RU2255775C1 - Method for treating parkinson's disease - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: the present innovation deals with treating cerebral diseases, Parkinson's disease being among them. One should measure biochemical and immunological blood values of a patient, the values of MAO-B thrombocytes activity, the values of erythrocytes activity, Cu/Zn - TFD, the level of neuromediators of glutamate and taurine in blood plasma and circulating immune complexes (CIC) in blood serum. To perform the impact with laser irradiation it is necessary to choose the patients with all, several or only one value in ranges given below: MAO-B 90-250 nM/mg or MAO-B 0-47 nM/mg, at the norm of 73+7 nM/mg, Cu/Zn - TFD 1.2-2.5 U/mg or Cu/Zn - TFD 0-0.8 U/mg, at the norm of 1.5 ± 0.05 U/mg, CIC low-molecular fractions 100-300 c.u., at the norm of 80 ± 5.0 c.u., CIC average-molecular fractions 48-150 c.u., at the norm of 39 ± 2 c.u., affected ratio of glutamate to taurine. Impact should be carried out intravenously with the help of a light guide at the power at its end being 1 mW and wave length of 632.8 daily for 5 d, every seance lasts for 20 min, then medicinal therapy should be fulfilled without laser impact by repeating the course of laser irradiation in a year. The method enables to increase the quality in treating Parkinson's disease due to stimulating the system of antiradical tissue protection, increased protective body reserves and correction of immune disorders.

EFFECT: higher efficiency of therapy.

Description

The invention relates to medicine and can be used in the treatment of diseases of the brain, such as Parkinson's disease.

According to various researchers, the spread of Parkinson's disease ranges from 65 to 187 cases and averages 100 cases per 100,000 people.

The main treatment for Parkinson's disease today is replacement therapy using DOPA-containing drugs. However, with prolonged use, it leads to various complications (Kryzhanovsky GN, et al. Parkinson's disease. M: Medicine 2002).

In many cases, the effectiveness of the treatment of brain diseases is enhanced by laser therapy.

A known method of treating focal brain lesions in severe traumatic brain injury by exposure to laser radiation (RF Patent No. 2194549, CL A 61 N 5/067, 1999). A catheter is inserted in the area of the greatest damage to the brain substance, through which in the postoperative period carry out irradiation with a laser beam with a wavelength of 0.63 μm, a power of 5 mW for 5 minutes for 2-5 days. The method allows to achieve regression of neurological symptoms and to increase the level of consciousness of the patient.

There is also a method of laser therapy for traumatic brain injury by contacting low-intensity laser radiation with a wavelength of 0.89 microns on the carotid arteries on both sides daily for 10 days for 1-3 minutes each (RF Patent No. 2207172, class A 61 N 5/067, 2002).

There is also a known method of correction of the treatment of neuropsychiatric disorders by laser therapy. Namely, the effect of endovascular laser therapy and antioxidants on clinical and immunological parameters and energy metabolism in patients with schizophrenia was studied (Kutko II et al. The effect of endovascular laser therapy on clinical and immunological patients with schizophrenia. S.C. Neurology and Psychiatry Journal. Korsakova, vol. 96, No. 2 1996, p. 34-36).

Closest to the invention is a method of increasing the effectiveness of the treatment of Parkinson's disease, which consists in exposure along with drug therapy with low-intensity laser radiation to the blood of a patient (Rassokhin V.F. Laser therapy in neurology. Kiev: Naukova Dumka, 2001, p.27). According to this method, it is recommended, along with pharmacotherapy, to use the contact method of infrared laser therapy for the patient’s blood at a radiation power density of 1 - 1.5 mW with a wavelength of 0.89 and 1.3 μm. Sessions are held in the first month - once every 2-3 days, and then - during the course of treatment with drugs - every other day 15-20 times.

However, since the infrared spectrum wavelengths are used in this method, this does not allow metal-containing antioxidant protection enzymes to be influenced, such as SOD, catalase, and therefore makes it impossible to correct oxidative stress processes in the body. In addition, it does not allow a differentiated approach to the treatment of this disease.

The technical result of the invention is improving the quality of treatment for Parkinson's disease by stimulating the anti-radical tissue defense system, increasing the body's protective reserves and correcting immunity disorders.

This result is achieved by the fact that only those patients are exposed to laser irradiation, for whom all, several or one of the biochemical and immunological parameters of the blood are within the following limits:

MAO - B from 90 to 250 nmol / mg or

MAO - B from 0 to 47 nmol / mg (at a rate of 73 ± 7 n mol / mg),

Cu / Zn - SOD from 1.2 to 2.5 u / mg or

Cu / Zn - SOD from 0 to 0.8 u / mg (with a norm of 1.05 ± 0.05 u / mg),

fine molecular weight fractions of the CEC from 100 to 300 conventional units (at a rate of 80 ± 5.0 conventional units),

medium molecular weight fractions of the CEC from 48 to 150 conventional units (at a rate of 39 ± 2 conventional units),

the level of neurotransmitters of glutamate and taurine in blood plasma is not related by the equation y = (0.9x + 30) ± 15 μmol / l,

where x is the amount of glutamine in the blood plasma, µmol / l,

y is the amount of taurine in blood plasma, µmol / L.

Moreover, they are exposed to low-intensity radiation intravenously using a fiber with a power at its end of 1 mW and a wavelength of 632.8 nm daily for 5 days, each session is carried out for 20 minutes, then continue drug therapy without laser exposure, repeating the course of laser therapy after a year.

Parkinson's disease is based on metabolic disorders of mediators. The main morphological substrate of the disease is the dopaminergic system of the substantia nigra of the brain, in which glutamate and aspartate play the role of exciting neurotransmitters. Disruption of their metabolism in Parkinson's disease is one of the causes of oxidative stress, the development of which is expressed both in the imbalance between the prooxidant and antioxidant systems of the body, and in the change in the content of exciting and inhibitory neurotransmitter amino acids in the brain and, possibly, in other body tissues.

Impaired dopamine metabolism is accompanied by a change in the activity of monoamine oxidase B (MAO-B). By catalyzing the oxidative deamination reaction, MAO-B not only inactivates biogenic amines, but also promotes the formation of highly reactive compounds - aldehydes, ammonia, and hydrogen peroxide. In the body, hydrogen peroxide is, in turn, a source of more dangerous oxygen radicals - hydroxyl radical and superoxide, and this leads to the initiation of oxidative stress in the tissues.

Based on this, the invention proposes a study of the biochemical parameters of the blood of patients and the selection of patients for treatment, depending on the indicators of antioxidant protection.

Thus, in the pathogenesis of Parkinson's disease, an essential role is played by violations in the antiradical defense system. MAO-B, SOD, catalase are metal-containing enzymes capable of absorbing coherent monochromatic radiation at a wavelength of 632.8 nm.

In Parkinson's disease, there is an increase in the permeability of the blood-brain barrier, as a result of which circulating immune complexes (IR) antigen - antibody complement can accumulate in the blood of patients. These complexes can exhibit a toxic effect, most pronounced in medium and low molecular weight fractions. For this reason, measuring the level of IR is of great prognostic value for the choice of tactics of therapeutic measures and patient management, the results of the study. This decision was led by measuring the activity of platelet monoamine oxidase B (MAO - B) as an enzyme directly involved in the metabolism of dopamine, erythrocytic Cu / Zn - superoxide dismutase (SOD) and catalase - the most important antioxidant enzymes, excitatory and inhibitory neurotransmitters of blood glutamate as well as indicators of humoral immunity - circulating IR high- and medium-molecular fractions.

Laser irradiation was used in the present invention as a means of stimulating the body's antioxidant defense system, as well as extracorporeal induction of cells - immunogenesis regulators. The positive clinical effect of laser therapy is associated with the modulating effect of GNL on the mechanisms that control the interactions between non-enzymatic (taurine) and enzymatic (SOD) factors of antioxidant tissue protection and factors of humoral immunity. In addition, it is the result of improved blood microcirculation, as well as the removal or reduction of immunodeficiency manifestations.

Moreover, on the basis of clinical studies, it was found that the best effect of laser irradiation was in patients who had been taking DOPA drugs for a long time and who had reduced sensitivity to basic anti-Parkinsonian therapy and, as a result, iatrogenic complications from the therapy are taking place. Therefore, the claimed method is used for patients in whom the MAO-B, Cu / Zn-SOD indicators are either increased or decreased, the level of IR is increased, as well as those in which the glutamate / taurine ratio is violated due to depletion of the body's protective reserves.

Patients with indicators lying within the described limits are given laser therapy sessions without stopping drug therapy, in the modes and terms according to the claimed method. After treatment, these indicators return to normal, which confirms the effectiveness of treatment in this way.

EXAMPLE OF IMPLEMENTATION OF THE METHOD.

The technique of intravenous laser therapy using the He-Ne optical generator ALOK-1 with a wavelength of 632.8 nm and a power at the end of the fiber of 1 mW (power density - 0.5 W / cm) was used

Intravenous irradiation of blood was performed to achieve a better effect on blood cells compared with cutaneous irradiation.

The wavelength of 632.8 nm was chosen in this method because it has the absorption of metal enzymes - catalase, Cu / Zn-superoxide dismutase.

A disposable light guide was used, which was inserted into the cubital vein.

The power of a single exposure was selected from the need to exclude adverse reactions (for example, hemolysis, cytolysis, etc.) during drug therapy (L. L. Goncharova et al. International Medical Reviews. T.2, No. 1, p.15-19, 1994).

Based on the same considerations, it was recommended in the proposed method and the number of sessions - 5 to 20 minutes.

Patients were observed 6-9-12 months after treatment by the proposed method: exacerbation of the disease was not observed.

70 people with Parkinson's disease were examined.

The results of biochemical studies revealed the heterogeneity of BP by the activity of MAO B and Cu / Zn-SOD. The examined patients were divided into two groups: the first with significantly increased (40 people) and the second with reduced (30 people) activity of both enzymes (the average MAO B activity in patients of the 1st group was 120 nmol BA / mg protein per hour, 2 groups - 46 120 nmol BA / mg protein per hour; activity of Cu / Zn-SOD - 1.34 and 0.78 U / mg Hb, respectively). A group of patients with reduced activity of these enzymes was characterized by a milder form of the disease, and with increased activity - a longer and more severe course of the disease. Patients of both groups showed a tendency to lower catalase relative to the control group.

Analysis of the blood levels of patients with neurotransmitter amino acids showed that patients of group 2 are characterized by an increased content of glutamate and taurine, and a positive correlation is found between these parameters. Based on the known facts of the participation of taurine in the regulation of glutamate receptor activity, we can consider this factor as one of the elements of the adaptive response. Therefore, at the initial stages of PD development, the body's compensatory reserves are not yet depleted, which is expressed, in particular, in an increase in the amount of taurine in blood plasma. In patients of group 1, the level of taurine is slightly reduced and there is no correlation between taurine and glutamate.

A correlation analysis of the studied clinical and biochemical parameters found in patients of group 1 a direct relationship between the severity of the disease, the total dose of DOPA drugs taken during treatment, and the activity of MAO B.

Thus, the activity of MAO B and Cu / Zn-SOD of the formed elements of peripheral blood, as well as the level of glutamate and taurine in blood plasma are important characteristics of PD development, which adequately reflect the processes occurring in the brain.

After carrying out a course of laser therapy for patients, we found changes towards normalizing the activity of MAO B and Cu / Zn-SOD in patients of both groups - in the 1st group, these parameters significantly decreased, and in the 2nd group they increased, approaching the norm. Changes in catalase after laser treatment were also directed towards normalization. After laser therapy, an increase in taurine level was observed in group 1 patients, which led to a normalization of the glutamate / taurine ratio. In our opinion, this indicates laser stimulation of the body's adaptive system. Neurological deficit in patients of both groups against the background of laser treatment was significantly reduced. In patients with severe stage of PD, there is a more pronounced clinical effect of laser therapy with a positive correlation between neurological deficit and treatment effectiveness. The effect of the laser on the neurological deficit of the patient was all the more effective the disease manifested at a later age.

The biochemical heterogeneity of Parkinson's disease discovered by us is also traced on the example of some immunological parameters. The amount of IR in the blood serum of patients of the groups described by us was significantly different. The number of circulating IR low molecular weight fractions (NICs) in the examined patients of group 1 turned out to be significantly higher than normal (115 ± 9 conv. Units with a norm of 80 ± 5 conv. Units), the level of the average molecular fraction (sIC) tended to increase, and the level of high molecular weight fraction was not changed. The same indices in patients of group 2 (with reduced activity of MAO B and Cu / Zn-SOD) did not significantly differ from the norm, and the level of high molecular weight IR showed a slight downward trend.

After laser therapy in patients of group 1, a decrease in the number of low molecular weight IR fractions to normal values was noted.

The revealed heterogeneity of MAO B is, in our opinion, an important factor that should be taken into account to determine the treatment protocol. Laser therapy has a better effect on patients of the so-called group 1 - with a longer and more severe stage of the disease, as well as on patients of group 2, whose MAO B and Cu / Zn-SOD activities are quite different from the norm.

According to the testimony of the proposed method, laser therapy was performed in 54 patients.

As expected, laser irradiation together with drug therapy had a positive effect on neurological symptoms, as well as biochemical and immunological parameters of patients with Parkinson's disease. The data obtained during biochemical studies allow us to conclude that the laser has a normalizing effect on the enzymatic anti-radical defense system, the amino acid composition of the blood, and immune parameters. This action is all the more pronounced, the more pronounced in patients are deviations (in one direction or another) in the studied parameters. Thus, the use of a laser as a therapeutic method gives the most pronounced clinical effect in the late stages of the disease. This allowed us to selectively recommend laser therapy to those patients whose described biochemical and immune parameters deviate from the norm by the above values.

Claims (1)

A way to increase the effectiveness of the treatment of Parkinson’s disease, which consists in exposure along with drug therapy with laser radiation to the patient’s blood, characterized in that it also measures the biochemical and immunological parameters of the patient’s blood, namely, MAO-B platelet activity indicators, Cu / Zn erythrocyte activity indicators - SOD , the plasma level of the neurotransmitters glutamate and taurine and circulating immune complexes (CECs) in the blood serum, patients with all , several or one of the indicators within the following limits: MAO-B 90 - 250 nmol / mg or MAO-B 0 - 47 nmol / mg with a norm of (73 + 7) nmol / mg Cu / Zn - SOD 1.2 - 2.5 u / mg or Cu / Zn - SOD 0 - 0.8 u / mg at normal (1.05 ± 0.05) u / mg Small molecular fractions CEC 100 - 300 conventional units at a rate of (80 ± 5.0) conventional units The average molecular fractions of the CEC 48 - 150 conventional units at normal (39 ± 2) conventional units the broken ratio of glutamate to taurine levels, exposure is carried out intravenously using a fiber with a power at its end of 1 mW and a wavelength of 632.8 nm daily for 5 days, each session is carried out for 20 minutes, then continue drug therapy without laser exposure, repeating the course of laser irradiation in a year.