DRD2 activation inhibits choroidal neovascularization in patients with Parkinson’s disease and age-related macular degeneration

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Mathis, Thibaud | Baudin, Florian | Mariet, Anne-Sophie | Augustin, Sébastien | Bricout, Marion | Przegralek, Lauriane | Roubeix, Christophe | Benzenine, Éric | Blot, Guillaume | Nous, Caroline | Kodjikian, Laurent | Mauget-Faÿsse, Martine | Sahel, José-Alain | Plevin, Robin | Zeitz, Christina | Delarasse, Cécile | Guillonneau, Xavier | Creuzot-Garcher, Catherine | Quantin, Catherine | Hunot, Stéphane | Sennlaub, Florian

Edité par CCSD ; American Society for Clinical Investigation -

Corresponding author: florian.sennlaub@inserm.fr. International audience. Neovascular age-related macular degeneration (nAMD) remains a major cause of visual impairment and puts considerable burden on patients and health care systems. L-DOPA-treated Parkinson Disease (PD) patients have been shown to be partially protected from nAMD, but the mechanism remains unknown. Using murine models, combining 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD and laser-induced nAMD, standard PD treatment of L-DOPA/DOPA-decarboxylase inhibitor, or specific dopamine receptor inhibitors, we here demonstrate that L-DOPA treatment-induced increase of dopamine mediated dopamine receptor D2 (DRD2) signaling inhibits choroidal neovascularization independently of MPTP-associated nigrostriatal pathway lesion. Analyzing a retrospective cohort of more than two hundred thousand nAMD patients receiving anti-VEGF treatment from the French nationwide insurance database, we show that DRD2-agonist treated (PD) patients have a significantly delayed age of onset for nAMD (81.4 (±7.0) vs 79.4 (±8.1) years old, respectively, p<0.0001) and reduced need for anti-VEGF therapies (-0.6 injections per 100 mg/day daily dose of DRD2 agonists the second year of treatment), similar to the L-DOPA treatment. While providing a mechanistic explanation for an intriguing epidemiological observation, our findings suggest that systemic DRD2 agonists might constitute an adjuvant therapy to delay and reduce the need for anti-VEGF therapy in nAMD patients.

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