{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T01:32:31Z","timestamp":1773797551939,"version":"3.50.1"},"reference-count":21,"publisher":"Centre for Evaluation in Education and Science (CEON\/CEES)","issue":"3","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/BY\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Biochemistry"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Background: Parkinson's disease (PD) is characterised by\nprogressive neurodegeneration and dopamine deficiency.\nLevodopa remains a cornerstone treatment, but its longterm use is associated with motor complications and\nreduced efficacy. This study investigates the clinical benefits of combining pramipexole with Levodopa in PD\npatients, focusing on improvements in oxidative stress,\ncognitive function, and motor control. Additionally, the\nstudy explores the role of novel biomarkers, including\nglutaredoxin-1 (Grx1), peroxiredoxin-3 (Prx3), thioredoxin\n(Trx), 8-hydroxy-2'-deoxyguanosine (8-OHdG), and neurosteroid dehydroepiandrosterone sulfate (DHEA-S), in\nevaluating oxidative stress and neuroprotection.\nMethods: A total of 92 PD patients were enrolled and\nassigned to either a levodopa monotherapy group (n=46)\nor a pramipexole-levodopa combination group (n=46).\nClinical efficacy was assessed using the Unified Parkinson's\nDisease Rating Scale (UPDRS). Cognitive function was\nevaluated using the Mini-Mental State Examination\n(MMSE) and the Montreal Cognitive Assessment (MoCA).\nOxidative stress markers (SOD, GSH, GSH-PX, CAT, along\nwith Grx1, Prx3, Trx, and 8-OHdG) were measured in\nserum samples. Additionally, DHEA-S was analysed as a\nneurosteroid biomarker to assess its potential role in cognitive and motor function improvements. Quality of life\n(QOL) was evaluated using the PDQ-39 questionnaire. Results: The combination therapy group exhibited a significantly higher effective rate (93.48% ) compared to the levodopa group (78.26% ) (P&amp;lt; 0.05). UPDRS scores were significantly lower in the combination group at 6- and\n12-week post-treatment (P &amp;lt; 0 .0 5 ). The combination\ngroup also showed a significantly lower incidence of\nadverse drug reactions (6.52% vs. 23.91% , P&amp;lt; 0.05). After\n3 months, the combination group displayed significantly\nhigher levels of SOD, GSH, GSH-PX, CAT, Grx1, Prx3, and\nTrx, while 8-OHdG levels were significantly reduced, indicating enhanced neuroprotection and reduced oxidative\nstress. DHEA-S levels were also elevated, correlating with\nimproved MMSE and M oCA scores (P &amp;lt; 0 .0 5 ). The\nobserved DHEA-S elevation in the combination group may\nbe due to pramipexole's dopaminergic modulation of\nhypothalamic-pituitary-adrenal axis activity, potentially\nenhancing adrenal steroidogenesis. Alternatively, improvements in motor and cognitive function may reduce chronic\nstress, indirectly elevating DHEA-S. It suggests a neurosteroid-mediated cognitive benefit. QOL was significantly\nbetter in the combination group after 3 months of intervention (P&amp;lt; 0.05).\nConclusions: Pramipexole combined with Levodopa significantly improves clinical outcomes, reduces adverse effects,\nenhances cognitive function, and alleviates oxidative stress\nin PD patients. The inclusion of novel biomarkers such as\nGrx1, Prx3, Trx, 8-OHdG, and DHEA-S provides deeper\ninsight into the molecular mechanisms underlying these\ntherapeutic effects. This combination therapy represents a\nvaluable strategy for improving PD management and warrants wider clinical application.<\/jats:p>","DOI":"10.5937\/jomb0-59700","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:51:24Z","timestamp":1756371084000},"page":"539-549","source":"Crossref","is-referenced-by-count":0,"title":["Pramipexole enhances levodopa's therapeutic efficacy in Parkinson's disease: Role of glutaredoxin-1 (GRX1), peroxiredoxin3 (PRX3), thioredoxin (TRX), 8-hydroxy-2 -deoxyguanosine (8-OHDG), and neurosteroid dehydroepiandrosterone sulfate (DHEA-S)"],"prefix":"10.5937","volume":"45","author":[{"given":"Yu","family":"Shu","sequence":"first","affiliation":[{"name":"The Fourth People's Hospital of Zhenjiang, Department of Neurology, Zhenjiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinjun","family":"Qian","sequence":"additional","affiliation":[{"name":"The Fourth People's Hospital of Zhenjiang, Department of Neurology, Zhenjiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3964","reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Postuma RB, Gagnon JF Bertrand JA, G\u00e9nier Marchand D, Montplaisir JY Parkinson risk in idiopathic REM sleep behavior disorder: preparing for neuroprotective trials. Neurology 2015; 84(11): 1104-13;","DOI":"10.1212\/WNL.0000000000001364"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Hauser RA, Pahwa R, Tanner CM, Oertel W, Isaacson SH, Johnson R, et al. ADS-5102 (Amantadine) Extended-Release Capsules for Levodopa-Induced Dyskinesia in Parkinson's Disease (EASE LID 2 Study): Interim Results of an Open-Label Safety Study. J Parkinsons Dis 2017; 7(3): 511-22;","DOI":"10.3233\/JPD-171134"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Elgueta D, Aymerich MS, Contreras F Montoya A, Celorrio M, Rojo-Bustamante E, et al. Pharmacologic antagonism of dopamine receptor D3 attenuates neurodegeneration and motor impairment in a mouse model of Parkinson's disease. Neuropharmacology 2017; 113(Pt A): 110-23;","DOI":"10.1016\/j.neuropharm.2016.09.028"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Antonini A, Calandrella D. 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