L-Dopa Prodrugs: An Overview of Trends for Improving Parkinsons Disease Treatment

Antonio      Di Stefano; Piera      Sozio; Laura      Serafina Cerasa; Antonio      Iannitelli

doi:10.2174/138161211798194495

Abstract

L-Dopa is the mainstay of Parkinsons disease therapy; this drug is usually administered orally, but it is extensively metabolized in the gastrointestinal tract, so that relatively little arrives in the bloodstream as intact L-Dopa. The peripheral conversion of L-Dopa by amino acid decarboxylase to dopamine is responsible for the typical gastrointestinal and cardiovascular side effects. To minimize the conversion to dopamine outside the central nervous system, L-Dopa is usually given in combination with peripheral inhibitors of amino acid decarboxylase. In spite of that, other central nervous side effects such as dyskinesia, on-off phenomenon and end-of-dose deterioration still remain. The main factors responsible for the poor bioavailability are the drugs physical-chemical properties: low water and lipid solubility, resulting in unfavorable partition, and the high susceptibility to chemical and enzymatic degradation. Starting from these considerations the prodrug approach has been applied to L-Dopa in order to overcome its metabolism problems and to improve its bioavailability. The goal of this paper is to provide the reader with a critical overview on L-Dopa prodrugs here classified according to the nature of the main chemical modification on L-Dopa backbone that led to the formation of the desired derivative.

Keywords: Parkinson's disease, L-dopa, dopamine, prodrugs, codrugs, antiparkinson, dyskinesia, plasma, chronic oxidative stress, cell death