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The long term use of levodopa increases oxidative stress through monoamine oxidase led enzymatic degradation of synthesized dopamine causing neuronal damage and cytotoxicity. The oxidative stress is caused by the formation of reactive oxygen species (H 2 O 2 ) during the monoamine oxidase led metabolism of dopamine.
l-DOPA, also known as l-3,4-dihydroxyphenylalanine and used medically as levodopa, is made and used as part of the normal biology of some plants [2] and animals, including humans. Humans, as well as a portion of the other animals that utilize l -DOPA, make it via biosynthesis from the amino acid l -tyrosine .
Carbidopa/levodopa, also known as levocarb and co-careldopa, is the combination of the two medications carbidopa and levodopa. [6] It is primarily used to manage the symptoms of Parkinson's disease , but it does not slow down the disease or stop it from getting worse. [ 6 ]
Levodopa-induced dyskinesia (LID) is a form of dyskinesia associated with levodopa (l-DOPA), used to treat Parkinson's disease. It often involves hyperkinetic movements, including chorea, dystonia, and athetosis. [1] In the context of Parkinson's disease (PD), dyskinesia is often the result of long-term dopamine therapy.
However, present gold-standard treatment of PD using levodopa is associated with motor complications, and does not prevent disease progression. [79] More effective and long-term treatment of PD are urgently needed to control its progression. [79] In vivo gene therapy is a new approach for treatment of PD. [80]
Droxidopa, also known as (–)-threo-3-(3,4-dihydroxyphenyl)-L-serine (L-DOPS), is a substituted phenethylamine and is chemically analogous to levodopa (L-3,4-dihydroxyphenylalanine; L-DOPA). Whereas levodopa functions as a precursor and prodrug to dopamine , droxidopa is a precursor and prodrug of norepinephrine .
Entacapone together with levodopa and carbidopa allows levodopa to have a longer effect in the brain and reduces Parkinson's disease signs and symptoms for a greater length of time than levodopa and carbidopa therapy alone. [2] Entacapone is a selective and reversible inhibitor of the enzyme catechol-O-methyltransferase (COMT). [2]
[2] [3] [5] Subsequently, it is rapidly converted into levodopa by carboxylesterases. [ 2 ] [ 3 ] [ 5 ] Levodopa itself can only be transported by a short section of the small intestine and hence XP-21279 allows more time for levodopa to be absorbed , in turn resulting in an increased duration and possibly reduced fluctuations in dopamine ...