Adenosine A₂A-receptor antagonist istradefylline enhances the motor response of L-DOPA without worsening dyskinesia in MPTP-treated common marmosets

J Pharmacol Sci. 2014;124(4):480-5. doi: 10.1254/jphs.13250fp. Epub 2014 Mar 28.

Abstract

The adenosine A₂A-receptor antagonist istradefylline decreases OFF time in patients with Parkinson's disease who are already treated with optimal doses of dopaminergic medication but can cause an increase in non-troublesome dyskinesia. Preclinical experiments have shown that A₂A antagonists are most effective in potentiating motor function when combined with sub-maximal doses of L-DOPA. However, the effects of combining istradefylline with sub-optimal L-DOPA treatment on established dyskinesia have not been studied. We now examine the effects of acute and repeated administration of istradefylline on dyskinesia in MPTP-treated common marmosets previously primed to exhibit involuntary movements by prior exposure to L-DOPA. In these animals, single dose acute oral administration of istradefylline (10 mg/kg) enhanced and prolonged the anti-parkinsonian effects of a sub-optimal dose of L-DOPA (2.5 mg/kg). The chronic co-administration of istradefylline (10 mg/kg) with L-DOPA (2.5 mg/kg) for 21 days did not worsen the severity of existing dyskinesia. Rather, the severity of dyskinesia tended to be reduced over the 21-day treatment period. These results suggest that istradefylline can be used to potentiate the effects of sub-optimal doses of L-DOPA in the treatment of Parkinson's disease without causing or worsening dyskinesia.

MeSH terms

  • Adenosine A2 Receptor Antagonists / pharmacology*
  • Administration, Oral
  • Animals
  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / pharmacology*
  • Callithrix
  • Drug Synergism
  • Dyskinesias / physiopathology*
  • Female
  • Levodopa / administration & dosage
  • Levodopa / pharmacology*
  • Male
  • Motor Activity / drug effects*
  • Parkinsonian Disorders / physiopathology*
  • Purines / administration & dosage
  • Purines / pharmacology*

Substances

  • Adenosine A2 Receptor Antagonists
  • Antiparkinson Agents
  • Purines
  • istradefylline
  • Levodopa