Levodopa Levels Research Articles

Continuous Subcutaneous Foslevodopa-Foscarbidopa in Parkinson's Disease: A Mini-Review of Current Scope and Future Outlook.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, primarily because of the impairment of dopaminergic neurons. Long-term use of levodopa, the standard PD treatment, often results in fluctuating therapeutic effects and dyskinesia, necessitating alternative therapies. This review aims to synthesize current insights and clinical experiences with foslevodopa-foscarbidopa, focusing on its pharmacokinetics, efficacy, and safety profile, to evaluate its potential in transforming PD therapy. A systematic literature search was conducted up to November 2023 using databases PubMed, Web of Science, and Cochrane Library. The search yielded eight eligible articles, including pharmacological studies, case reports, observational studies, and controlled trials. No language restrictions were applied. Foslevodopa and foscarbidopa, as prodrugs of levodopa and carbidopa, exhibited excellent chemical stability and solubility, facilitating continuous subcutaneous infusion. Clinical trials demonstrated that these prodrugs maintain stable levodopa levels, thereby addressing the limitations of oral levodopa therapy. Phase 1 and 3 studies indicated significant improvements in motor function and quality of life in advanced PD patients. However, a higher incidence of treatment-emergent adverse events, mainly infusion site reactions, was observed compared to oral therapies. Foslevodopa-foscarbidopa emerges as a promising alternative for advanced PD treatment, offering sustained symptom control. Its efficacy in managing motor fluctuations and dyskinesia makes it a viable option in the PD therapeutic spectrum. Future research should focus on long-term safety, economic impact, and broader accessibility. Foslevodopa-foscarbidopa is now commercially distributed in many countries in Europe and in Japan.

L-DOPA ELICITATION THROUGH CALCIUM ION MEDIATED CHANNEL IN CALLUS CULTURES OF MUCUNA PRURIENS

Objective: The production of L-Dopa in callus cultures of Mucuna pruriens is influenced by substances that regulate calcium channels. Methods: M. pruriens seeds were gathered from the Western Ghats area in Tamil Nadu. L-Dopa was obtained by the Brain (1976) method, A. niger cultures were used for fungal elicitor preparation, and the assay of Ca2+ATPase was studied. Results: The use of fungal triggers resulted in increased L-Dopa levels on the 9th day but reduced levels on the 24th day of culture. When calcium channel modulators like verapamil and chlorpromazine were added, it decreased the growth of calli and L-Dopa production, suggesting the role played by calcium ion channels in L-Dopa synthesis. The calcium ionophore A23187 enhanced calli growth and L-Dopa production, increasing Ca2+ATPase activity. Particularly on the 12th d, Ca2+ATPase was notably active, while the presence of calcium ionophore boosted L-Dopa biosynthesis. Conclusion: The use of fungal elicitors in in vitro cultures of Mucuna pruriens is recommended as a potential method to increase the production of secondary metabolites.

The Potential of Natural Levodopa in Koro Benguk Seeds (Mucuna pruriens) for Treatment in Parkinson's Disease

Mucuna pruriens also known as velvet bean (koro benguk) is a plant commonly found in tropical regions, including Indonesia. Mucuna pruriens is known to contain high levels of Levodopa, making it a potential natural treatment for Parkinson's disease. Parkinson's disease is a neurodegenerative disorder characterized by tremors, rigidity, bradykinesia, and postural instability. The estimated global incidence of Parkinson's disease in 2024 is expected to reach 12 to 17 million patients. Synthetic Levodopa has been the standard and proven effective therapy for Parkinson's disease. The method used in the preparation of this article is a literature review by collecting relevant and focused articles. The literature sources were accessed through comprehensive searches in three databases (Pubmed, Google Scholar, and Researchgate) from 2014 to 2024, using keywords such as “Mucuna pruriens,” “Levodopa,” and “Parkinson's disease.” The result of the literature review indicates that Levodopa is the dominant active component found in Mucuna pruriens compared to other compounds. The naturally occurring Levodopa functions as a precursor to dopamine, which plays a role in the treatment of Parkinson's disease, thus it can be developed into a complementary therapy in regions with abundant resources.

Quercetin Alleviates Insulin Resistance and Repairs Intestinal Barrier in db/db Mice by Modulating Gut Microbiota.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease which seriously affects public health. Gut microbiota remains a dynamic balance state in healthy individuals, and its disorder may affect health status and even results in metabolic diseases. Quercetin, a natural flavonoid, has been shown to have biological activities that can be used in the prevention and treatment of metabolic diseases. This study aimed to explore the mechanism of quercetin in alleviating T2DM based on gut microbiota. db/db mice were adopted as the model for T2DM in this study. After 10 weeks of administration, quercetin could significantly decrease the levels of body weight, fasting blood glucose (FBG), serum insulin (INS), the homeostasis model assessment of insulin resistance (HOMA-IR), monocyte chemoattractant protein-1 (MCP-1), D-lactic acid (D-LA), and lipopolysaccharide (LPS) in db/db mice. 16S rRNA gene sequencing and untargeted metabolomics analysis were performed to compare the differences of gut microbiota and metabolites among the groups. The results demonstrated that quercetin decreased the abundance of Proteobacteria, Bacteroides, Escherichia-Shigella and Escherichia_coli. Moreover, metabolomics analysis showed that the levels of L-Dopa and S-Adenosyl-L-methionine (SAM) were significantly increased, but 3-Methoxytyramine (3-MET), L-Aspartic acid, L-Glutamic acid, and Androstenedione were significantly decreased under quercetin intervention. Taken together, quercetin could exert its hypoglycemic effect, alleviate insulin resistance, repair the intestinal barrier, remodel the intestinal microbiota, and alter the metabolites of db/db mice.

Biosensor Strip for Rapid On-site Assessment of Levodopa Pharmacokinetics along with Motor Performance in Parkinson's Disease.

While levodopa (L-Dopa) is the primary treatment for alleviating Parkinson's disease (PD), its efficacy is hindered by challenges such as a short half-life and inconsistent plasma levels. As PD progresses, the rising need for increased and more frequent L-Dopa doses coupled with symptom fluctuations and dyskinesias underscores the urgency for improved comprehension of the interplay between L-Dopa levels and PD motor symptoms. Addressing this critical need, we present a decentralized testing method using a disposable biosensor strip and a universal slope (U-slope) calibration-free approach. This enables reliable, rapid, simple, and cost-effective decentralized L-Dopa measurements from capillary blood. A pilot study with PD persons demonstrates the ability to monitor real-time L-Dopa pharmacokinetics from fingerstick blood after oral L-Dopa-Carbidopa (C-Dopa) tablet administration. Correlating capillary blood L-Dopa levels with PD motor scores revealed a well-defined inverse correlation with temporal motor fluctuations. We compared the resulting dynamic capillary blood L-Dopa levels with plasma L-Dopa levels using the traditional but clinically impractical high-performance liquid chromatography technique. By providing timely feedback on a proper L-Dopa dosing regimen in a decentralized and rapid fashion, this new biosensing platform will facilitate tailored optimal L-Dopa dosing, towards improving symptom management and enhancing health-related quality of life.

Sublingual apomorphine in the treatment of Parkinson's disease.

Advanced Parkinson´s disease (PD) is often complicated by fluctuations of disability depending on plasma levels of levodopa. For most patients OFF phases with worsening of tremor and immobility, but also pain, depression, autonomic symptoms are troublesome. While adjustments of levodopa administrations can relief such fluctuations for some time, "on demand" therapies become more and more important. These "on demand" therapies should provide fast and efficacious relief. During the past years, new options for on demand therapies in PD-associated OFF episodes have been developed, including new formulations of levodopa and apomorphine to provide fast and readily accessible on demand treatment. In this narrative review, the challenges of the treatment of PD-associated fluctuations and OFF states are addressed, with a special focus on sublingual apomorphine (SL-APO) including the results from recent clinical trials.

Continuous Levodopa Delivery with an Intraoral Micropump System: An Open-Label Pharmacokinetics and Clinical Study.

Double-blind studies have demonstrated that motor complications in Parkinson's disease (PD) can be reduced with continuous delivery of levodopa. The DopaFuse system is a novel, intraoral micropump that attaches to a retainer and uses a propellant to deliver levodopa/carbidopa (LD/CD) continuously into the mouth. Evaluate the safety, pharmacokinetics, and efficacy of LD/CD delivered via the DopaFuse system compared to treatment with intermittent doses of standard oral LD/CD in PD patients with motor fluctuations. This was a 2-week, open-label study (NCT04778176) in 16 PD patients treated with ≥4 levodopa doses/day and experiencing motor fluctuations. On Day 1 (clinic setting) patients received their usual dose of standard LD/CD; DopaFuse therapy was initiated on Day 2, and on Day 3 patients received DopaFuse plus a morning oral LD/CD dose. Patients returned home on Days 4-14 and returned for in-clinic assessment on Day 15. Continuous DopaFuse delivery of LD/CD was associated with reduced variability in plasma levodopa levels compared to oral LD/CD (mean ± SD levodopa Fluctuation Index reduced from 2.15 ± 0.59 on Day1 to 1.50 ± 0.55 on Day 2 (P = 0.0129) and to 1.03 ± 0.53 on Day 3 (P < 0.0001)). This pharmacokinetic improvement translated into significantly reduced OFF time with DopaFuse therapy (reduction of -1.72 ± 0.37 h at Day 15; P = 0.0004) and increased ON time without severe dyskinesias (increase of 1.72 ± 0.37 h at Day 15; P = 0.0004) versus oral LD/CD administration. DopaFuse therapy was not associated with any clinically significant adverse events. Continuous delivery of LD/CD using the DopaFuse system was associated with significantly less variability in plasma levodopa concentrations and reductions in OFF time compared to treatment with standard oral LD/CD therapy and was well tolerated. © 2024 International Parkinson and Movement Disorder Society.

Auricular acupuncture plays a neuroprotective role in 6-hydroxydopamine-induced Parkinson's disease in rats

BackgroundParkinson's disease (PD) is the second-most common neurodegenerative disease. Currently, PD treatment is symptomatic and involves the use of dopamine-based therapies. This study investigated auricular acupuncture on motor and cognitive abilities in rats with 6-OHDA-induced PD. MethodsA PD rat model was established by bilaterally injecting 6-OHDA into the lateral dorsal striatum. Then, 2- or 15-Hz auricular electroacupuncture (EA) was applied to the auricular CO15 and CO12 points bilaterally for 20 min three times a week for four consecutive weeks. ResultsBoth the latency to fall and rest time of the open field test in the EA15 group were greater than in the 6-OHDA group (p < 0.001 and p < 0.05). The time spent on the two-object recognition task was greater in the EA15 group and EA2 group than in the 6-OHDA group (p < 0.01 and p < 0.05). More tyrosine hydroxylase (TH)-positive neurons and fibers were noted in the dorsolateral striatum and substantia nigra (SN) (all p < 0.05). TH expression in the SN was greater in the EA15 group than that in the 6-OHDA group (p < 0.05), while α-synuclein expression in the SN was stronger in the 6-OHDA group than in the EA15 group (p < 0.05). The l-DOPA level in the striatum was higher in the EA15 group than in the 6-OHDA group (p < 0.05). ConclusionAccording to the results, rats with 6-OHDA-induced PD may benefit from auricular EA in terms of motor and cognitive behavior as well as neuroprotection.

Real-time Levodopa Level Monitoring from Capillary Blood in Parkinson’s Disease: A Pilot Study (P9-3.014)

Real-time Levodopa Level Monitoring from Capillary Blood in Parkinson’s Disease: A Pilot Study (P9-3.014)

The effects of Nardosinone on levodopa intervention in the treatment of Parkinson's disease

BackgroundThe roots and rhizomes of Nardostachys jatamansi DC. are reported to be useful for the treatment of Parkinson's disease (PD). Previous research has also shown that Nardosinone, the main active component isolated from Nardostachys jatamansi DC., exhibits the potential to treat PD. Aim of the studyTo investigate how the effects of Nardosinone could assist levodopa in the treatment of PD, how this process changes the intestinal flora, and to explore the effective forms of Nardosinone in the intestinal flora. Material and methodsWe used behavioral experiments, and hematoxylin-eosin staining and immunohistochemical staining, to investigate the effects of a combination of Nardosinone and levodopa on rotenone-induced PD rats. In addition, we used LC/MS-MS to determine the levels of levodopa, 5-hydroxytryptamine, dopamine and its metabolite 3, 4-dihydroxyphenylacetic acid, and homovanillic acid, to investigate the effect of the intestinal flora on co-administration in the treatment of PD. LC/MS-MS was also used to detect the metabolites of Nardosinone on the gastrointestinal tract and intestinal flora. ResultsThe behavioral disorders and neuronal damage associated with PD were significantly improved following the co-administration. Analysis also revealed that the co-administration increased the levels of five neurotransmitters in the striatum, plasma and feces. In vitro experiments further demonstrated that the levels of dopamine and levodopa were increased in the intestinal flora. In total, five metabolites of Nardosinone were identified. ConclusionOur findings indicate that Nardosinone and its metabolites might act as a potential adjutant to enhance the efficacy of levodopa via the intestinal flora, thus expanding the therapeutic potential of the combination of Chinese and Western medicine as a treatment method for PD.

Distribution of Vicine, Convicine and Levodopa in Faba Bean Plant Tissues Determined by UltraHigh Performance Liquid Chromatography-Electrospray Ionization Mass Spectrometry

Faba bean is an emerging pulse crop for the Canada Prairies and is becoming an increasingly important source of plant sourced protein. It also has a high content of levodopa (up to 0.1 % of the dry seed weight), a nutraceutical compound for treating Parkinson's Disease (PD). The presence of pyrimidine glycosides, vicine and convicine, however, restricts the use of faba due to their potential to cause favism in susceptible individuals. For the rapid separation and quantification of levodopa, vicine and convicine, a 5-min ultrahigh performance liquid chromatography-electrospray ionization mass spectrometry method (UHPLC-ESI MS) was developed. This method provided a wide linear range of quantification (4.8 nM to 60 µM for vicine, and 6.0 nM to 24 µM for convicine and levodopa), and low limit of detection (1.2 to 3.0 nM). The method was applied in the analysis of diverse faba bean samples, from dehulled mature faba bean and seed coat, to fresh plant tissues such as flowers, leaves, stems, roots and pods. The results indicated that fresh faba bean plant tissues, such as leaves and flowers, had the highest concentration of levodopa and low level of VC, which makes them an alternative source of plant-based l-DOPA with potential as a food-based treatment for Parkinson's Disease.

Comparing the effect of intravenous versus intracranial grafting of mesenchymal stem cells against parkinsonism in a rat model: Behavioral, biochemical, pathological and immunohistochemical studies.

Parkinson's disease (PD) is one of the most common neurodegenerative diseases worldwide. Currently applied therapeutic protocols are limited to improve the motor functions of patients. Therefore, seeking alternative regimes with better therapeutic impact is crucial. This study aims to validate the therapeutic impact of mesenchymal stem cell injection using two delivery methods, intracranial administration and intravenous administration, on rotenone (ROT)-induced PD model in rats. Our work included behavioral, biochemical, histological, and molecular investigations. Open field test (OFT) and rotarod tests were applied. Important oxidative stress, antioxidant and proinflammatory markers were monitored. Substantia Nigra and Striatum tissues were examined histologically and the molecular expression of DOPA decarboxylase, Tyrosine hydroxylase, and α-synuclein in neurons in these tissues were investigated. Our results showed that MSC grafting improved motor and memory impairments and oxidative stress status that were observed after ROT administration. Additionally, BM-MSCs application restored SOD and CAT activities and the levels of DA, L-Dopa, IL6, IL1β, and TNFα. Moreover, MSC grafting overwhelmed the pathological changes induced by ROT and normalized the expression of Tyrosine hydroxylase, DOPA decarboxylase, and α-synuclein towards the control values in the Nigral and Striatal tissues of male rats. Conclusively, both administration routes improved motor function, protection of the nigrostriatal system, and improved striatal dopamine release. The observed beneficial effect of applying MSCs suggests potential benefits in clinical applications. No significant differences in the outcomes of the treatment would favor a certain way of MSC application over the other. However, the intravenous delivery method seems to be safer and more feasible compared to the intrastriatal method.

Satisfaction with videoconferencing support for levodopa-carbidopa intestinal gel: An observational study.

Levodopa-carbidopa intestinal gel (LCIG) is a continuously delivered Parkinson's disease therapy intended to stabilize plasma levodopa levels. Patients receiving LCIG require education and follow-up. Some LCIG support programs use video-assisted telenursing. To examine how videoconferencing impacts satisfaction with LCIG support programs. FACILITATE CARE (Feasibility of video-Assisted Care for Intestinal Levodopa Infusion with Telenursing - observAtional Trial Evaluating patient and Caregiver Acceptance in REal life) was a 12-week, prospective, open-label, 2-arm, parallel-group, observational study assessing satisfaction with LCIG support in patients who self-assigned to video or audio-only arms. Patients aged 18-85 years had completed LCIG titration and owned a videoconferencing device (video arm only). A visual analog scale measured satisfaction (1-10, 10 being most satisfied). Patients' mean (standard deviation) ages were 67.9 (7.4, n = 26) and 71.1 (6.2, n = 15) years in the video and audio arms, respectively. Patients, caregivers, and physicians in both groups reported satisfaction scores of 8-10 with LCIG support personnel, communication access, and assistance with becoming independent. At week 12, the Modified Caregiver Strain Index least square means change from baseline was lower in the video vs. audio arm (-2.3 [1.0] vs. 1.6 [1.2]). LCIG support personnel travel time was lower in the video vs. audio arm (125.7 [70.2] vs. 203.0 [70.0] minutes). LCIG support programs are associated with high patient, caregiver, and physician satisfaction; video and audioconferencing satisfaction are similarly high. Video-assisted telenursing may be a convenient communication avenue and may reduce caregiver burden. ClinicalTrials.gov; NCT04500106.

Investigation of the effects of Toxoplasma gondii on behavioral and molecular mechanism in bradyzoite stage

Toxoplasma gondii is a single-celled parasite that causes a disease called toxoplasmosis. It can reach the central nervous system, but the mechanism of T. gondii disrupting the functioning of these brain regions occurs in bradyzoite stage of parasite, causing brain damage by forming tissue cysts in brain. In our study, the effects of T. gondii on locomotor activity, anxiety, learning and memory, and norepinephrine (NE), levodopa (L-DOPA), dopamine (DA) and 3,4-D-dihydroxyphenylacetic acid (DOPAC) catecholamines in amygdala, striatum, prefrontal cortex and hippocampus regions of the brain were investigated in bradyzoite stage. Twenty male Albino mice Mus musculus, 4–5 weeks old, weighing 20–25 g, were used. T. gondii inoculated to mice intraperitonealy with 48–50-hour passages of T. gondii RH Ankara strain. For intraperitoneal inoculation of mice 5x104 tachyzoites per mouse. No inoculation was made in control group (n: 20). Locomotor activity behavior in open field test (OFT), anxious behavior in elevated plus maze (EPM), and learning behavior in novel object recognition (NOR) tests were evaluated. NE, L-DOPA, DA and DOPAC were measured by HPLC in brain tissues of amygdala, striatum, prefrontal cortex and hippocampus. A decrease was observed in the locomotor activity, anxiety and learning values of the T. gondii group compared to the control group (p < 0.05). The heighten in NE and L-DOPA levels in amygdala tissue of T. gondii group compared to control group, an elevation in NE, L-DOPA, DA and DOPAC levels in striatum tissue, and an increase in levels of NE in prefrontal cortex tissue were detected in monoamine results. In hippocampus tissue, an increase was observed in DA levels, while a decrease was observed in NE, L-DOPA and DOPAC levels. In our study, it has been shown that T. gondii in bradyzoite stage reduces locomotor activity, causes learning and memory impairment, and has anxiogenic effects.

Reduced Plasma Levodopa Fluctuations with More Frequent Administration of a Novel Carbidopa/Levodopa Functionally Scored Tablet.

Levodopa/carbidopa remains the gold standard for treating Parkinsondisease (PD), but chronic pulsatile administration contributes to motor complications. This Phase 1 study used a new immediate-release (IR) formulation of carbidopa/levodopa 25/100mg that is functionally scored for easy and precise splitting to evaluate the effects on levodopa plasma variability when smaller doses are taken more frequently. These functionally scored tablets were shown to be bioequivalent to carbidopa/levodopa 25-/100-mg IR generic reference tablets. Twenty-two healthy volunteers received a whole tablet every 4 hours versus half of the tablet every 2 hours. Plasma levodopa fluctuations were significantly reduced with half-tablets dosed every 2 hours, with a 44% reduction in peaks (P< .0001). While drug exposure did not differ, parameters that underlie motor response variations, including mean peak-to-trough difference and variance, were 51% and 56% less, respectively, with more frequent dosing (both P ≤ .0024). Safety and tolerability of both regimens were similar. In conclusion, more frequent administration of half-tablets of the new functionally scored IR formulation safely provided more constant levodopa levels than whole tablets dosed less often. This tablet technology could facilitate the benefits of more physiologic dopamine replenishment in patients with PD, particularly those with reduced manual dexterity.

Bioactive components and mechanisms of Pu-erh tea in improving levodopa metabolism in rats through COMT inhibition.

Catechol-O-methyltransferase (COMT) plays a central role in the metabolic inactivation of endogenous neurotransmitters and xenobiotic drugs and hormones having catecholic structures. Its inhibitors are used in clinical practice to treat Parkinson's disease. In this study, a fluorescence-based visualization inhibitor screening method was developed to assess the inhibition activity on COMT both in vitro and in living cells. Following the screening of 94 natural products, Pu-erh tea extract exhibited the most potent inhibitory effect on COMT with an IC50 value of 0.34 μg mL-1. In vivo experiments revealed that Pu-erh tea extract substantially hindered COMT-mediated levodopa metabolism in rats, resulting in a significant increase in levodopa levels and a notable decrease in 3-O-methyldopa in plasma. Subsequently, the chemical components of Pu-erh tea were analyzed using UHPLC-Q-Exactive Orbitrap HRMS, identifying 24 major components. Among them, epigallocatechin gallate, gallocatechin gallate, epicatechin gallate, and catechin gallate exhibited potent inhibition of COMT activity with IC50 values from 93.7 nM to 125.8 nM and were the main bioactive constituents in Pu-erh tea responsible for its COMT inhibition effect. Inhibition kinetics analyses and docking simulations revealed that these compounds competitively inhibit COMT-mediated O-methylation at the catechol site. Overall, this study not only explained how Pu-erh tea catechins inhibit COMT, suggesting Pu-erh tea as a potential dietary intervention for Parkinson's disease, but also introduced a new strategy for discovering COMT inhibitors more effectively.

Elucidating the efficacy of functionalized multi-walled carbon nanotube in the biogenesis of L-Dopa and antioxidant metabolites in cell cultures of Hybanthus enneaspermus

Hybanthus enneaspermus (L.)F.Muell. is a highly indispensable medicinal herb yielding L-Dopa, deemed the gold standard drug among the therapeutic options for Parkinson's disease. This investigation is the first attempt to evaluate the eliciting influence of carboxylic acid functionalized multi-walled carbon nanotube (MWCNT-COOH) on the biosynthesis of L-Dopa and on biomass aggregation and antioxidant metabolites in H. enneaspermus cell suspension cultures. Suspension cells were accomplished from friable calli generated from the nodal segments of H. enneaspermus in Murashige and Skoog (MS) liquid medium infused with 2 mg L−1 2, 4-Dichlorophenoxyacetic acid (2, 4-D), and 0.3 mg L−1meta-Topolin (mT). The influence of MWCNTs on L-Dopa synthesis, biomass accumulation, and biochemical parameters was examined on the basis of the exposure time and in a concentration-dependent manner of MWCNTs. The inclusion of 30 mg L−1 MWCNTs increased the biomass and the L-Dopa level by 2.00 and 16.37-folds, respectively, compared with that of the control. Furthermore, the effect of MWCNTs on physiological parameters such as catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPX), ascorbate peroxidase (APX), hydrogen peroxide (H2O2), malondialdehyde (MDA) content, 2-diphenylpicrylhydrazyl (DPPH), and ferric-reducing ability of plasma (FRAP) was examined over the elicited cells. Among the antioxidant enzymatic activities, CAT enhanced 8.0 fold compared with that of the control. MDA and DPPH content enhanced 2.60 and 1.12 folds, respectively, compared with that of the control. The current study showed that MWCNTs offer new possibilities for their usage over in vitro by acting as potential innovative plant metabolite elicitors and stress-protecting entities.

Sensory neuropathy complicated with de novo diabetes mellitus during levodopa‐carbidopa intestinal gel infusion in a patient with Parkinson's disease: A case report

AbstractLevodopa‐carbidopa intestinal gel therapy (LCIG), an effective treatment for advanced Parkinson's disease, can cause peripheral neuropathy. We present a 39‐year‐old man with LCIG‐related neuropathy with de novo diabetes mellitus (DM), decreased vitamin B6 and folate levels, and elevated homocysteine levels that developed over 2 years of LCIG treatment. Physicians should assess levels of levodopa metabolism‐associated vitamins and monitor risk factors of peripheral neuropathy, such as DM, before and after LCIG initiation.

A Critical Overview of Enzyme-Based Electrochemical Biosensors for L-Dopa Detection in Biological Samples

L-Dopa is an intermediate amino acid in the biosynthesis of endogenous catecholamines, such as dopamine. It is currently considered to be the optimal dopaminergic treatment for Parkinson’s disease, a neurodegenerative disorder affecting around 1% of the population. In an advanced stage of the disease, complications such as dyskinesia and psychosis are caused by fluctuations in plasma drug levels. Real-time monitoring of L-Dopa levels would be advantageous for properly adjusting drug dosing, thus improving therapeutic efficacy. Electrochemical methods have advantages such as easy-to-use instrumentation, fast response time, and high sensitivity, and are suitable for miniaturization, enabling the fabrication of implantable or wearable devices. This review reports on research papers of the past 20 years (2003–2023) dealing with enzyme-based biosensors for the electrochemical detection of L-Dopa in biological samples. Specifically, amperometric and voltammetric biosensors, whose output signal is a measurable current, are discussed. The approach adopted includes an initial study of the steps required to assemble the devices, i.e., electrode modification and enzyme immobilization. Then, all issues related to their analytical performance in terms of sensitivity, selectivity, and capability to analyze real samples are critically discussed. The paper aims to provide an assessment of recent developments while highlighting limitations such as poor selectivity and long-term stability, and the laborious and time-consuming fabrication protocol that needs to be addressed from the perspective of the integrated clinical management of Parkinson’s disease.

Crop protection potential of the leaves of Juglans mandshurica Maxim.: The phenoloxidase promoting related insecticidal effect of its ethanolic extract

Juglans mandshurica Maxim. (JM) is cultivated for timber production, food, and the pharmaceutical industry. Although its leaves (JML) are usually discarded as agricultural waste, they have attracted researchers’ attention for reutilization. The present research was therefore carried out to investigate the crop protection potential of JML. First, phenoloxidase-related insecticidal effects were predicted according to in vitro tyrosinase-potentiating property of JML extracts using its 70% and 90% ethanolic extracts from different collection dates (June, July, and August). This was subsequently verified by using diverse bioassay experiments to evaluate its in vivo bioactivity against Plutella xylostella Linnaeus, Aphis gossypii Glover, and Pieris rapae Linne. The results showed that, 90% ethanolic JML extract (20 mg/mL) had the strongest selective anti-feeding activity, with 87.74% and 79.35% deterrence against A. gossypii and P. rapae, respectively. After four days of oral administration, the 70% ethanolic JML extract (50 mg/mL) showed ∼100% corrected mortality in all test insects. Furthermore, regarding contact toxicities, the JML extracts (25 mg/mL) induced ∼71%, 56%, and 82% corrected mortalities against P. xylostella, P. rapae, and A. gossypii, respectively. Among them, JML extracts showed the strongest growth inhibition against P. xylostella (34.12%) and P. rapae (41.23%) after 24 h treatment. Second, the insecticidal mechanism of JML was investigated by targeting the phenoloxidase (PO) of P. xylostella. The insect’s PO activity was promoted in vitro with the maximum efficacy of 35.09% from 9 mg/mL of JML extract, and this increasing potential could also be observed in the in vivo evaluation. For instance, after the administration of LC70 of JML extract till the 4th instar of the insect, stronger PO activity was detected compared to the control group (77.3% vs. 58.0%). The level of L-Dopa, a key intermediate of PO, significantly increased (31.11 μg/mL) in the hemolymph of insects when treated with the LC70 of JML extract compared with the control group (4.29 μg/mL). The qRT-PCR-mediated mRNA expression analysis confirmed increased PO expression in P. xylostella compared to the control group after JML extract administration. Finally, UPLC-Q-TOF-MS coupled with partial least squared discriminant analysis (PLS-DA) was used to rapidly profile and characterize the 18 compounds as the index ingredients that were related to PO enzymatic activity potentiation or insecticidal effects in the JML extracts. Therefore, our research highlights the potential of J. mandshurica for insecticide development and demonstrates that JML’s abnormal promotion of insect PO activity contributes to its toxicity against pests.