Potential protective role of ACE-inhibitors and AT1 receptor blockers against levodopa-induced dyskinesias:a retrospective case-control study  

作　　者：Elena Contaldi Luca Magistrelli Anna VMilner Marco Cosentino Franca Marino Cristoforo Comi 

机构地区：[1]Movement Disorders Centre,Neurology Unit,Department of Translational Medicine,University of Piemonte Orientale,Novara,Italy [2]PhD Program in Medical Sciences and Biotechnology,University of Piemonte Orientale,Novara,Italy [3]PhD Program in Clinical and Experimental Medicine and Medical Humanities,University of Insubria,Varese,Italy [4]Center of Research in Medical Pharmacology,University of Insubria,Varese,Italy [5]Center for Research in Neuroscience,University of Insubria,Varese,Italy

出　　处：《Neural Regeneration Research》2021年第12期2475-2478,共4页中国神经再生研究（英文版）

摘　　要：Growing evidence has highlighted that angiotensin-converting enzyme(ACE)-inhibitors(ACEi)/AT1 receptor blockers(ARBs)may influence the complex interplay between dopamine and the renin-angiotensin system in the nigrostriatal pathway,thus affecting the development of levodopa-induced dyskinesia in Parkinson’s disease(PD).In the present study,we analyzed whether the use of this class of medication was associated with a reduced occurrence of levodopa-induced dyskinesia,using electronically-stored information of idiopathic PD patients enrolled at Novara University Hospital“Maggiore della Carità”.We conducted a retrospective case-control study identifying PD patients with dyskinesias(PwD;n=47)as cases.For each PwD we selected a non-dyskinetic control(NoD),nearly perfectly matched according to sex,Unified Parkinson’s Disease Rating Scale(UPDRS)part III score,and duration of antiparkinsonian treatment.Binary logistic regression was used to evaluate whether dyskinesias were associated with ACEi/ARBs use.Ninety-four PD patients were included,aged 72.18±9 years,with an average disease duration of 10.20±4.8 years and 9.04±4.9 years of antiparkinsonian treatment.The mean UPDRS part III score was 18.87±7.6 and the median HY stage was 2.In the NoD group,25(53.2%)were users and 22(46.8%)non-users of ACEi/ARBs.Conversely,in the PwD group,11(23.4%)were users and 36 non-users(76.6%)of this drug class(Pearson chi-square=8.824,P=0.003).Concerning general medication,there were no other statistically significant differences between groups.After controlling for tremor dominant phenotype,levodopa equivalent daily dose,HY 3-4,and disease duration,ACEi/ARBs use was a significant predictor of a lower occurrence of dyskinesia(OR=0.226,95%CI:0.080-0.636,P=0.005).Therefore,our study suggests that ACEi/ARBs may reduce levodopa-induced dyskinesia occurrence and,thanks to good tolerability and easy management,represent a feasible choice when dealing with the treatment of hypertension in PD patients.The study was approved by the Ethic

关 键 词：angiotensin-converting enzyme inhibitors AT1 receptor blockers DYSKINESIAS hypertension LEVODOPA motor complications NEUROINFLAMMATION Parkinson’s disease renin-angiotensin system 

分 类 号：R453[医药卫生—治疗学] R741[医药卫生—临床医学]