In 1976, a 23-year-old graduate student in chemistry named Barry Kidston was searching for a way to make a
legal recreational drug. Having read the paper by Ziering and Lee, he deduced that he could make a drug with pethidine's effects without its legal restrictions, because desmethylprodine is a different molecule and had never been addressed by law. Kidston successfully synthesized and used desmethylprodine for several months, after which he suddenly came down with the symptoms of
Parkinson's disease and was hospitalized. Physicians were perplexed, because Parkinson's disease would be a great rarity in someone so young, but
L-DOPA, the standard drug for Parkinson's, relieved his symptoms. L-DOPA is a precursor for dopamine, the neurotransmitter whose lack produces Parkinson's symptoms. It was later found that his development of Parkinson's was due to a common impurity in the synthesis of MPPP called
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), a
neurotoxin that specifically targets dopamine-producing neurons. The intermediate
tertiary alcohol is liable to dehydration in acidic conditions if the reaction temperature rises above 30 °C. Kidston did not realize this and esterified the intermediate with
propionic anhydride at an elevated temperature. Consequently, he produced MPTP as a major impurity.
1-Methyl-4-phenylpyridinium (MPP+), a metabolite of MPTP, causes rapid onset of irreversible symptoms similar to Parkinson's disease. MPTP is metabolized to the neurotoxin MPP+ by the enzyme
MAO-B, which is expressed in glial cells. This selectively kills brain tissue in the area of the brain called the
substantia nigra and causes permanent Parkinsonian symptoms. ==Analogs==