Atremorine in Parkinson's disease: From dopaminergic neuroprotection to pharmacogenomics.

Abstract

Atremorine is a novel bioproduct obtained by nondenaturing biotechnological processes from a genetic species of Vicia faba. Atremorine is a potent dopamine (DA) enhancer with powerful effects on the neuronal dopaminergic system, acting as a neuroprotective agent in Parkinson's disease (PD). Over 97% of PD patients respond to a single dose of Atremorine (5 g, p.o.) 1 h after administration. This response is gender-, time-, dose-, and genotype-dependent, with optimal doses ranging from 5 to 20 g/day, depending upon disease severity and concomitant medication. Drug-free patients show an increase in DA levels from 12.14 ± 0.34 pg/ml to 6463.21 ± 1306.90 pg/ml; and patients chronically treated with anti-PD drugs show an increase in DA levels from 1321.53 ± 389.94 pg/ml to 16,028.54 ± 4783.98 pg/ml, indicating that Atremorine potentiates the dopaminergic effects of conventional anti-PD drugs. Atremorine also influences the levels of other neurotransmitters (adrenaline, noradrenaline) and hormones which are regulated by DA (e.g., prolactin, PRL), with no effect on serotonin or histamine. The variability in Atremorine-induced DA response is highly attributable to pharmacogenetic factors. Polymorphic variants in pathogenic (SNCA, NUCKS1, ITGA8, GPNMB, GCH1, BCKDK, APOE, LRRK2, ACMSD), mechanistic (DRD2), metabolic (CYP2D6, CYP2C9, CYP2C19, CYP3A4/5, NAT2), transporter (ABCB1, SLC6A2, SLC6A3, SLC6A4) and pleiotropic genes (APOE) influence the DA response to Atremorine and its psychomotor and brain effects. Atremorine enhances DNA methylation and displays epigenetic activity via modulation of the pharmacoepigenetic network. Atremorine is a novel neuroprotective agent for dopaminergic neurons with potential prophylactic and therapeutic activity in PD.

• Authors: Ramón Cacabelos, Iván Carrera, Olaia Martínez, Ramón Alejo, Lucía Fernández-Novoa, Pablo Cacabelos, Lola Corzo, Susana Rodríguez, Margarita Alcaraz, Laura Nebril, Iván Tellado, Natalia Cacabelos, Rocío Pego, Vinogran Naidoo, Juan C Carril
• Journal: Medicinal research reviews (Med Res Rev) Vol. 41 Issue 5 Pg. 2841-2886 (09 2021) ISSN: 1098-1128 [Electronic] United States
• PMID: 34106485 (Publication Type: Journal Article)
• Copyright: © 2021 Wiley Periodicals LLC.

Chemical References

• Atremorine
• Dopamine Plasma Membrane Transport Proteins
• GPNMB protein, human
• Membrane Glycoproteins
• SLC6A3 protein, human
• SLC6A4 protein, human
• Serotonin Plasma Membrane Transport Proteins
• Levodopa
• Arylamine N-Acetyltransferase
• NAT2 protein, human
• Dopamine

Topics

• Arylamine N-Acetyltransferase
• Dopamine
• Dopamine Plasma Membrane Transport Proteins
• Humans
• Levodopa
• Membrane Glycoproteins
• Neuroprotection
• Parkinson Disease (drug therapy, genetics)
• Pharmacogenetics
• Serotonin Plasma Membrane Transport Proteins