ABSTRACT
Así como planteamos en la primera entrega de esta serie de artículos de actualización sobre la obesidad, resulta urgente revisar el abordaje tradicional que la comunidad médica le ofrece a las personas con cuerpos gordos. En este segundo artículo desarrollaremos en profundidad diferentes alternativas terapéuticas para los pacientes que desean bajar de peso:plan alimentario, actividad física, tratamiento farmacológico y cirugía metabólica. (AU)
As we proposed in the first issue of this series of articles, it is urgent to review the traditional approach that the medical community offers to people with fat bodies. This second article will develop different therapeutic alternatives for patients who want to lose weight: eating plans, physical activity, pharmacological treatment, and metabolic surgery. (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Exercise , Bupropion/administration & dosage , Diet , Overweight/therapy , Bariatric Surgery , Glucagon-Like Peptide-1 Receptor/agonists , Naltrexone/administration & dosage , Obesity/therapy , Body Mass Index , Bupropion/adverse effects , Glucagon-Like Peptide-1 Receptor/administration & dosage , Healthy Lifestyle , Weight Prejudice , Food, Processed , Naltrexone/adverse effectsABSTRACT
This study aimed to investigate the protective effect of salvinorin A on the cerebral pial artery after forebrain ischemia and explore related mechanisms. Thirty Sprague-Dawley rats received forebrain ischemia for 10 min. The dilation responses of the cerebral pial artery to hypercapnia and hypotension were assessed in rats before and 1 h after ischemia. The ischemia reperfusion (IR) control group received DMSO (1 µL/kg) immediately after ischemia. Two different doses of salvinorin A (10 and 20 µg/kg) were administered following the onset of reperfusion. The 5th, 6th, and 7th groups received salvinorin A (20 µg/kg) and LY294002 (10 µM), L-NAME (10 μM), or norbinaltorphimine (norBIN, 1 μM) after ischemia. The levels of cGMP in the cerebrospinal fluid (CSF) were also measured. The phosphorylation of AKT (p-AKT) was measured in the cerebral cortex by western blot at 24 h post-ischemia. Cell necrosis and apoptosis were examined by hematoxylin-eosin staining (HE) and TUNEL staining, respectively. The motor function of the rats was evaluated at 1, 2, and 5 days post-ischemia. The dilation responses of the cerebral pial artery were significantly impaired after ischemia and were preserved by salvinorin A treatment. In addition, salvinorin A significantly increased the levels of cGMP and p-AKT, suppressed cell necrosis and apoptosis of the cerebral cortex and improved the motor function of the rats. These effects were abolished by LY294002, L-NAME, and norBIN. Salvinorin A preserved cerebral pial artery autoregulation in response to hypercapnia and hypotension via the PI3K/AKT/cGMP pathway.
Subject(s)
Animals , Male , Rats , Cerebral Arteries/drug effects , Brain Ischemia/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Diterpenes, Clerodane/pharmacology , Signal Transduction , Cerebral Arteries/physiopathology , Brain Ischemia/drug therapy , Morpholines/administration & dosage , Chromones/administration & dosage , Rats, Sprague-Dawley , Cyclic GMP/cerebrospinal fluid , Cyclic GMP/metabolism , NG-Nitroarginine Methyl Ester , Diterpenes, Clerodane/antagonists & inhibitors , Disease Models, Animal , Naltrexone/administration & dosage , Naltrexone/analogs & derivativesABSTRACT
PURPOSE: Nociceptin/orphanin FQ (N/OFQ) as an endogeneous hexadecapeptide is known to exert antinociceptive effects spinally. The aims of this study were to demonstrate the antinociceptive effects of i.t. N/OFQ and to investigate the possible interaction between N/OFQ and endogenous opioid systems using selective opioid receptor antagonists in rat formalin tests. MATERIALS AND METHODS: I.t. N/OFQ was injected in different doses (1-10 nmol) via a lumbar catheter prior to a 50 microL injection of 5% formalin into the right hindpaw of rats. Flinching responses were measured from 0-10 min (phase I, an initial acute state) and 11-60 min (phase II, a prolonged tonic state). To observe which opioid receptors are involved in the anti-nociceptive effect of i.t. N/OFQ in the rat-formalin tests, naltrindole (5-20 nmol), beta-funaltrexamine (1-10 nmol), and norbinaltorphimine (10 nmol), selective delta-, micro- and kappa-opioid receptor antagonists, respectively, were administered intrathecally 5 min after i.t. N/OFQ. RESULTS: I.t. N/OFQ attenuated the formalin-induced flinching responses in a dose-dependent manner in both phases I and II. I.t. administration of naltrindole and beta-funaltrexamine dose-dependently reversed the N/OFQ-induced attenuation of flinching responses in both phases; however, norbinaltorphimine did not. CONCLUSION: I.t. N/OFQ exerted an antinociceptive effect in both phases of the rat-formalin test through the nociceptin opioid peptide receptor. In addition, the results suggested that delta- and micro-opioid receptors, but not kappa-opioid receptors, are involved in the antinociceptive effects of N/OFQ in the spinal cord of rats.
Subject(s)
Animals , Male , Rats , Analgesics/administration & dosage , Formaldehyde/toxicity , Injections, Spinal , Naltrexone/administration & dosage , Narcotic Antagonists/administration & dosage , Opioid Peptides/administration & dosage , Pain Measurement , Rats, Sprague-Dawley , Receptors, Opioid/agonistsABSTRACT
Se revisa la bibliografía médica existente respecto a las posibles interacciones entre el consumo de alcohol y opioides, los posibles mecanismos de interacción del alcohol con los receptores del sistema opioide, las hipótesis explicativas de como dicho sistema promueve la ingesta de alcohol y los resultados obtenidos en animales de experimentación con el uso de fármacos antagonistas opioides. Se analizan los tres estudios clínicos más importantes que utilizan naltrexona en el tratamiento de la dependencia a alcohol. Dos de ellos sugieren que el fármaco pareciera disminuir la tasa de recaída, en el otro estudio no se encuentran diferencias significativas entre el uso del fármaco y placebo. Se concluye que es necesario continuar y perfeccionar la investigación en este tema, para lo cual se debiera definir y uniformar conceptos tales como recaídas, efectividad de tratamiento e intentar objetivar la ingesta, sus montos, sin depender necesariamente de los autorreportes de los pacientes. Hechas estas precisiones los resultados de la investigación permitirían aclarar la real efectividad de éste y otros fármacos
Subject(s)
Humans , Alcoholism/drug therapy , Naltrexone/administration & dosage , Narcotic Antagonists/administration & dosage , Stress, Psychological/complications , Narcotics/pharmacokineticsABSTRACT
Se presenta el caso de un ciclo ovulatorio en una paciente portadora de amenorrea hipotalámica secundaria, cuya inducción de ovulación se efectuó mediante la administración oral de un antagonista opiáceo específico: Naltrexona, en una dosis de 50 mg/día por 26 días. El desarrollo folicular fue monitorizado mediante ultrasonografía transabdominal y mediciones plasmáticas seriadas de hormona luteinizante (LH), folículo estimulante (FSH), estradiol (E2) y progesterona (P4). Tanto el perfil hormonal como el seguimiento ecográfico fueron compatibles con ciclo ovulatorio con folículo único. Después de la discontinuación del tratamiento, la paciente se hizo nuevamente amenorreica declinando los valores de gonadotrofinas y estradiol a los niveles observados antes del inicio del tratamiento. Estos datos demuestran que la naltrexona puede ser un agente útil en la inducción de ovulación de pacientes con amenorrea hipotalámica