ABSTRACT
Dentre os sistemas neurais responsáveis pela ingestão dos alimentos, destaca-se a via dopaminérgica mesolímbica que, através da liberação de dopamina nos núcleos de accumbens, desperta prazer e motivação para recompensas químicas e naturais. Esta via de recompensa age através dos receptores dopaminérgicos transmembranares, que variam de DRD1 a DRD5. Desta forma, considerando os efeitos prazerosos despertados pela ingestão alimentar, é plausível que variações genéticas em genes do sistema dopaminérgico possam ter um papel na arquitetura genética da obesidade. Este estudo tem como objetivo realizar uma revisão narrativa da literatura sobre a influência de variantes genéticas nos receptores dopaminérgicos em fenótipos relacionados com a obesidade. Em conjunto, os principais achados desta revisão indicaram que os genes codificadores dos receptores DRD2 e DRD4 possam ser os mais relevantes no contexto da obesidade e fenótipos relacionados. No entanto, a obesidade é uma doença complexa e multifatorial e novos estudos são ainda necessários para uma melhor compreensão do impacto da dopamina nos desfechos relacionado à obesidade. É importante também destacar que esses efeitos podem ser específicos para subgrupos de pacientes e que outros fatores, além das variantes genéticas, devem ser considerados. (AU)
Among the neural systems responsible for food ingestion, the mesolimbic dopaminergic pathway stands out by eliciting pleasure and motivation for chemical and natural rewards through the release of dopamine in the nucleus accumbens. This reward pathway is regulated by transmembrane dopaminergic receptors, which range from DRD1 to DRD5. Thus, considering the pleasurable effects aroused by food intake, it is plausible that genetic variations in genes of the dopaminergic system may have a role in the genetic architecture of obesity. This study aims to conduct a narrative review of the literature on the influence of genetic variants of dopaminergic receptors on obesity-related phenotypes. Taken together, the main findings of this review indicated that the genes encoding the DRD2 and DRD4 receptors may be the most relevant in the context of obesity and related phenotypes. However, obesity is a complex and multifactorial disease and new studies are still being conducted to better understand the impact of dopamine on obesity-related outcomes. It is also important to note that these effects can be specific to subgroups of patients and that other factors, in addition to genetic variants, must be considered. (AU)
Subject(s)
Dopamine , Receptors, Dopamine , Feeding Behavior , Obesity , Protein Serine-Threonine KinasesABSTRACT
RESUMEN El síndrome neuroléptico maligno like o crisis acinética es una rara y potencialmente letal complicación del abandono de medicación de los pacientes con enfermedad de Parkinson. Se presenta el caso clínico de un paciente de sexo masculino de 52 años de edad, con antecedente de enfermedad de Parkinson de 10 años de evolución que se encuentra en tratamiento con levodopa-carbidopa. Acude a consultar por disminución del estado de conciencia y rigidez muscular generalizada, relacionado con el abandono de medicación 7 días antes del inicio de los síntomas.
ABSTRACT Neuroleptic malignant-like syndrome or akinetic crisis is a rare and potentially lethal complication of the withdrawal of medication of patients with Parkinson's disease. We present the clinical case of 52-year man with 10-year history of Parkinson's disease who is being treated with levodopa-carbidopa. He consults for decreased level of consciousness and general muscular rigidity, related to the withdrawal of the medication 7 days before the onset of symptoms.
ABSTRACT
The aim of the present study was designed to establish comparatively the inhibitory effects of D1-like and D2-like dopaminergic receptor agonists, SKF81297 and R(-)-TNPA on the release of catecholamines (CA) evoked by cholinergic stimulation and membrane depolarization from the isolated perfused model of the rat adrenal medulla. SKF81297 (30 micrometer) and R-(-)-TNPA (30 micrometer) perfused into an adrenal vein for 60 min, produced great inhibition in the CA secretory responses evoked by ACh (5.32x10(-3) M), DMPP (10(-4) M), McN-A-343 (10(-4) M), high K+ (5.6x10(-2) M), Bay-K-8644 (10 micrometer), and cyclopiazonic acid (10 micrometer), respectively. For the release of CA evoked by ACh, high K+, DMPP, McN-A-343, Bay-K-8644 and cyclopiazonic acid, the following rank order of inhibitory potency was obtained: SKF81297>R-(-)-TNPA. However, R(+)-SCH23390, a selectve D1-like dopaminergic receptor antagonist, and S(-)-raclopride, a selectve D2-like dopaminergic receptor antagonist, enhanced the CA secretory responses evoked by ACh, high K+, DMPP, McN-A-343, Bay-K-8644 and cyclopiazonic acid only for 0~4 min. The rank order for the enhancement of CA release evoked by high K+, McN-A-343 and cyclopiazonic acid was R(+)-SCH23390>S(-)-raclopride. Also, the rank order for ACh, DMPP and Bay-K-8644 was S(-)-raclopride > R(+)-SCH23390. Taken together, these results demonstrate that both SKF81297 and R-(-)-TNPA inhibit the CA release evoked by stimulation of cholinergic (both nicotinic and muscarinic) receptors and the membrane depolarization from the isolated perfused rat adrenal gland without affecting the basal release, respectively, but both R(+)-SCH23390 and S(-)-raclopride facilitate the CA release evoked by them. It seems likely that the inhibitory effects of SKF81297 and R-(-)-TNPA are mediated by the activation of D1-like and D2-like dopaminergic receptors located on the rat adrenomedullary chromaffin cells, respectively, whereas the facilitatory effects of R(+)-SCH23390 and S(-)-raclopride are mediated by the blockade of D1-like and D2-like dopaminergic receptors, respectively: this action is possibly associated with extra- and intracellular calcium mobilization. Based on these results, it is thought that the presence of dopaminergic D1 receptors may play an important role in regulation of the rat adrenomedullary CA secretion, in addition to well-known dopaminergic D2 receptors.