L-745,870 reduces L-DOPA-induced dyskinesia in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned macaque model of Parkinson's disease

J Pharmacol Exp Ther. 2012 Aug;342(2):576-85. doi: 10.1124/jpet.112.195693. Epub 2012 May 22.

Abstract

L-DOPA-induced dyskinesia remains an unmet challenge in the treatment of Parkinson's disease (PD). Here, we investigate the potential antidyskinetic efficacy of 3-([4-(4-chlorophenyl)piperazin-1-yl]methyl)-1H-pyrrolo[2,3-b]pyridine (L-745,870), a potent and selective dopamine D(4) receptor antagonist with a good toxicology profile and an excellent safety and tolerability record in phase I/II clinical studies, for non-PD indications. Six macaques were rendered parkinsonian by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine administration. After induction of stable and marked dyskinesia, animals were administered acute challenges of L-745,870 in combination with L-DOPA. To guarantee D(4) selectivity at the doses used in the study, we determined the plasma, cerebrospinal fluid, and brain levels of L-745,870. Coadministration of L-745,870 (1 mg/kg) and L-DOPA significantly reduced the severity of dyskinesia, by up to 59%, in comparison with L-DOPA alone (P < 0.01). L-745,870 had no effect on the duration of antiparkinsonian benefit (ON-time) (P > 0.05). However, L-745,870 (1 mg/kg) significantly increased the duration of ON-time without disabling dyskinesia (+204%; P < 0.001) and decreased duration of ON-time with disabling dyskinesia compared with L-DOPA alone (-56%; P < 0.01). Brain levels of L-745,870 (∼600 ng/g) were within the range at which L-745,870 provides selective D(4) receptor antagonism. Plasma levels were comparable with those demonstrated to be well tolerated in human studies. These data suggest that selective D(4) receptor antagonists represent a potential therapeutic approach for L-DOPA-induced dyskinesia. It is noteworthy that L-745,870 has already undergone significant clinical development, has an excellent profile for a therapeutic candidate, and could be advanced rapidly to phase IIa clinical studies for dyskinesia in PD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine / pharmacology*
  • Animals
  • Antiparkinson Agents / blood
  • Antiparkinson Agents / cerebrospinal fluid
  • Antiparkinson Agents / pharmacokinetics
  • Antiparkinson Agents / pharmacology*
  • Brain / drug effects
  • Brain / metabolism
  • Drug Interactions
  • Dyskinesias / blood
  • Dyskinesias / cerebrospinal fluid
  • Dyskinesias / drug therapy*
  • Dyskinesias / metabolism
  • Female
  • Levodopa / pharmacology*
  • Macaca
  • Male
  • Motor Activity / drug effects
  • Parkinson Disease / blood
  • Parkinson Disease / cerebrospinal fluid
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / metabolism
  • Pyridines / blood
  • Pyridines / cerebrospinal fluid
  • Pyridines / pharmacokinetics
  • Pyridines / pharmacology*
  • Pyrroles / blood
  • Pyrroles / cerebrospinal fluid
  • Pyrroles / pharmacokinetics
  • Pyrroles / pharmacology*
  • Receptors, Dopamine D4 / antagonists & inhibitors
  • Receptors, Dopamine D4 / metabolism

Substances

  • 3-((4-(4-chlorophenyl)piperazin-1-yl)methyl)-1H-pyrrolo(2,3-b)pyridine
  • Antiparkinson Agents
  • Pyridines
  • Pyrroles
  • Receptors, Dopamine D4
  • Levodopa
  • 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine