Combined 5-HT1A and 5-HT1B receptor agonists for the treatment of l-DOPA-induced dyskinesia

A Munoz, Q Li, F Gardoni, E Marcello, C Qin… - Brain, 2008 - academic.oup.com
A Munoz, Q Li, F Gardoni, E Marcello, C Qin, T Carlsson, D Kirik, M Di Luca, A Björklund
Brain, 2008academic.oup.com
Appearance of dyskinesia is a common problem of long-term l-DOPA treatment in
Parkinson's disease patients and represents a major limitation for the pharmacological
management of the motor symptoms in advanced disease stages. We have recently
demonstrated that dopamine released from serotonin neurons is responsible for l-DOPA-
induced dyskinesia in 6-hydroxydopamine (6-OHDA)-lesioned rats, raising the possibility
that blockade of serotonin neuron activity by combination of 5-HT1A and 5-HT1B agonists …
Abstract
Appearance of dyskinesia is a common problem of long-term l-DOPA treatment in Parkinson's disease patients and represents a major limitation for the pharmacological management of the motor symptoms in advanced disease stages. We have recently demonstrated that dopamine released from serotonin neurons is responsible for l-DOPA-induced dyskinesia in 6-hydroxydopamine (6-OHDA)-lesioned rats, raising the possibility that blockade of serotonin neuron activity by combination of 5-HT1A and 5-HT1B agonists could reduce l-DOPA-induced dyskinesia. In the present study, we have investigated the efficacy of 5-HT1A and 5-HT1B agonists to counteract l-DOPA-induced dyskinesia in 1-methyl-4-phenyl 1,2,3,6-tetrahydropyridine (MPTP)-treated macaques, the gold standard model of Parkinson's disease. In addition, we have studied the ability of this treatment to prevent development of l-DOPA-induced dyskinesia in 6-OHDA-lesioned rats. The results demonstrate the existence of a potent synergistic effect between 5-HT1A and 5-HT1B agonists in their ability to dampen l-DOPA-induced dyskinesia in the MPTP-treated macaques. Sub-threshold doses of the drugs, which individually produced no effect, were able to reduce the abnormal involuntary movements by up to 80% when administered in combination, without affecting the anti-parkinsonian properties of l-DOPA. Furthermore, chronic administration of low doses of the 5-HT1 agonists in combination was able to prevent development of dyskinesia, and reduce the up-regulation of FosB after daily treatment with l-DOPA in the rat 6-OHDA model. Our results support the importance of a clinical investigation of the effect of 5-HT1A and 5-HT1B agonists, particularly in combination, in dyskinetic l-DOPA-treated Parkinson's disease patients.
Oxford University Press