medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-2-86-93medsovet-6739Research ArticleПАРКИНСОНИЗМPARKINSONISMАгонисты дофаминовых рецепторов: классические и нестандартные сферы примененияDopamine receptor agonists: standard and non-standard applications in medicinehttps://orcid.org/0000-0002-2600-0573ВасенинаЕ. Е.VaseninaE. E.

к.м.н., доцент кафедры неврологии с курсом рефлексологии и мануальной терапии 

 125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1 

 Cand. Sci. (Med.), Associate Professor of the Department of Neurology with a Course of Reflexology and Manual Therapy

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia 

hel_vas@mail.ruhttps://orcid.org/0000-0002-8714-2698ГанькинаО. А.GankinaO. A.

 к.м.н., ассистент кафедры неврологии с курсом рефлексологии и мануальной терапии 

 125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1 

 Cand. Sci. (Med.), Assistant of the Department of Neurology with a Course of Reflexology and Manual Therapy 

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia 

ganya1987@mail.ruhttps://orcid.org/0000-0003-3872-5923ЛевинО. С.LevinO. S.

 д.м.н., профессор, заведующий кафедрой неврологии с курсом рефлексологии и мануальной терапии 

 125993, Россия, Москва, ул. Баррикадная, д. 2/1, стр. 1 

 Dr. Sci. (Med.), Professor, Head of the Department of Neurology with a Course of Reflexology and Manual Therapy 

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia 

neurolev@mail.ruРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation202212032022028693Copyright © Васенина Е.Е., Ганькина О.А., Левин О.С., 20222022Васенина Е.Е., Ганькина О.А., Левин О.С.Vasenina E.E., Gankina O.A., Levin O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6739

Агонисты дофаминовых рецепторов (АДР) – класс лекарственных препаратов, обладающих способностью непосредственно стимулировать дофаминергические рецепторы, обеспечивая более сильный эффект эндогенного дофамина, что широко используется в лечении патологий, сопровождающихся дефицитом дофаминергической нейротрансмиссии. Классическим гиподофаминергическим заболеванием является болезнь Паркинсона (БП), и традиционно АДР ассоциируются именно с данной патологией. Однако даже самый первый АДР бромокриптин, получивший широкое применение в лечении БП, исходно был зарегистрирован как средство для лечения гиперпролактинемии и ассоциированных с ним аденом гипофиза и до сих пор широко применяется в гинекологии и эндокринологии. В ряде стран АДР используются в лечении сахарногодиабета, при нарушении пищевого поведения, в терапии зависимостей. Дофамин – важный нейромедиатор эмоционального контроля, главный нейротрасмиттер системы вознаграждения, что и определило интерес к изучению исконно дофаминергических средств в лечении первичных психиатрических заболеваний, а также для коррекции вторичных аффективных расстройств. Экспериментальная эффективность АДР в замедлении скорости прогрессирования нейродегенеративного процесса при тяжелых некурабельных заболеваниях, а также потенциальная нейропротекция при цереброваскулярной недостаточности позволит в будущем определить критерии использования АДР в данных нестандартных ситуациях, что, возможно, повлечет за собой даже изменение клинических рекомендаций лечения отдельных нозологий. В статье представлены как традиционные сферы использования АДР, так и обзор нестандартных областей применения данного класса препаратов с обсуждением тех исследований, которые были проведены в последние годы. В дальнейшем, вероятно, ожидается переосмысление восприятия АДР как класса преимущественно противопаркинсонических препаратов с расширением их терапевтических показаний.

Dopamine receptor agonists (DRA) are a class of therapeutic drugs able to directly stimulate dopaminergic receptors facilitating a stronger effect of the endogenous dopamine, which is widely used in treatment of diseases that are accompanied with dopaminergic neurotransmission deficiency. A classical hypodopaminergic condition is Parkinson’s disease and DRA are traditionally associated with it. However, even the first DRA, Bromocriptine, widely adopted in PD treatment, was initially registered as a medication for treatment of prolactinaemia and associated pituitary adenomas and is still widely used in gynecology and endocrinology. In several countries DRA are used in treatment of diabetes, eating disorders, and addictions. Dopamine is the cardinal neurotransmitter of the emotional control and the main neurotransmitter of the reward system, and that defines the interest for researching the dopaminergic agents in treatment of primarily mental illnesses, as well as correction of secondary affective disorders. The experimental effectiveness of ADR in slowing down the rate of progression of the neurodegenerative process in severe incurable diseases, as well as potential neuroprotection in cerebrovascular insufficiency, will allow in the future to determine the criteria for the use of ADR in these non-standard situations, which may even lead to a change in clinical recommendations for the treatment of individual nosologies. Presented in this article are both traditional uses of DRA and an overview of non-standard applications of this class of medications with a discussion of recent studies. In the future, the likelihood of a rethinking of ADRs as a class of only antiparkinsonian drugs, with the expansion of their therapeutic indications.

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The authors declare that there are no conflicts of interest present.