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Monoamine oxidase (MAO) is a flavin adenine dinucleotidase (FAD) located mainly on the outer membrane of mitochondria in tissue cells such as the brain, liver and intestinal mucosa. MAO catalyzes the deamination of monoamines to produce hydrogen peroxide, ammonia and aldehydes. The reaction process of monoamine deamination catalyzed by monoamine oxidase is as follows: R—CH2—NH2 + O2 + H2O→RCHO + H2O2 + NH3.
MAO plays an important role in the central nervous system and nerve endings. The activity of abnormal MAO-B is associated with neurological disorders such as Parkinson's syndrome and Alzheimer's disease. Mao-a is closely associated with the development of mental disorders such as depression. Studies have found that MAO activity increases with age, so MAO is an aging marker enzyme that indirectly reflects the degree of aging of organisms.

Figure 1. Partial map of tyrosine metabolism with the involvement of monoamine oxidase (MAO) (Bénilde Bonnefille, et al, 2018)
The Mechanism of Action of MAO
MAO is an important inactivation enzyme for monoamines, such as norepinephrine, tyramine, etc. Two isoforms were identified: monoamineoxidase A (mao-a) and monoamineoxidase B (mao-b). Both are covalently linked to a cysteine residue in the active central region by a flavin adenine dinucleotide coenzyme, which catalyzes the oxidation of various amines in the organism, ultimately producing aldehydes and hydrogen peroxide to participate in cellular oxidation.
MAO-A has a greater affinity for serotonin and norepinephrine, while MAO-B preferentially deamination of benzylamine and phenethylamine. MAO-A is present in the adrenergic neurons of the stomach, intestines, liver, kidneys, lungs, and brain. It is mainly associated with 5-hydroxytryptamine (5-HT), norepinephrine, dopamine, and tyramine-based plates. MAO-B is mainly found in peripheral platelets and 5-HT neurons and glial cells in the brain.
Monoamine oxidase inhibitors (MAOIs) are a class of substances that inhibit the activity of monoamine oxidase (MAO) in the body and are used to treat a variety of neurological diseases. While MAOIs are a class of drugs that selectively inhibit MAO activity in vivo. They can inhibit these two isomers non-selectively or selectively, but it is considered that inhibition of MAO-A is necessary for antidepressant effects, while inhibiting MAO -B is effective for the treatment of Parkinson's disease (PD).
MAO and Central Nervous System
In the Central nervous system (CNS), MAO-A is mainly located in the axons of the neuron, and MAO-B is mainly located in the colloidal cells. When the activity of MAO-A and MAO-B enzymes is affected and the enzyme activity is too high or too low, the metabolism of monoamine neurotransmitters in CNS is abnormal, which leads to A variety of neurological diseases. For example, high accumulation of dobutamine in CNS may lead to schizophrenia, and low accumulation of dobutamine may lead to depression. Studies have also shown that MAO activity is related to the age of the body. With the increase of age, the activity of MAO-B in the brain is significantly increased, while the change of MAO-A is not obvious.
MAO inhibitors can be classified into MAO-A inhibitors and MAO-B inhibitors to its existence in two different forms: MAO-A inhibitor and MAO-B inhibitor. MAO-A inhibitors are mainly used to treat diseases such as neurasthenia, depression and anxiety, while MAO-B inhibitors are considered to have the potential to treat AD and PD, so in monoamine oxidase inhibitor drugs for neurodegenerative diseases, Most of the MAO-B inhibitors are drugs. A number of monoamine oxidase inhibitors have been discovered in the past few decades, including pyrazoles, imidazoles, coumarins, flavonoids, azoles, thiazoles, oxazolidinones.
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