Proceedings; Biochemistry of circadian rhythm in endogenous depression.
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Biomedical subjects
Publications and source records attributed to P Riederer.
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Varying reactions of the vegetative nerve system to various point combinations (for example: vomiting, dizziness, diarrhea, urge to urinate, fatigue or drowsiness, headache), especially to the needling of Tai Chong (Li 3), induced us to perform biochemical studies before and after acupuncture treatment. A group of children and a group of adults were studied. The material studied was urine and blood; from the children, urine only. The following were determined in the urine: indolacetic acid, 5-hydroxy-indol-3-acetic acid, homovanillic acid, and vanillic-mandelic acid; in the blood, tyrosine and tryptophan (free and bound). Individual points with wide influence (He Gu = LI 4; Zu San Li = St 36; Tai Chong = Li 3) and their combination with generally effective points were tested. The needling of Tai Chong especially showed a clear increase in indolamine metabolism. Isolated increases in metabolites of catecholamine metabolism could be correlated with the patient's increased physical activity after acupuncture. Noteworthy is the observation that no significant chemical reactions were evident if local reactions to the needling no longer appeared at the end of a series of acupuncture treatments.
The potentiation of the anti akinetic effect after L-Dopa treatment by an inhibitor of monoamine oxidase (MAO) "B", Deprenil, has been demonstrated in parkinsonian patients with or without previous L-Dopa theapy. Application of the drug has been performed orally, intravenously and intramuscularly. Excellent kinetic effects resulted when combined with Madopar. The combined treatment with L-Dopa was highly effective when applicated i.v. or i.m. Deprenil is an inhibitor of MAO-B and is characterized by less frequent side effects. These are predominantly involuntary movements and confusion, which can be eliminated by lowering the dosage of Deprenil. A daily rhythm of MAO could be demonstrated in several areas of human brains as well as in a control group as in parkinsonian patients with or without L-Dopa therapy. Maximal activity of MAO occurs between noon and 6p.m. The clinical and biochemical data are discussed regarding the off-phenomenons as Deprenil is an excellent drug for preventing these.
Biochemical human post-mortem studies on depressed patients indicate an unspecific deficiency of neurotransmitters in several brain areas. The loss of drive of these patients could be correlated with a decrease of striatal dopamine concentration. Noradrenaline was significantly diminished in red nucleus, a fact which points to the characteristic posture of depressed patients. Serotonin was diminished in all brain areas. During remission all values trended to be normal. There also exists a circadian disrhythm in depressed patients resulting in lowered VMA- and HVA-levels in urines during the morning and a remission to normal values in the evening. This agrees with the findings of lowered blood tyrosine levels in the morning. The ratio of blood tyrosine and tryptophan is disturbed during depression and recovers during remission. Central and peripheral biochemical mechanisms seems to be involved in depression syndrom.
1. A Dopa-medication leads sometimes in Parkinsonian patients to a psychosis. 2. The diminished capacity of striatal dopaminergic neurons to store DA leads to a storage of DA in serotoninergic or noradrenergic neurons. 3. Extrastriatal noradrenergic and/or serotoninergic neurons are involved. 4. Dopaminergic receptors of the striatium are not involved because of a lack of kinetic response after L-Dopa application in Parkinsonian patients with akinetic crises. 5. Extrastriatal dopaminergic receptors of DA as "false transmitter" at serotoninergic receptors seem to be responsible for the production of psychotic symptoms, whereas noradrenaline is not responsible. Psychotic symptoms can be imagined to be triggered by a contact of a transmitter to a nonspecific receptor.
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The determination of free L-tryptophan depends on several analytical well checked points e.g. absorbing effects, pH of the serum, dependence of the throughput, concentration dependence of retention, volume ultrafiltrated, cut-off, temperature dependence of the binding rate, purification on ion-exchange column, interfering substances of the fluorometric method. Ultrafiltration was compared to an ultracentrifugation technique. In normal human serum the concentration of free L-tryptophan is 3,1 +/- 0,6 microgram/ml and of the bound plus free form 12,2 +/- 1,12 microgram/ml. Both values are dependent on the albumin concentration.
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