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Rev. bras. neurol ; 31(3): 131-8, maio-jun. 1995.
Artículo en Inglés | LILACS | ID: lil-166791

RESUMEN

(-) Deprenil (Selegiline, Jumex, Eldepryl, Movergan), a close structural relative to phenylethylamine (PEA), is a drug with a unique pharmacological spectrum. It is a highly potent and selective, irreversible inhibitor of B-type monoamine oxidase (MAO), a predominantly glial enzyme in the brain. The activity of this enzyme significantly increases with age. (-) Deprenyl, the first slective inhibitor of MAO-B described in literature, has become the universally used research tool for selectively blocking B-type MAO. It is the only selectively inhibitor in clinical use. (-) Deprenyl interferes with the uptake of catecholamines and indirectly acting sympathomimetics beacuse it is handled by the catecholaminergic neuron in a way similar to the physiological substances transported through the axonal and organ and vesicular membrane. The unique behavior or (-)deprenyl is that, in striking contrast to PEA and its relatives, it does not displace the transmitter from storage, ie, it is not a releaser. The net result is that (-)de inhibits the releasing effect of tyramine, and, at present, is the only safe MAO inhibitor than can be administered without dietary precautions. Maintenance on (-)deprenyl selectively enhances superoxide dismutase (SOD) and catalase activity in the striatum. This effect is unrelated to its effect on MAO-B and the inhibitory effects of thhe drug on neurotransmitter uptake. Maintenance on (-)deprenyl facilitates the activity of the catecholaminergic system in the brain, and this effect, too, is unrelated to either its effects on MAO or on neurotransmitter uptake. (-)Deprenyl protects the nigrostriatal dopaminergic neurons against selective neurotoxins (6-hydroxy-dopamine, MPTP,DSP-4). Maintenance on (-)deprenyl prevents the characteristic age-related morphological changes in the neuromelanin granules of the neurocytes in the substantia nigra. All in all, (-)deprenyl increases the activity of the nigrostriatal dopaminergic system and slows its age-related decline. Maitenance of male rats on (-)deprenyl delays the loss of the capacity to ejaculate, slows the decline of learning and memory, and significanthy lengthens the lifespan as compared with saline-treated rats. Parkinson's disease patients on levodopa plus (-)deprenyl (1o mg daily) live significanthy longer than those on levodopa alone. (-)Deprenyl is the first drug that retards the progress of Parkinson's disease patients maintained on (-)deprenyl need levodopa significanthy later than their placebo-treated peers. Maintenance on (-)deprenyl improves significantly the performance of patients with Alzheimer's disease. It is concluded that Parkinson's disease patients need to be treated daily with 10 mg (-)deprenyl from diagnosis until death, irrespective of other medication. We propose that the healthy be maintained on 10-15 mg (-)deprenyl weekly starting at 45 in order to combat the age-related decline of the nigrostriatal dopaminergic neurons. Prophylactic (-)deprenyl medication seems to offer a reasonable prospect of improving the quality of life in the later decades, delaying the time of natural death and decreasing the susceptibility of age-related neurological diseases, like Parkinson's disease and Alzheimer's disease


Asunto(s)
Humanos , Enfermedad de Alzheimer/tratamiento farmacológico , Enfermedad de Alzheimer/terapia , Enfermedad de Parkinson/tratamiento farmacológico , Enfermedad de Parkinson/terapia , Levodopa/uso terapéutico , Selegilina/uso terapéutico
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