COMPOSITION FOR REGULATING DOPAMINE OR NOREPINEPHRINE LEVELS IN NEURONAL SYNAPSES

Abstract: A material and composition are provided for regulating dopamine or norepinephrine levels in neuronal synapses. The levels of dopamine and/or norepinephrine are regulated by administering a neutral amino acid composition to a patient wherein increased or decreased brain levels of dopamine and/or norepinephrine are effected when the composition contains increased or decreased amounts of tyrosine and/or phenylalanine. Increased or decreased brain levels of serotonin are obtained when the amino acid composition contains increased or decreased amounts of tryptophan. The neutral amino acid composition can be administered alone or concomitantly with a drug which increases or decreases dopaminergic or noradrenergic neurotransmission.

Description: A MATERIAL AND COMPOSITION FOR REGULATING DOPAMINE OR NOREPINEPHRINE LEVELS IN NEURONAL SYNAPSES This invention is concerned with a material for use in regulating (increasing or decreasing) the amount of dopamine or norepinephrine released into neuronal synapses. The invention also relates to a pharmaceutical composition comprising such a material. It is known that the neurotransmitters dopamine and norepinephrine are derived from dihydroxyphenylalanine (DOPA). DOPA is, in turn, produced in neurons by the enzymatic hydroxylation of the amino acid tyrosine. This process is catalyzed by the enzyme tyrosine hydroxylase. The DOPA is decarboxylated to dopamine by the enzyme aromatic L-amino acid decarboxylase (AAAD) and norepinephrine is produced from dopamine in neurons that also contain the enzyme dopamine beta-hydroxylase. It is also known that within this reaction chain, the rate-limiting step is the conversion of tyrosine to DOPA. For this reason, DOPA has been administered to patients who suffer medical disability resulting from dopamine deficiency in diseases such as Parkinsonls Disease. Unfortunately, DOPA, when administered, is taken up by cells throughout the body and converted to dopamine and this interferes with the normal metabolic processes in these other cells. In addition, DOPA interferes with the body's normal storage of the neurotransmitter serotonin, and lowers brain levels of the compound 5-adenosylmethionine. It is believed that these effects contribute to such unwanted side-effects as the "On-Off Phenomenon" and, in some patients, psychotic symptoms. Other types of drugs that act by increasing dopamine and norepinephrine levels in synapses include the Monoamine Oxidase Inhibitors (which slow the destruction of these neurotransmitters) and the tricyclic antidepressants; these compounds, which are used in treating diseases like depression; also relatively non-specific - producing many chemical effects besides increasing synaptic dopamine and norepinephrine levels - and thus have a range of unwanted side-effects such as the dangerous increases in blood pressure that occur when peoples receiving monoamine oxidase inhibitors eat certain foods. Other diseases appear to be caused by the presence of excessive quantities of dopamine or norepinephrine within synapses including psychosis (too much dopamine), movement disorders like tardive dyskinesia and the Gilles de la Tourette Syndrome (too much dopamine), and hypertension and cardiac arrhythmias (too much norepinephrine released from sympathetic neurons). These diseases now usually are treated by drugs that block the interactions of dopamine or norepinephrine with their post-synaptic receptors, such as phenothiazines or butyrophenones. However, these agents all exhibit some non-specific actions as well, and thus cause side-effects. Prior attempts to increase or decrease the levels of dopamine or norepinephrine by modifying neuronal tyrosine levels had been deemed unsuccessful because the total amounts of these compounds in brains and tissues were not noted to change. It was first observed in Wurtman et al (Science 185:183-184, July 12, 1974) that increases in brain DOPA concentrations, which, under the conditions of the experiments, varied in proportion to the rates at which dopamine and norepinephrine were being synthesized could be obtained by increasing brain tyrosine concentrations, and that decreases in brain DOPA concentrations could be produced by giving rats treatments that decreased brain tyrosine. An example of a treatment that increased brain tyrosine was the administration of tyrosine itself; an example of a treatment that decreased brain tyrosine was the administration of one of the other neutral amino acids, e.g. leucine, that competes with plasma tyrosine for uptake into the brain. Prior to that disclosure, it had been believed that the rate-limiting enzyme, tyrosine hydroxylase, was so saturated with tyrosine, that increases or decreases in brain tyrosine levels would not affect tyrosine's conversion to DOPA. In neither the above Wurtman et al article nor a subsequent paper by Gibson and Wurtman (Biochem.Pharmacology, 26:11371142, June, 1977) was it actually shown that such changes in DOPA accumulation were accompanied by changes in brain dopamine nor norepinephrine levels. Furthermore, in neither was it shown that changing brain tyrosine levels had any effect on the amounts of dopamine nor norepinephrine released into synapses. It is an object of the present invention to provide a means for increasing or decreasing the amounts of dopamine and/or norepinephrine that actually are present within synapses. Such changes in synaptic transmitter levels need not be associated with changes in the total amounts of dopamine or norepinephrine present in the brain or other tissues, inasmuch as it is now known that not all of the molecules of the transmitters that are stored in neurons are equally accessable for relase into synapses. It is another object of the invention to provide such a means which is biochemically specific and which lacks the undesirable side effects associated with administration of DOPA, the PIWO inhibitors, the phenothiazines, and the other drugs described above. Such a means can by itself be therapeutic in various disease states. Alternatively, it can be used in combination with other drugs to amplify their therapeutic effects. A therapeutic material embodying the invention can be used for treating diseases associated with a deficiency or an excess of dopamine and/or norepinephrine in synapses. We have found that treatments that increase or decrease neuronal tyrosine levels can also cause corresponding increases or reductions in the amounts of dopamine or norepinephrine released into synapses. The tyrosine, its precursor, phenylalanine, or other neutral amino acids can be administered alone or in admixtures, with or without other drugs, in order to raise or lower brain tyrosine (and phenylalanine) levels, and thereby to treat diseases associated with deficiency or excess of dopamine and/or norepinephrine in synapses. By varying the proportion of tryptohan, another amino acid, in the mixture, the synthesis and synaptic release of serotonin, another brain neurotransmitter, can similarly be controlled. Increased intrasynaptic dopamine levels are obtained after tyrosine and/or phenylalanine administration only when the dopamine-releasing neurons are active, i.e. are firing frequently. Increased synaptic norepinephrine levels are obtained by giving tyrosine regardless of whether the norepinephrine-releasing neurons are or are not especially active. Decreases in dopamine and norepinephrine release into synapses can be obtained by lowering brain tyrosine levels by administering neutral amino acid compositions low in tyrosine levels. Decreases in serotonin release can similarly be obtained by lowering brain tryptophan levels. By regulating the proportion of tyrosine in a given mixture of neutral amino acids, it can be caused to increase or decrease dopamine and/ or norepinephrine release. Phenylalanine can, in low doses, be used in place of tyrosine. Tryptophanis proportion in the neutral amino acid mixture can be used to regulate serotonin's release into synapses while regulating dopamine and norepinephrine release as described herein. The invention provides a material for use in regulating the amount of dopamine or norepinephrine released into synapses in the brain, characterised by a neutral amino acid which is tyrosine, phenylalanine or a mixture thereof (with or without other neutral amino acids) and is effective to regulate blood plasma levels of tyrosine or phenylalanine to form corresponding amounts of dopamine and/or norepinephrine in the brain. The material may be associated with a drug which induces an increase or decrease in dopaminergic or noradrenergic neurotransmission; this drug may be provided separately or in admixture with the said material. The invention also provides a composition in pharmaceutical dosage form comprising material according to the invention. The invention also provides a pharmaceutical composition comprising an excipient and material according to the invention. The invention also provides a pharmaceutical composition.comprising (a) a drug which, when administered to a human having active dopamine-releasing neurons increases or decreases dopaminergic neurotransmission and (b) a neutral amino acid which comprises tyrosine, phenylalanine or mixtures of tyrosine and phenylalanine to increase or decrease dopaminergic neurotransmission. The invention also provides a pharmaceutical composition comprising (a) a drug which, when administered to a human, increases or decreases dopaminergic neurotransmission and (b) a neutral amino acid which comprises tyrosine, phenylalanine or mixtures of tyrosine and phenylalanine (with or without other neutral amino acids) to increase or decrease brain norepinephrine levels. The compositions are, for example, provided in unit dosage form. There now follows a description to be read with reference to the accompanying drawings of embodiments of the invention. This description is given by way of example only, and not by way of limitation of the invention. In the drawings: Figure 1 is a graph illustrating norepinephrine synthesis in the brains of rats; and Figure 2 is a graph illustrating a correlation between homovallic acid and brain tyrosine in rats. Tyrosine and/or phenylalanine and/or other neutral amino acids is administered to a patient either alone or in combination with one or more other drugs thereby to increase or decrease the levels of dopamine and/or norepinephrine which are released into synapses. Serotonin release also can be controlled at the same time by varying the proportion of tryptophan present in the amino acid mixture. In order to increase dopamine release, it is necessary that the dopamine-releasing neurons in the patient's brain be relatively active, i.e. are firing frequently, such as is the case in patients with Parkinson's Disease. However, release of norepinephrine or serotonin into synapses can be varied using amino acid mixtures whether or not the norepinephrinereleasing or serotonin-releasing neurons are especially active. Similarly, decreases in dopamine or norepinephrine release can be produced by administering amino acid mixtures that compete with tyrosine for uptake for the brain thereby decreasing brain tyrosine levels. The composition of the amino acid mixture that is utilized depends upon the nature of the illness in the patient that is to be treated. When there is need to increase dopamine and/or norepinephrine release without increasing that of serotonin, tyrosine (and/or phenylalanine) is adminstered, with or withoutother amino acids not including serotonin's precursor, tryptophan, in doses ranging between 5 mg/kg and 200 mg/kg. This therapy is useful, alone or as an adjunct to drug therapies, in treating Parkinson's Disease, certain types of depression, essential hypertension, or the low blood-pressure that results from impaired peripheral sympathetic nervous function (orthostatic hypotension). In some situations, phenylalanine can be used as a substitute for tyrosine, inasmuch as much of this amino acid is converted to tyrosine in the liver, and released into the blood stream for uptake into the brain. However, plasma phenylalanine levels should be less than about double those of tyrosine, since at the higher levels, phenylalanine competes with tyrosine for uptake into the brain, and can inhibit the enzyme tyrosine hydroxylase. When there is need to sustain or increase brain serotonin levels while increasing dopamine or norepinephrine release, these compositions also contain tryptophan in addition to tyrosine and/or phenylalanine and other neutral amino acids. This combination is especially useful in treating certain types of depression, or sleep disorders. Other neutral amino acids than these compositions can contain include the branched-chain amino acids (leucine, isoleucine, Valine), as well as methionine, threonine, and histidine. The amino acids can be supplied as monomers or as natural or synthetic polymers, e.g. peptides. The phenylalanine, tryptophan and tyrosine will be referred to collectively as "the useful amino acids". When there is need to decrease synaptic dopamine levels, for example, in psychosis, or in such movement disorders as tardive dyskinesia or Gilles de la Tourettets Syndrome, i.e., diseases in which dopaminergic neurons are probably hyperactive, neutral amino acid mixtures are administered which contain relatively little or no tyrosine or phenylalanine. Similar mixtures can be used to decrease synaptic norepinephrine, and to increase or decrease synaptic serotonin depending upon their tryptophan contents. The ratios of the plasma concentrations of tyrosine, phenylalanine and tryptophan to the sum of the other neutral amino acids are normally about 0.08-0.12, 0.07-0.12 and o.06-o.i4 respectively, depending on the composition of the diet. In some diseases, e.g., cirrhosis of the liver leading to coma; diabetes; hyperinsulinism; such catabolic states as starvation, cachexia, disseminated cancer, or severe burns or trauma, these ratios are abnormal, causing changes in brain dopamine, norepinephrine and serotonin release. The particular compositions used in these situations are designed to restore the plasma ratios to normal In the primarily neurologic or psychiatric diseases listed above, the goal of amino acid therapy is to raise or lower these ratios above or below their normal ranges, in order to increase or decrease the release of dopamine or norepinephrine (or serotonin) into synapses. The tyrosine, phenylalanine and other neutral amino acids can be administered as free amino acids, esters, salts, natural or synthetic polymers, or as constituents of foods. The route of administration can be oral or parenteral, e.g., intravenous. EXAILE I This example illustrates that brain norepinephrine can be synthesized by increasing brain tyrosine levels. This example shows that the rate at which 3 methoxy-4-hydroxy-phenylethyleneglycolsulfate (MOPEG-S04), the major brain metabolite of norepinephrine, accumulates in rat brain also varies as a function of brain tyrosine levels. This shows that brain tyrosine levels affect not only the synthesis, but also the turnover and release of brain norepinephrine. Male Sprague-Dawley rats (Charles River Breeding Laboratories, Wilmington, MA) weighing 150 g were housed in hanging cages (6-8 per cage), given ad libitum access to tap water and a 26% protein diet (Charles River Rat Mouse-Hamster Maintenance Formula 24RF), and maintained under light (300 microwatts/cm2; Vita-Lite, Duro-Test Corp., North Bergen, N.J.) between 8 At4 and 8 PEI daily. Rats used for diet experiments were fasted overnight and then allowed to consume the experimental diet starçing at 10 SI. Diets of different compositions were prepared in agar gel (35 g/100 ml of water) as described by Gibso et al, Biochem. Pharmacol., 26, 1137-1142 (1977). All amino acids and drugs were injected intraperitoneally. Norepinephrine synthesis and turnover in brain neurons were estimated by measuring the rate of accumulation of MOPEG-S04 after probenecid administration or exposure to a cold environment. .he MQPEG-S04 in brain homogenates was isolated using an anion exchange column (A-25 DEAE Sephadex; Pharmacia, Piscataway, N.J.); the method used was basically that of Meek and Neff, Br. J. Pharmacol., 45, 435-441 (1972), but modified to allow both tyrosine and MOPEG-S04 to be measured in the same sample. An aliquot of each homogenate (in 0.15 M ZnSO4) was first assayed for tyrosine by the method of Waalkes and Udenfriend, J. Lab. Clin. Med., 50, 733-736 (1957). An equal volume of 0.15 M barium hydroxide was then added to the remaining homogenate, which was rehomogenized (Polytron, Brinkman Instruments, N.Y.), centrifuged and assayed for MOPEG-S04 by the method of Meek and Neff above. Recoveries of MOPEG-S04 and tyrosine from whole brain homogenates were 7o75cA and 85-952b respectively. Tyrosine (Grand Island Biological Co., Long Island, N.Y.) and probenecid (Sigma Chemical Co., St. Louis, Wiz), which are poorly soluble in water, were dissolved in dilute NaOH; the solutions were then buffered to pH 7.4 with hydrochloric acid and brought to a known volume with saline. This yielded a fine suspension that was suitable for injection. In experiments on stress produced by exposure to cold, animals received the more soluble ethyl-ester form of tyrosine (J.T. Baker, Phillipsburg, N.J.), instead of tyrosine itself, to raise brain tyrosine levels. Data were analyzed by one-way or two-way analysis of variance. Probenecid treatment significantly raised the MOPEG-S04 level in brain from 123 ng/g in diluentinjected controls to 175 ng/g in probenecid-treated animals (P < 0.001) (Table I). Tyrosine administration alone had no effect on brain NOPEG-S04; however, pretreatment with this amino acid significantly enhanced the probenecid-induced rise in MOPEG-S04 (to 203 ng/g, as compared with 175 ng/kg in rats receiving probenecid alone (P < 0.01; Table I). TABLE I Accumulation of MOPEG-S04 after Probenecid Administration and Pretreatment with Thrrosine Brain Tyrosine Level Brain MOPEG-S04Level Wg/g) (np/p, ' Pretreatment Diluent Probenecid Diluent Probenecid Diluent 13.9 + 0.5 15.7 + 0.7 123 + 6 175 + 6 Tyrosine 23.3 + 1.5 24.7 + 1.3 127 + 2 203 + 8 Note: In each of 3 experiments, groups of 4-6 rats were injected with either a dose of tyrosine (100 mg/ kg, i.p.) known to accelerate brain dopa synthesis or its diluent and, 30 min. later, with probenecid (400 mg/kg, i.p.) or its diluent. Animals were killed 60 min. after the second injection, and their whole brains were analyzed for tyrosine and MOPEG-S04. Tyrosine administration significantly raised brain tyrosine levels (P + 0.001) whereas probenecid failed to modify brain tyrosine or its response to exogenous tyrosine. Probenecid significantly raised brain MOPEG-S04 (P + O.OQ1), and tyrosine pretreatment significantly enhanced this response (P + 0.01). Data were analyzed by two-way analysis of variance. Values are expressed as means + SEMI. Placing the rats in a cold environment (40C) increases norepinephrine turnover; this accelerates the formation of both norepinephrine itself and its metabolite, MOPEG-S04, , in brain neurons. The rats were exposed to cold to determine whether treatments that changed brain tyrosine levels could influence the rate at which the brain accumulates MOPEG-S04 in rats exposed to cold stress and not given probenecid (Fig. 1). Exposure to cold for 1 hr. increased brain I.OPEG-S04 levels by about 40% (from 80 ng/g to 114 ng/g; P < 0.01). .In animals treated with either of the amino acids or with saline, brain tyrosine levels paralleled, and were significantly correlated with, those of MOPEG-SO4 (r = 77, P < 0.05; Fig. 1). Pretreatment with tyrosine raised brain tyrosine levels by about 80G,' (from 13.3 yug/g, in saline-injected animals, to 24.6jug/g; P < 0.01) and those of MOPEG-S04 by 70% (from 114 ng/g to 193 ng/g; P < 0.01). Pretreatment with valine failed, in this study, to cause significant alterations in brain tyrosine or NOPEG-S04 levels (14.3pug/g and 117 ng/g, respectively); however, brain tyrosine and MOPEG-S04 levels were also significantly correlated in these animals, as in other experimental groups (Fig. 1). The relationship shown in Fig. 1 was obtained as follows: Groups of rats were injected intraperitoneally with valine (200 mg/kg), an amino acid that competes with tyrosine for uptake into the brain (8), or with tyrosine (125 mg/kg of the ethyl ester) or saline; 30 min. later they were placed in single cages. in a cold (4 C) environment. After 1 hr., all animals were killed, and their whole brains were analyzed for tyrosine and NOPEG-S04. Control animals were injected with saline and left at room temperature (220C), also in single cages, for 90 min. Each point represents the tyrosine and MOPEG-S04 levels present in a single brain. Data were pooled from several experiments. Brain tyrosine and M0PEG-SO4 levels in animals kept at room temperature were 14.6pug/g and 80 ng/g, respectively. In Fig. 1, the symbols are as follows: closed circles, animals pretreated with valine; open circles, animals pretreated with saline; closed squares, animals pretreated with tyrosine. To determine whether physiologic variations in brain tyrosine level. might also influence brain norepinephrine synthesis and turnover (as estimated by measuring IIOPEG-S04 levels), the accumulation of this metabolite in animals exposed to a cold environment was examined after being allowed to consume a single meal that could be likely to elevate tyrosine levels. Animals that had been fasted. overnight were given access to either a protein-free (0% casein) or a 40o0 casein meal between 10 and 11 EtI; they were then placed in the cold (4 C) for 1 hr., after which they were killed, and their brain analyzed for tyrosine and MOPEG-S04. Fasted control animals remained at room temperature (220C) during this 2-hr. period. Exposure to cold accelerated the accumulation of MOPEG-S04 in brains of fasted rats, from 123 ng/g (in fasted control animals kept at 22 C) to 163 ng/g (P c 0.05); this treatment had no effect on brain tyrosine levels (10.1 ug/g vs. 10.5 g/g). Among animals placed in the cold, consumption of either a 0% or a 40N casein meal enhanced brain MOPEG-S04 accumulation by 40 50% (Table II; P < 0.01). The 0% casein meal increased brain tyrosine by about 40% (P < 0.01), whereas the 40,S casein meal increased brain tyrosine by 77% (P < 0.01). When the consumption of a protein-free meal failed to elevate brain tyrosine levels, brain MOPEG-S04 levels also failed to rise (Table II). Among protein-fed animals in this study, the brain tyrosine level increased by about 50% (from 13.4 to 19.5 g/g, P( 0.01), and brain MOPEG-S04 rose in parallel. These data show that treatments that increased brain tyrosine levels can accelerate the accumulation of the norepinephrine metabolite IdOPEG-S04 in the brains of rats pretreated with probenecid or exposed to a cold environment. Such treatments can be pharmacologic (i.e., intraperitoneal injection of tyrosine) or physiologic (i.e., consumption of a high-protein meal). They are compatible with the high Km of tyrosine hydroxy- lase for its substrate, relative to brain tyrosine concentrations. The enzyme is especially vulnerable to substrate limitation when it has been activated, inasmuch as activation selectively enhances its affinity for its cofactor. MOPEG-S04 is the major metabolite of norepinephrine formed in rat brain and it is transported out of the brain by a probenecid-sensitive mechanism. After probenecid administration, MOPEG-SOX accumulates at a linear rate in rat brain for at least 60 min. Since brain norepinephrine levels remain constant during this interval, the rate of MOPEG-S04 accumulation provides a useful index of the rate of norepinephrine synthesis. This rate apparently is lower in unstressed, probenecidtreated rats than in animals placed in the cold (Tables I and II), however, in both circumstances, it is depended on brain tyrosine levels. TABLE II Brain MOPEG-S04 Accumulation after Ingestion of a Single Protein-free or 40', Protein Diet among Rats placed in a Cold Environment Treatment Tyrosine MOPEG-S04 Eg/g) (ng/g) EXPERIMENT I Fasted 10.5 + 0.55 163 q 9 Protein-free 14.4 + 0.24* 239 + 17* (0% Casein) 40% Casein 18.1 + 0.85* I 228 + 9* I EXPERIMENT II Fasted 13.4 0.67 195 9 Protein-free 13.3 0.81 182 18 (OgC Casein) 40% Casein 19.5 1.03* 264 20* * Values are significantly different from corres ponding fasted group (P < 0.01). Values are significantly different from corres ponding protein-free group (p c 0.01) Note: Groups of 4-6 rats were fasted overnight and then allowed access to one of the test diets at 10 AM. At 11 AM, animals were placed in an environmental chamber at 40C for 1 hr. They were killed at noon, and their whole brains were analyzed for tyrosine and MOPEG-S04. Animals given protein-free and 40% protein diets consumed 9.7 and 10.5 g, respectively, in Experiment I, and 6.2 and 8.0 g in Experiment II. Data presented as means + SEM. EXAMPLE II This example illustrates that brain dopamine release can be enhanced by increasing brain tyrosine levels. To determine whether tyrosine levels also affect the synaptic release of catecholamine neurotransmitters, the effect of tyrosine administration on the accumulation of the dopamine metabolite, homovanlllic acid (HVA) was examined in brains of animals pretreated either with probenecid (a compound that prevents the egress of organic acids from the cerebrospinal fluid, Spector and Lorenzo, 1974) or with haloperidol (a drug that blocks central dopaminergic receptors, Ungerstedt et al, 1969). It was found that increasing the brain tyrosine levels accelerates IWA accumulation in brains of haloperidoltreated animals, but not in animals given probenecid. Male, 150 to 200 g Sprague-Dawley rats (Charles River Breeding Laboratories,Wilmington, ItL) were exposed to light (Vita-Lite, Duro-Test Co., North Bergen, N.J.) between 9 EI and 9 PM daily and allowed access to Big Red Rat Chow (Charles River Breeding Laboratories) and water ad libitum. Drugs were injected intraperitoneally at a volume of 2 ml/kg body weight. Haloperidol was administered as a soluble prep2ration (Haldols McNeil Laboratories, La Jolla, CA); tyrosine and probenecid (Sigma Chemical Co., St. Louis, MO) were dissolved in 1 N NaOH and adjusted to pH 10.0. Control animals received the appropriate diluents. Twenty minutes after an injection of tyrosine (100 mg/kg) or its diluent, the animals received haloperidol (2 mg/kg) or probenecid (290 mg/kg); 70 min. later they were killed by decapitation. Brains were quickl, removed, and the striata were dissected out (Glowins1i and Iverson, 1966), frozen on dry ice, and subsequently assayed for HVA. Tyrosine was assayed in homogenates of the-remaining brain (Waalkes and Udenfriend, 1957). To affirm that tyrosine concentration in the homogenates of remaining brain are similar to those in striatum homogenates, brains were compared from groups of 6 animals treated, some of which had received tyrosine and/or haloperidol, and no statistical significance was detected. Tyrosine hydroxylase activity was measured bv a modification of the method of Waymire et al. (1971). Corpora striata were homogenized in 10 volumes of 0.05 M Tris-acetate buffer (pH 6.0), containing 0.2 per cent Triton X-100 (Harleco, Philadelphia, PA). The homogenates were centrifuged for 10 min. at 10,000 g, and the super- natant fluids were collected for assay (Coyle, 1972). The assay medium contained, in a total volume of 110 l: 50 Fl of a supernatant fluid; 65 nnoles of D:.:'H4 (2-amino4-hydroxy-6, 7-dimethyl-5, 6,7, 8-tetrahydropteridine hydrochloride (synthetic cofactor obtained from Calbiochem, San Diego, CA); 29 nanomoles of pyridoxal phosphate; 4 nanomoles of 2-mercaptoethanol; 240 units of catalase; 0.01 millimoles phosphate buffer (pH 6.2); and 10 l of aromatic L-amino acid decarboxylase prepared from hog kidneys (Coyle, 1972). Samples were preincubated for 2 min. at 370C. The reaction was started by adding 10 pl of L- 1-14C - tyrosine (specific activity, 0 90 FCi/rsole) to a final concentration of 0.1 mt in the assay medium and then incubating the sample at 370C for 30 min. The assay was stopped by the addition of 0.5 ml of 10 per cent trichloroacetic acid. The acidified medium was then shaken for 2 hours to recover the 14CO2, which was trapped by folded filter paper strips placed in 0.2 ml of NCS tissue solubilizer (Amersham/Searle, Arlington Heights, IL). The strips were then transferred to scintillation vials containing 10 ml of Aquasol (New England Nuclear, Boston, MA), and their radioactivity was counted. Blanks utilized either boiled supernatant fluids or complete assay mixtures containing monoiodotyrosine (0.2 mM); both methods yielded similar results. Tyrosine administration markedly potentiated (by 59 per cent; P < 0.001) the accumulation of HVA in striata of haloperidol-treated rats (Fig. 2). It failed, however, to affect the HVA levels in animals given probenecid, even though brain tyrosine levels were elevated to an equivalent extent (Fig. 2). Among haloperidol-treated rats, striatal HVA and brain tyrosine concentrations were highly correlated (r = 0.70; P < 0.01) (Fig. 2); no such correlation was observed in probenecid-treated animals. The failure of HVA accumulation (and thus of dopamine formation) to vary with brain tyrosine level in probenecid-treated rats may reflect the operation of a receptor-mediated feedback mechanism, which couples the activation of striatal dopamine receptors to a suppression of dopamine synthesis. It can be postulated that tyrosine administration initially enhances the synthesis and release of dopamine in striata of probenecid-treated animals, and that the consequent increase in the activation of dopamine receptors causes a feedback decrease in dopamine formation. The decrease in dopamine formation would lead to a fall in the production of HVA. This hypothetical feedback mechanism would fail to operate in haloperidol-treated animals; hence, tyrosine levels could continue to affect dopamine synthesis, even after dopamine release was accelerated. To examine the possibility that the failure of tyrosine administration to accelerate striatal IWA accumulation in probenecid-treated rats resulted from a feedback change in the kinetic properties of tyrosine hydroxylase, we measured the enzyme's affinity for tyrosine and for its pterin cofactor, DMPH4, on brain samples from each of our experimental groups. The prior administration of tyrosine failed to affect the Kms of tyrosine hydroxylase for tyrosine of DMPH4 in vitro (Table I). A & noted previously (Zivkovic et al, 1974; Zivkovic and Guidotti, 1974), haloperidol administration did decrease the enzyme's Km for DI E 4 (Table III). Fig. 2 of tyrosine administration on the accumulation of HVA in corpora striata of rats given haloperidol or probenecid. Rats received tyrosin (100 mg/kg) or its diluent followed in 20 min. by haloperidol (2 mg/kg) or probenecid (200 mg/kg); they were sacrificed 70 min. after the second injection. Data from individual animals receiving haloperidol are indicated by open circles; data from rats receiving haloperidol plus tyrosine are indicated by closed circles. Striatal HVA levels were highly correlated with brain tyrosine levels in all animals receiving hzloeridol (r = 0.70; P < 0.01). In contrast, the striatal HVA levels of animals receiving probenecid alone (n = 17) did not differ from those of rats receiving probenecid plus tyrosine (n = 11). Brain tyrosine and striatal HVA concentrations in each group were (respecti.vely): probenecid, 17.65 + 1.33 and 1.30 + 0.10 Fg/g; probenecid plus tyrosine, 44.06 + 3.91 and 1.31 + 0.11 Xg/g; haloperidol, 17.03 + 0.97 and 2.00 + 0.10 Sg/g; ; and haloperidol plus tyrosine, 36.02 + 2.50 and 3.19 + 0.20 sg/g- TABLE III Effect of Pretreatment with Tyrosine or its Diluent, Plus Probenecid or Haloperidol, on the Kms of Striatal Tyrosine Hydroxylase for Tyrosine and DMPH4 Treatment Km for Km for tyrosine ( M) DMPH4 (mM) Probenecid 53.9 + 2.2 0.72 + 0.01 Probenecid plus tyrosine 52.1 + 1.7 0.67 9 0.06 Haloperidol 48.1 + 1.9 0.13 + 0.01 Haloperidol plus tyrosine 48.4 + 1.1 0.12 + 0.01 Animals were treated as described for Fig. 3. Samples of striatum were assayed for tyrosine hydroxylase activity by using tyrosine concentrations of 0.125 1.0 mM and DMPH4 concentrations of 0.1 to 0.5 Si. Haloperidol administration with or without tyroslne significantly reduced the Km of tyrosine hydoxylase for DiSH4, as compared to that observed in probenecid-treated animals (P c 0.001, Studentts t-test). These data provide further support for the hypothesis that tyrosine hydroxylase may not always be saturated with its amino acid substrate in vivo - i.e., in animals whose brains are synthesizing larger-than- normal quantities of dopamine as a consequence of dopamine-receptor blockade (by haloperidol). Moreover, they show that increasing the saturation of the enzyme (by administering tyrosine) can enhance not only the formation of dopa and of the catecholamine neurotransmitter, dopamine, but also the release of this transmitter. Control by tyrosine of dopamine synthesis and release can be expected to operate whenever dopaminergic neurons are firing frequently, e.g., in Parkinsonts Disease; after haloperidol.

Claims: Claims: 1. A material for use in regulating the amount of dopamine or norepinephrine released into synapses in the brain, characterised by a neutral amino acid which is tyrosine, phenylalanine or a mixture thereof (with or without other neutral amino acids) and is effective to regulate blood plasma levels of tyrosine or phenylalanine to form corresponding amounts of dopamine and/or norepinephrine in the brain. 2. A material according to clan 1 wherein said amino acid is tyrosine and also comprising tryptophan in an amount to increase or decrease brain serotonin levels. 3. A material according to claim 1 characterised by tyrosine and phenylalanine, the amount of phenylalanine being less than that which competes with tyrosine for uptake into the brain. 4. A material according to claim 1 for use in the treatment of a disease that causes dopamine-releasing neurons to be active and containing tyrosine or phenylalanine. 5. A material according to claim 1 characterised by association with a drug which induces an increase or decrease in dopaminergic neurotransmission. 6. A material according to claim 1 characterised by association with a drug which induces an increase or decrease in noradrenergic neurotransmission. 7. A composition in pharmaceutical dosage form comprising material according to any one of the preceding claims. 8. A pharmaceutical composition comprising an excipient and material according to any one of claims 1 to 6. 9. A pharmaceutical composition comprising (a) a drug which, when administered to a human haring active dopamine-releasing neurons increases or decreases dopaminergic neurotransmission and (b) a neutral amino acid which comprises tyrosine, phenylalanine or mixture of tyrosine and phenylalanine to increase or decrease dopaminergic nurotransmission, 10. A pharmaceutical composition comprising (a) a drug which, when adminstered to a human, increases or decreases dopaminergic neurotransmission and (b) a neutral amino acid which comprises tyrosine, phenylalanine or mixtures of tyrosine and phenylalanine (with or without other neutral amino acids) to increase or decrease brain norepinephrine levels.

Inventors: WURTMAN, RICHARD J.
Applicants: MASSACHUSETTS INSTITUTE OF TECHNOLOGY
Application year: 1979
Main classification: A61K31
IPC codes: A61K31, A61P25, G06F9, A61P5