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Food Interactions, Sirtuins, Genes, Homeostasis, and General Discussion
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Protein-rich foods can interfere with or potentiate the absorption of various medications such as antihypertensive beta-blocker drugs (propranolol, metoprolol, oxprenolol, etc.), anti-asthmatic drug (theophylline), and anti-Parkinsonian’s drugs (levodopa, carbidopa) (24). Consuming a meal high in protein and taking propranolol concurrently can increase the beta-blocker’s bioavailability, thereby increasing its side effects like bradycardia, hypotension, and bronchoconstriction (24). In contrast, high-protein diets can decrease concentration and efficacy of carbidopa, levodopa, and theophylline, resulting in low drug efficacy and aggravation of disease (24).
Homeostasis of Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
TH is a mixed function oxidase that uses L-tyrosine and molecular oxygen as substrates, and L-tetrahydrobiopterin (BH4) and ferrous iron (Fe2+) as cofactors [3]. Tyrosine is one of the 20 standard amino acids used by cells to synthesize proteins. It is a nonessential amino acid with a polar side chain group. Given its natural abundance, catecholamine levels are not influenced either by changing the dietary levels of tyrosine or by its parenteral administration, even at large amounts. Because of its essential role as a cofactor in TH enzymatic activity, a deficiency in BH4 can cause systemic deficiencies of catecholamines. One example of BH4 deficiency is the development of dopamine-responsive dystonia, characterized by increased muscle tone and Parkinsonian features. This condition can be treated with carbidopa/levodopa which directly restores dopamine levels within the brain.
Purine, pyrimidine and porphyria disorders
Published in Steve Hannigan, Inherited Metabolic Diseases: A Guide to 100 Conditions, 2018
No treatment exists for this condition. Haloperidol has been tried, and although it decreases the uric acid levels, it does not improve the neurological outcome. Some symptoms may be relieved by giving carbidopa/levodopa, diazepam, phenobarbital or haloperidol. The patient’s teeth may have been removed in the past to limit self destructive behaviour, but the use of mouth-guards should be tried irst. Treatment for individuals with this disease aims to relieve any symptoms and to provide support in the care of the individual. Afected individuals become fearful and upset when left unrestrained or unprotected. In the past the outcome was likely to be poor, but it has been improved by the encouragement of dedicated parents. Genetic counselling may be of beneit to the families of individuals afected by this disorder.
In vitro and in vivo characterization of Entacapone-loaded nanostructured lipid carriers developed by quality-by-design approach
Published in Drug Delivery, 2022
Yogeeta Agrawal, Kiran Patil, Hitendra Mahajan, Mrugendra Potdar, Pratiksha Joshi, Kartik Nakhate, Charu Sharma, Sameer N. Goyal, Shreesh Ojha
Entacapone, a nitro catechol compound (Figure 1), has been approved for clinical use in patients with PD. It inhibits the degradation of dopamine and levodopa by blocking the enzyme Catechol-O-Methyl Transferase (COMT) (Najib, 2001). It enhances the action of dopamine and reduces the onset of motor complications to a certain extent. It is used along with carbidopa-levodopa therapy to overcome the ‘wear-off’ symptoms (Antonini et al., 2018; Müller, 2020). But Entacapone is a BCS class IV drug with low aqueous solubility and low permeability (Bommaka et al., 2018). Moreover, the bioavailability may also be affected by high lipophilicity, pre-systemic clearance in the gastrointestinal mucosa, and the P-GP efflux mechanism (Garg et al., 2020). Therefore, the major challenge is to formulate the drug delivery system that possibly tackles all these problems and increases the bioavailability and residence of the drug.
Practical pearls to improve the efficacy and tolerability of levodopa in Parkinson’s disease
Published in Expert Review of Neurotherapeutics, 2022
Abhishek Lenka, Gianluca Di Maria, Guillaume Lamotte, Laxman Bahroo, Joseph Jankovic
It is well-known that the clinical efficacy of levodopa may be affected by the timing and content of meals [29,30]. Most studies have reported a blunted effect of levodopa in the context of protein-rich food [31]. It was initially presumed that the low clinical efficacy results from the competition of levodopa with the large neutral amino acids from dietary proteins for the common active transporter in the stomach and intestine. However, several studies failed to find a good correlation between the degree of motor fluctuation with the blood levels of levodopa after food [32,33]. This led to the speculation that amino acids from the dietary protein probably compete with levodopa at the BBB and CNS neurons [32,33]. Nevertheless, appropriate modification in the content and timing of the meals, may improve the bioavailability of levodopa, irrespective of the site of competition (central or peripheral). This phenomenon is applicable to both IR and ER formulation of levodopa [34]. As mentioned above, there are two formulations of ER levodopa: 1. controlled-release (CR) levodopa tablet and 2. a capsule containing a mixture of IR and ER microbeads (Rytary). The carbidopa/levodopa CR preparation is rarely used as it provides inconsistent absorption and erratic blood and brain levels of levodopa, and it has an increased risk of levodopa-related dyskinesia. Some clinicians, however, prescribe carbidopa/levodopa CR as a nighttime formulation of levodopa for patients who experience troublesome nighttime motor symptoms.
Diet Quality and Nutrition Concerns of People with Parkinson’s Disease and Their Informal Caregivers: A Mixed Methods Study
Published in Journal of Nutrition in Gerontology and Geriatrics, 2022
Dara L. LoBuono, Kyla S. Shea, Alison Tovar, Skye N. Leedahl, Leslie Mahler, Furong Xu, Ingrid E. Lofgren
Parkinson’s disease (PD) is a progressive neurodegenerative movement disorder that impacts nearly one million Americans,1,2 and that number is expected to double by 2030.3 Disease stage and sequalae (conditions that result specifically from PD), physiological factors and treatments, and associated side effects of PD can compromise dietary intake and quality.4,5 Additionally, the most effective medication for managing PD, carbidopa-levodopa, competes for absorption with dietary protein.6,7 This food-druginteraction makes timing when to consume protein and take medications a challenge for people with PD (PwPD).4 Over-time, patients with higher dietary protein intake may require higher levodopa doses and eventually the medication loses its effectiveness.6,7 Other nutrition concerns include: weight management (e.g., being over- or underweight), maintaining optimal food and fluid intake while managing dysphagia (e.g., difficulty swallowing), and preventing and correcting micronutrient deficiencies.4 Diet quality, as measured by the Healthy Eating Index-2015 (HEI-2015), is a proxy of the Dietary Guidelines for Americans (DGAs). Disease sequelae can impact diet quality, resulting in a variability in weight and nutrition status. Unfortunately, few studies have examined the diet quality of PwPD.8,9