L-DOPA OVERLOAD: MECHANISMS FOR THE SIDE EFFECTS.

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L-dopa, the precursor of dopamine (DA), is the most effective drug used for treating the symptoms of Parkinson's disease (PD), but its use is limited by serious side effects that occur after continuous use. The causes are unknown, but during L-dopa treatments tissue L-dopa greatly exceeds the barely detectable levels that normally exist, therefore the overload of L-dopa dys-regulates the catecholamine system. Our hypothesis proposes that enzymes that sense the high levels of L-dopa and DA as substrates, such as L- aromatic amino acid decarboxylase (LAAD), dopamine (DA)-beta hydroxylase (DBH) and catechol-O- methyltransferase (COMT), as well as methionine adenosyltransferase (MAT) that catalyses the synthesis of the cofactor, S-adenosylmethionine, for the metabolism of L-dopa and DA, are induced. The induction of COMT and MAT will increase the metabolism of L-dopa and DA and will generate interfering methyl metabolites. The induction of DBH will produce ectopic norepinephrine (NE) that may dilute the efficacy of DA in the nigrostriatal pathway. The induced LAAD will accelerate the catalysis of L-dopa to DA, causing DA surge. DA in turn will cause feedback inhibition of LAAD, generating a pulsatile supply of DA that may help to cause the on-off effects. ¿We base our hypothesis on preliminary results showing that L-dopa induced COMT and MAT, enzymes that, in turn, metabolize L-dopa and DA. L-dopa also induced brain LAAD. The methyl metabolites of DA, 3-methoxytyramine (3-MT) and 3,4-dimethoxyl-phenylethylamine (DIMPEA), respectively, decreased and increased motor activities and DA receptor binding and 3-O-methyldopa (3- OMD) occurred in high levels in rat models of PD injected with L-dopa and in L-dopa-treated PD patients. 3- OMD decreased the efficacy of L-dopa and the turnover of DA. Studies also found that cardiac arrhythmia in L-dopa-treated PD patients was caused by increased NE. ¿ The specific aims are: (# 1) To further study the induction of COMT, MAT as well as LAAD and DBH by L-dopa. (# 2) Determine if the induction of LAAD causes DA surges and that DA in turn counter inhibits LAAD causing a pulsatile supply of DA that may be related to the on-off effects. (# 3) Localize DBH induction and NE production in nigrostriatal neurons and determine if NE is co-released with DA from striatal tissues. (#4) Evaluate the behavioral and receptor effects of 3-O-methyldopa, 3-MT and DIMPEA, to know if they contribute to the side effects of L-dopa. ¿The studies will focus on changes in the basal ganglia. The biochemical pathways being studied are at the crux of drug actions and the results can be readily translated into therapy, so, the outlook for the project is to find agents that will target specific enzymes and metabolic pathways at times when the beneficial effects of L-dopa will not be compromised.