioavailability, short half-life and the wide range of inter- and intrapatient variations of plasma levels. An l-dopa–lazabemide prodrug is proposed to overcome the problems associated with l-dopa absorption. Lazabemide is a monoamine oxidase (MAO)-B inhibitor, a class of compounds that slows the depletion of dopamine stores in Parkinson’s disease and elevates dopamine levels produced by exogenously administered l-dopa. l-Dopa was linked at the carboxylate with the primary aminyl functional group of lazabemide via an amide, a strategy which is anticipated to protect l-dopa against peripheral decarboxylation and possibly also enhance the membrane permeability of the prodrug. Selected physicochemical and biochemical properties of the prodrug were determined and included lipophilicity (logD), solubility, passive diffusion permeability, pKa, chemical and metabolic stability as well as cytotoxicity. Although oral and i.p. treatment of mice with the prodrug did not result in enhanced striatal dopamine levels, 3,4-dihydroxyphenylacetic acid (DOPAC) levels were significantly depressed compared to saline, l-dopa and carbidopa/l-dopa treatment. Based on the results, further preclinical evaluation of the l-dopa–lazabemide prodrug should be undertaken with the aim of discovering prodrugs that may be advanced to the clinical stages of development.
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Wollmer E, Klein S. A review of patient-specific gastrointestinal parameters as a platform for developing in vitro models for predicting the in vivo performance of oral dosage forms in patients with Parkinson’s disease. Int J Pharm 2017; 533:298-314. [DOI: 10.1016/j.ijpharm.2017.08.126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/25/2017] [Accepted: 08/31/2017] [Indexed: 02/06/2023]
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Vijiaratnam N, Evans AH. Treatment advances in Parkinson disease: Same script different cast? J Clin Neurosci 2017; 47:354-355. [PMID: 29037937 DOI: 10.1016/j.jocn.2017.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Nirosen Vijiaratnam
- Department of Neurology, Western Health, Gordon Street, Footscray 3011, Victoria, Australia.
| | - Andrew H Evans
- Movement Disorders Service, Department of Neurology, The Royal Melbourne Hospital, Grattan St, Parkville 3050, Australia
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Obeso J, Stamelou M, Goetz C, Poewe W, Lang A, Weintraub D, Burn D, Halliday G, Bezard E, Przedborski S, Lehericy S, Brooks D, Rothwell J, Hallett M, DeLong M, Marras C, Tanner C, Ross G, Langston J, Klein C, Bonifati V, Jankovic J, Lozano A, Deuschl G, Bergman H, Tolosa E, Rodriguez-Violante M, Fahn S, Postuma R, Berg D, Marek K, Standaert D, Surmeier D, Olanow C, Kordower J, Calabresi P, Schapira A, Stoessl A. Past, present, and future of Parkinson's disease: A special essay on the 200th Anniversary of the Shaking Palsy. Mov Disord 2017; 32:1264-1310. [PMID: 28887905 PMCID: PMC5685546 DOI: 10.1002/mds.27115] [Citation(s) in RCA: 498] [Impact Index Per Article: 71.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 12/12/2022] Open
Abstract
This article reviews and summarizes 200 years of Parkinson's disease. It comprises a relevant history of Dr. James Parkinson's himself and what he described accurately and what he missed from today's perspective. Parkinson's disease today is understood as a multietiological condition with uncertain etiopathogenesis. Many advances have occurred regarding pathophysiology and symptomatic treatments, but critically important issues are still pending resolution. Among the latter, the need to modify disease progression is undoubtedly a priority. In sum, this multiple-author article, prepared to commemorate the bicentenary of the shaking palsy, provides a historical state-of-the-art account of what has been achieved, the current situation, and how to progress toward resolving Parkinson's disease. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- J.A. Obeso
- HM CINAC, Hospital Universitario HM Puerta del Sur, Mostoles, Madrid, Spain
- Universidad CEU San Pablo, Madrid, Spain
- CIBERNED, Madrid, Spain
| | - M. Stamelou
- Department of Neurology, Philipps University, Marburg, Germany
- Parkinson’s Disease and Movement Disorders Department, HYGEIA Hospital and Attikon Hospital, University of Athens, Athens, Greece
| | - C.G. Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - W. Poewe
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - A.E. Lang
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson’s Disease, Toronto Western Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - D. Weintraub
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Parkinson’s Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Corporal Michael J. Crescenz Veteran’s Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - D. Burn
- Medical Sciences, Newcastle University, Newcastle, UK
| | - G.M. Halliday
- Brain and Mind Centre, Sydney Medical School, The University of Sydney, Sydney, Australia
- School of Medical Sciences, University of New South Wales and Neuroscience Research Australia, Sydney, Australia
| | - E. Bezard
- Université de Bordeaux, Institut des Maladies Neurodégénératives, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
- China Academy of Medical Sciences, Institute of Lab Animal Sciences, Beijing, China
| | - S. Przedborski
- Departments of Neurology, Pathology, and Cell Biology, the Center for Motor Neuron Biology and Disease, Columbia University, New York, New York, USA
- Columbia Translational Neuroscience Initiative, Columbia University, New York, New York, USA
| | - S. Lehericy
- Institut du Cerveau et de la Moelle épinière – ICM, Centre de NeuroImagerie de Recherche – CENIR, Sorbonne Universités, UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, Paris, France
- Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - D.J. Brooks
- Clinical Sciences Department, Newcastle University, Newcastle, UK
- Department of Nuclear Medicine, Aarhus University, Aarhus, Denmark
| | - J.C. Rothwell
- Human Neurophysiology, Sobell Department, UCL Institute of Neurology, London, UK
| | - M. Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - M.R. DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - C. Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson’s disease, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - C.M. Tanner
- Movement Disorders and Neuromodulation Center, Department of Neurology, University of California–San Francisco, San Francisco, California, USA
- Parkinson’s Disease Research, Education and Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - G.W. Ross
- Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii, USA
| | | | - C. Klein
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - V. Bonifati
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J. Jankovic
- Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - A.M. Lozano
- Department of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - G. Deuschl
- Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian Albrechts University Kiel, Kiel, Germany
| | - H. Bergman
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada, Jerusalem, Israel
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem, Israel
- Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel
| | - E. Tolosa
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - M. Rodriguez-Violante
- Movement Disorders Clinic, Clinical Neurodegenerative Research Unit, Mexico City, Mexico
- Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - S. Fahn
- Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - R.B. Postuma
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada
| | - D. Berg
- Klinikfür Neurologie, UKSH, Campus Kiel, Christian-Albrechts-Universität, Kiel, Germany
| | - K. Marek
- Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA
| | - D.G. Standaert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - D.J. Surmeier
- Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - C.W. Olanow
- Departments of Neurology and Neuroscience, Mount Sinai School of Medicine, New York, New York, USA
| | - J.H. Kordower
- Research Center for Brain Repair, Rush University Medical Center, Chicago, Illinois, USA
- Neuroscience Graduate Program, Rush University Medical Center, Chicago, Illinois, USA
| | - P. Calabresi
- Neurological Clinic, Department of Medicine, Hospital Santa Maria della Misericordia, University of Perugia, Perugia, Italy
- Laboratory of Neurophysiology, Santa Lucia Foundation, IRCCS, Rome, Italy
| | - A.H.V. Schapira
- University Department of Clinical Neurosciences, UCL Institute of Neurology, University College London, London, UK
| | - A.J. Stoessl
- Pacific Parkinson’s Research Centre, Division of Neurology & Djavadf Mowafaghian Centre for Brain Health, University of British Columbia, British Columbia, Canada
- Vancouver Coastal Health, Vancouver, British Columbia, Canada
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Freitas ME, Hess CW, Fox SH. Motor Complications of Dopaminergic Medications in Parkinson's Disease. Semin Neurol 2017; 37:147-157. [PMID: 28511255 DOI: 10.1055/s-0037-1602423] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Motor complications are a consequence of the chronic treatment of Parkinson's disease (PD) and include motor fluctuations (wearing-off phenomenon) and levodopa-induced dyskinesia. Both can have a significant impact on functionality and quality of life; thus, proper recognition and management is essential. The phenomenology and temporal relationship of motor complications to the schedule of levodopa dosing can be helpful in characterizing them. There are several therapeutic approaches to motor complications, including pharmacological and surgical options. The authors summarize the different types of motor complications according to phenomenology and the currently available medical treatments, including ongoing trials for the management of this condition.
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Affiliation(s)
- Maria Eliza Freitas
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Christopher W Hess
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida
| | - Susan H Fox
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
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