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Maryse



Parkinson's disease drugs like most other drugs used today, are chemicals
synthesised in the laboratory and then manufactured. Making drugs in the
laboratory is a slow, expensive and tedious process. This is one reason why
drugs are expensive. Large numbers of chemicals exist in plants and other
natural sources but only five percent of them have been explored to-date.
Plant based drugs for Parkinson's disease, include L-DOPA containing sources
such as the seeds of Mucuna pruriens  plant showing pods) and Vincia faba,
the same chemical compound that has been used for Parkinson's disease in the
last 30 years. Seeds of Datura stramonium have an anticholinergic effect,
similar to Artane and Cogentin. Banisterine from Banisteria caapi and
Nicotiana tabacum has monoamine oxidase inhibitor that is similar to
selegiline (deprenyl). In this article, we will discuss more about Mucuna
pruriens.
Before explaining how the powder from the Mucuna pruriens plant is being used
as an alternative therapy, it should be noted that Parkinson's disease
affects more than one million people in the U.S. alone, and new and effective
treatments for this particular disease are goals of many researchers.
Parkinson's disease is a degenerative neurological disease that primarily
impacts the part of the brain that produces dopamine, a chemical substance
that allows neurologic impulses to be sent from one terminal end of a nerve
cell to the beginning of another nerve cell terminal. In Parkinson's disease,
however, there is not enough dopamine produced by the brain for its needs.
The simple act of walking may not be so simple. The disease can effect the
body in many ways. The most common symptoms of the disease include trembling
(shaking), stooped posture, muscular stiffness, short shuffling steps,
speaking softly and rapidly, poor balance, poor handwriting, and of course,
slowness of body movements. The cause of the disease is not known, however, a
variety of medications can control the symptoms.
Physicians in ancient India first used Mucuna seeds in the treatment of
Parkinson's disease over 4500 years ago. The Indian medical system is called
Ayurveda, which is the world's oldest system of medicine based on scientific
principles. Ayurveda is founded on scientific principles. It has a long
history of use of herbal remedies and has documented data on mechanism of
action, specific action, short-term and long-term toxic effects, drug-drug
and drug-diet interaction with a long history of use in humans. As per
historical evidence, Parkinson's disease existed in ancient India and was
called Kampavata. This was over 4500 years ago even though the disease
acquired its present name from James Parkinson who redescribed the disease in
1817 A.D. In the Ayurvedic system, powder of Mucuna is used for treating
Parkinson's disease and is subjected to special processing. The English name
"cowage" plant (Mucuna pruriens) is derived from Hindi Kiwach. In Sanskrit,
it is called Atmagupta. Mucuna is a twiner with trifoliate leaves, purple
flowers, and turgid S-shaped pods covered with hairs that cause intense
itching on contact with the skin. The plant belongs to the family
Leguminosae, which is indigenous to India and has long been used in Ayurveda
since ancient times. Overdose effects of Mucuna were also recognized in
Ayurveda. These included headache, dystonia, fatigue, tremor, syncope, and
thirst. Many of these could also occur from synthetic L-DOPA. In the modern
times, two Indian scientists isolated L-DOPA from Mucuna in 1936 and
published their results. However, at that time the role of L-DOPA in
Parkinson's was not known, hence not much attention was given to the
discovery. Subsequently, when dopamine deficiency was linked to Parkinson's
disease in the 1960's, scientists got interested in finding a source of
L-DOPA for treatment of Parkinson's disease. Because, the presence of L-DOPA
was known to be present in the legume, initial attention was paid to extract
levodopa from various Mucuna seeds and in fact, over a thousand plants were
screened for the high content of L-DOPA. As L-DOPA was synthesized, further
work on extraction of L-DOPA from beans was abandoned.
The amount of Mucuna powder used by Ayurvedic physicians was small compared
to the amount of synthetic L-DOPA used to produce the same benefit; if one
looks at the amount of L-DOPA alone. This is what led to one of the authors
(BVM) to further study how such a small quantity of levodopa in Mucuna could
have helped and thought possibly that there could be other undiscovered drugs
in Mucuna that may enhance either the activity of L-DOPA such as carbidopa as
seen in Sinemet or there may be an independent compound in Mucuna that may
have a direct effect on symptoms of Parkinson's disease. This idea led to
collaboration between Drs. Manyam with Dr. K. M. Parikh, President of the
Zandu Pharmaceutical Works, a leading Ayurvedic manufacturing company located
in Bombay, India. Their team conducted a series of experiments to establish
and to develop a drug for Parkinson's disease from Mucuna  beans with skin
(left), beans with skin removed (right) and powder). The initial work
required making the drug from Mucuna palatable. They developed a preparation
and named it HP200, which is a powder form and has to be mixed with water
just before administration. This is the first "liquid levodopa" preparation
ever made. They also established that when mixed with water the preparation
remained stable for several hours. The powder was also tested so that there
was no loss of active compounds during storage.
Despite the fact Mucuna was used in the treatment of Parkinson's disease in
ancient times, it is still important today to establish that the drug dose
not have adverse effects on various vital organs. This was accomplished by
administering low to very high doses of the drug in rats and rabbits and
testing the effect of Mucuna on blood chemistry and blood count (such as the
one that many physicians perform in their offices and the hospitals) and
various organs. Some of the tests were done for as long as one year and the
results indicated no adverse effects were present from Mucuna preparations.
To establish how Mucuna would compare to synthetic L-DOPA, experiments were
undertaken in animal models of Parkinson's disease. Two different doses of
synthetic L-DOPA and two different doses of Mucuna were administered making
sure that the amount of L-DOPA present is the same in Mucuna as was the doses
of synthetic L-DOPA. The effects of the drugs were tested using a specially
designed instrument called "Rotometer." Dose for dose, Mucuna was two to
three times more effective than equivalent amounts of synthetic L-DOPA. This
suggests that Mucuna may contain compounds that make L-DOPA function better
such as carbidopa, tolcapone (Tasmar), or entacapone (COMTan). It may also
suggest that Mucuna independently improve symptoms of Parkinson's disease.
Although quite encouraging, more research is needed to confirm these
findings. This work was done at the time when the United States Congress
established the Office of Alternative Medicine in the National Institute of
Health and the work was one of the first to receive funding for alternative
medicine.
Additional studies in India were undertaken to establish the benefit of HP200
in patients with Parkinson's disease. Four medical centers were selected
involving sixty patients and several neurologists. The studies were conducted
for three months. During that time, the patients received HP200 while no
concomitant L-DOPA preparations were administered. Trained neurologists
monitored changes in the degree of patent's symptoms and any side effects. At
the end of the study, it was determined that the HP200 was highly beneficial
in the treatment of Parkinson's disease. The side effects were minimal. HP200
was approved by the Indian Food and Drug Administration and is available in
India under the brand name Zandopa. Further, the cost of the drug was much
cheaper compared to the synthetic drugs; thus it became more affordable to
the patients. The United States Food and Drug Administration approve the drug
for clinical studies, however, it is not available from the pharmacist.
Work on the Mucuna for Parkinson's disease is being continued. The importance
of this particular study is not that Mucuna is an alternative to L-DOPA,
rather it is that compounds occurring naturally in plants for example, may
contain biologically active components that can be isolated, tested, and used
to provide safer and better treatments for Parkinson's disease.

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