Neurology · 1989 · 114 citations · 0 references
Life SciencesBiochemistryPharmacologyBiochemical PharmacologyDrug MetabolismMetabolismDrug DispositionParkinson DiseaseXenobiotic MetabolismDetoxication MechanismsEtiologic HypothesisOrganic Sulfur MetabolismOxidationOxidative DetoxificationSulfate Conjugate ExcretionSulfur ToxicityXenobiotic Detoxification
We studied 68 patients with Parkinson's disease (PD) with probe drugs to determine whether a defect in metabolism might be an etiologic factor and found no difference between patients and controls in their ability to form the 4-hydroxy metabolite of debrisoquin. However, using S-carboxymethyl-L-cysteine, 63.2% (43/68) of PD patients had reduced S-oxidation capacity, while 35.3% (24/68) produced no sulfoxides (controls, 35.2% and 2.5%). When we studied acetaminophen (paracetamol) metabolism, only 29.6% of PD patients excreted greater than 5% of the dose as the sulfate conjugate; the corresponding figure for controls was 83.9%. These results suggest a deficiency in detoxication pathways involving sulfur metabolism. PD patients may be unusually susceptible to exogenous or even endogenous toxins.