Immunomodulatory effect and clinical outcome in Parkinson's disease patients on levodopa-pramipexole combo therapy: A two-year prospective study,Journal of Neuroimmunology

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Immunomodulatory effect and clinical outcome in Parkinson's disease patients on levodopa-pramipexole combo therapy: A two-year prospective study
Journal of Neuroimmunology ( IF 2.9 ) Pub Date : 2020-10-01 , DOI: 10.1016/j.jneuroim.2020.577328
Raquel Espinosa-Cárdenas ₁ , Asiel Arce-Sillas ₁ , Diana Álvarez-Luquin ₁ , Jaquelin Leyva-Hernández ₁ , Esteban Montes-Moratilla ₁ , Israel González-Saavedra ₁ , Marie Catherine Boll ₂ , Elizabeth Garcia-Garcia ₃ , Sandra Ángeles-Perea ₃ , Gladis Fragoso ₄ , Edda Sciutto ₄ , Laura Adalid-Peralta ₅

Affiliation

Parkinson's disease (PD), the second most frequent neurodegenerative disease, has been linked to increased central and peripheral inflammation. Although the response of the immune system to dopaminergic treatment remains to be fully understood, dopaminergic agonists are known to exhibit immunoregulatory properties which may, at least in part, explain their therapeutic effect in PD. This highlights the need of analyzing immune parameters in longitudinal studies on PD patients receiving specific therapeutic regimes. In this work, PD patients were included in a two-year prospective study comparing the effect of levodopa alone and a levodopa/pramipexole combo therapy on several regulatory and pro-inflammatory immune cell populations. We demonstrated that PD patients show decreased circulating levels of several important regulatory subpopulations, as determined by flow cytometry. Notably, when administered alone, levodopa decreased the levels of functional Bregs and SLAMF1+ tolerogenic DCs and increased the levels of total and HLA-DR+ classical monocytes, while the pramipexole/levodopa combo may promote Treg- and tolerogenic DC-mediated regulatory responses. These results suggest that a regime based on levodopa alone may promote a pro-inflammatory-type response in PD patients, but when combined with pramipexole, it promotes a clinically beneficial regulatory-type environment.

中文翻译：

帕金森病患者左旋多巴-普拉克索联合治疗的免疫调节作用和临床结果：一项为期两年的前瞻性研究

帕金森病 (PD) 是第二常见的神经退行性疾病，与中枢和外周炎症增加有关。尽管免疫系统对多巴胺能治疗的反应仍有待完全了解，但已知多巴胺能激动剂表现出免疫调节特性，这至少可以部分解释它们在 PD 中的治疗效果。这突出了在接受特定治疗方案的 PD 患者的纵向研究中分析免疫参数的必要性。在这项工作中，PD 患者被纳入了一项为期两年的前瞻性研究，该研究比较了单独使用左旋多巴和左旋多巴/普拉克索组合疗法对几种调节性和促炎性免疫细胞群的影响。我们证明 PD 患者的几个重要调节亚群的循环水平降低，由流式细胞术测定。值得注意的是，当单独给药时，左旋多巴降低了功能性 Bregs 和 SLAMF1+ 致耐受性 DC 的水平，并增加了总单核细胞和 HLA-DR+ 经典单核细胞的水平，而普拉克索/左旋多巴组合可能会促进 Treg 和致耐受性 DC 介导的调节反应。这些结果表明，仅基于左旋多巴的方案可能会促进 PD 患者的促炎型反应，但当与普拉克索联合使用时，它会促进临床有益的调节型环境。

更新日期：2020-10-01

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