Relationship between L-dopa induced dyskinesia and the dopamine D1 receptor in striatal neurons : experimental study and perspectives in therapeuticnovembre 2010 Directeur(s) de thèse : Bertrand BLOCH Résumé de thèse
In my thesis work, I studied the role of dopamine D1 receptor in L-dopa induced dyskinesia, a debilitating complication of Parkinson’s disease’s treatment. In condition of striatal denervation, that mimics the Parkinson’s disease environment, chronic treatment with L-dopa leads to major alterations of intraneuronal trafficking and dopamine D1 receptor signaling in the major target of dopamine neurons, the striatal medium spiny neurons. In particularly, there is a D1 receptor hypersensitivity in striatal neurons, with an increased abundance of D1 receptor at the plasma membrane and a decreased level of GRK6 protein expression, a key actor in desensitization mechanism, directly related with the apparition of dyskinesia.
In this context, I used different in vitro and in vivo experimental models and tools. I have associated cell and tissue imaging techniques and behavioural approaches in order to explore cellular and molecular events in striatal neuron and neuronal networks, linking the D1 receptor expression level, its cellular compartmentalization, its intraneuronal trafficking and the dyskinesia behaviour or equivalent pharmacological conditions.
We confirmed in the rat analog of L-dopa-induced dyskinesia, i.e., the L-dopa-induced abnormal involuntary movements in unilaterally 6-hydroxydopamine (6-OHDA)-lesioned animals, that D1 receptor is abnormally abundant in the plasma membrane of neurons in the striatum, whereas it should be internalized after stimulation by its natural ligand, the dopamine. We showed that nevertheless the internalization mechanisms after agonist stimulation remains functional. After D1 agonist administration in dyskinetic animals, D1 receptor abundance increases in the cytoplasmic compartments involved in the internalization and transport (vesicles) and degradation (multivesicular bodies) mechanisms. Based on D3 receptor antagonist experiment, we propose that this abnormal abundance and this lack of internalization could be due to heterodimerization between the D1 and D3 receptors. D1 and D3 receptors co-activation by L-dopa might anchor D1 receptor at the plasma membrane of striatal neurons.
In this context, analysis of proteasome involvement in the regulation of dopamine D1 receptor expression seemed particularly important, on the basis of the first studies underlying proteasome involvement in the activity and metabolism of neurotransmitter receptors. We demonstrated for the first time links between the proteasomal catalytic activity and D1 receptor intraneuronal dynamics and more particularly we showed that the proteasome chymotrypsin-like activity is reduced specifically in the striatum of dyskinetic animals, as a direct consequence of dopamine depletion associated with dopaminergic hyperstimulation.
We tested in experimental condition, a new « therapeutic »strategy in order to restore the dopamine D1 receptor homologous desensitization mechanism, correcting the GRK6 kinase deficit by gene transfer through the intrastriatal injection of a lentiviral vector. We showed that this approach reduces significantly the dyskinesia severity in rat and non-human primate models and restores the L-dopa therapeutic effects. These effects are a consequence of the homologous desensitization mechanisms restoration : indeed GRK6 overexpression provokes specific D1 receptor internalization.
Our results are part of a translational research conducted over several years in the laboratory from cell to patient, in order to translate our increased understanding of D1 receptor function abnormalities into therapeutic strategies for L-dopa induced dyskinesia. Our investigations show that it is possible to act on D1 receptor expression at the plasma membrane of striatal neurons via various routes, all resulting into diminished dyskinesia severity.