The Impact of L-DOPA and Entacapon Therapy on Plasma Level of Homocysteine in Parkinson’s Disease Patients

Česká verzia

Authors: M. Nevrlý ¹; P. Kaňovský ¹; H. Vranová ¹; I. Nestrašil ¹; K. Langová ²
Authors place of work: Neurologická klinika LF UP, FN Olomouc, 2Ústav lékařské biofyziky, UP Olomouc ¹
Published in the journal: Cesk Slov Neurol N 2008; 71/104(1): 55-60
Category: Original Paper

Summary

Introduction:
Homocysteine (HCY) is a risk factor for vascular diseases, cognitive impairment and dementia. Peripheral metabolism of L-DOPA via enzyme catechol-O-methyltransferase (COMT) is one of the possible sources of HCY. Some retrospective studies showed increased plasma HCY concentrations in patients suffering from Parkinson´s disease (PD) and long-term treated with L-DOPA. The aim of the study was to assess plasma HCY levels in L-DOPA treated PD patients and its influence by adding the inhibitor COMT (entacpone).

Methods:
Patients were divided into 3 groups: 1 – patients long-term treated with L-DOPA with added entacapone (30 patients, aged 50-82 years, mean 68,5 ± 8,5); 2 – L-DOPA naive patients, in which was start combined treatment with L-DOPA and entacapone (10 patients, aged 56-74 years, mean 67,7 ± 6,6); 3 – control group of subjects did not suffering of any neurodegenerative disease and were not treated with L-DOPA and entacapone (21 patients, aged 38-78 years, mean 51,7 ± 11,1).

Results:
In Group 1 was mean plasma HCY concentration 17,6 ± 6,6 (9,2-44,4) µmol/l and 8 weeks after adding entacapone 16,4 ± 5,5 (7,4-31,1) µmol/l. In Group 2 was found mean plasma HCY level 14,6 ± 4,7 (8,9-22,1) µmol/l and 8 weeks after combined therapy of L-DOPA and entacapone 15,1 ± 7,3 (8,1-31,1) µmol/l. In control group was found mean plasma HCY level 9,7 ± 2,8 (6,6-16,5) µmol/l.

Discussion:
Results of this study confirm, that patients long-term treated with L-DOPA have increased plasma HCY concentrations. However, do not confirm hypothesis, that combined treatment with L-DOPA and entacapone significantly decrease HCY plasma levels.

Key words:
homocysteine, Parkinson´s disease, entacapone, L-DOPA

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