RESUMEN
Small ruminant farming is of socio-economic and environmental importance to many rural communities around the world. The SMARTER H2020 project aims to redefine genetic selection criteria to increase the sustainability of the sector. The objective of this study was to analyse the selection and breeding management practices of small ruminant producers and breeders, linked with socio-technical elements that shape them. The study is based on farm surveys using semi-structured interviews conducted in five countries (France, Spain, Italy, Greece, and Uruguay) across 272 producers and breeders of 13 sheep and goat breeds, and 15 breed × system combinations. The information was collected in four sections. The first and second sections dealt with general elements of structure and management of the system and the flock/herd. The third section focused on selection and breeding management practices: criteria for culling and replacement of females, selection criteria for males, use of estimated breeding values and global indexes, and preferences for indexing new traits to increase the sustainability of their system. The fourth section aimed to collect socio-technical information. We used a data abstraction method to standardise the representation of these data. A mixed data factor analysis followed by a hierarchical ascending classification allowed the characterisation of three profiles of selection and breeding management: (1) a profile of producers (n = 93) of small flocks/herds, with little knowledge or use of genetic selection and improvement tools (selection index, artificial insemination, performance recording); these farmers do not feel that new traits are needed to improve the sustainability of their system. (2) a profile of producers (n = 34) of multibreed flocks/herds that rely significantly on grazing; they are familiar with genetic tools, they currently use AI; they would like the indexes to include more health and robustness characteristics, to make their animals more resistant and to increase the sustainability of their system. And (3) a profile of producers or breeders (n = 145) of large flocks/herds, with specific culling criteria; these farmers are satisfied with the current indexes to maintain the sustainability of their system. These results are elements that can be used by private breeding companies and associations to support the evolution of selection objectives to increase the resilience of animals and to improve the sustainability of the small ruminant breeding systems.
Asunto(s)
Crianza de Animales Domésticos , Cruzamiento , Agricultores , Cabras , Animales , Cruzamiento/métodos , Crianza de Animales Domésticos/métodos , Ovinos/genética , Ovinos/fisiología , Femenino , Masculino , Agricultores/psicología , Cabras/genética , Cabras/fisiología , España , Selección Genética , Uruguay , Italia , Francia , Grecia , Encuestas y CuestionariosAsunto(s)
Inhibidores de la Colinesterasa/uso terapéutico , Drogas Ilícitas/toxicidad , Psicosis Inducidas por Sustancias/tratamiento farmacológico , Rivastigmina/uso terapéutico , Escopolamina/toxicidad , Adolescente , Antipsicóticos/uso terapéutico , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Resultado del TratamientoRESUMEN
BACKGROUND: It is not quite well established how immune responses differ in term and preterm infants beyond the first year of life. This study aimed to evaluate aspects of the innate and adaptive immune responses in a group of preterm infants in comparison with their term peers. METHODS: In this cross-sectional study peripheral blood mononuclear cells (PBMC) were isolated from preterm and term children at age three years. Innate immune response was evaluated by the analysis of TLR receptors expression on CD11c+HLADRhigh cells and inflammatory cytokine production after PBMC stimulation with Toll like receptors (TLR) ligands. Adaptive immune response was evaluated by T cells' phenotyping and function after stimulation with polyclonal conventional T cell stimulus. CONCLUSION: We have found that the patterns of innate and adaptive immune responses at 3 years of age were not affected by the fact of the children having being born preterm or at term.
Asunto(s)
Leucocitos Mononucleares/inmunología , Nacimiento Prematuro/inmunología , Linfocitos T/inmunología , Inmunidad Adaptativa , Antígeno CD11c/metabolismo , Preescolar , Estudios Transversales , Citocinas/metabolismo , Femenino , Antígenos HLA-DR/metabolismo , Humanos , Inmunidad Innata , Inmunofenotipificación , Lactante , Recien Nacido Prematuro , Mediadores de Inflamación/metabolismo , Masculino , Receptores Toll-Like/metabolismoRESUMEN
The state of the art of Ethology in five Latin America countries is briefly presented here. The overall outlook regarding research laboratories and themes is promising: the community is numerous, active and there are topics addressing all aspects of animal behavior, especially in large countries like Brazil and Argentina. Ethology as an undergraduate discipline is generally a sub-category of Biology, being taught mainly at Zoology/ Psychology/ Ecology/ Agriculture Courses and at Medical Veterinary Schools, often as an eligible discipline. Ethology as a formal major Graduate Program is rare and mainly restricted to Brazil. Regular Ethology meetings are held in Argentina, Brazil and Uruguay. In Chile and Venezuela there is a small but very active community. Studies of animal behavior are often carried out in other areas than Biology, and there is a clear overlap of interest regarding the major topics of Ethology. Behavioral ecology, conservation, management and animal welfare are a priority in most countries, probably reflecting a general concern regarding endangered species and habitats of the continent. Here we present information aiming to create a network that will increase collaborations among researchers working within the ethological framework in Latin America. The IV Simpósio de Etologia na América Latina, entitled "Desarrollo de la Etología en Latinoamérica:¿ hacia un futuro regional ?" was held in November, 2013, as part of the XXXI Encontro Anual de Etologia (EAE), in São Paulo, SP, Brazil. The state of art of Animal Behavior in Argentina, Brazil, Chile, Uruguay and Venezuela were presented there and a set of six questions guided the presentations: 1) What are the main Ethology topics being studied in laboratories in your country? - 2) Are there undergraduate or graduate programs in the main universities? - 3) Is there an Animal Behavior Society? How interested is the community in establishing close ties among institutes or laboratories elsewhere in Latin America? - 4) Is there a site, a journal, a page on a social networking site for contact, communication and divulgation of original data? - 5) How active is the community regarding the wiliness to organize congresses, symposia, meetings, workshops, on-line courses regarding Ethology? - 6) Are there funding agencies to support exchange programs and research in Ethology? Additional data were collected from the last two EAE regarding researchers from Latin America that attended EAE meetings and a list of names and laboratories was compiled (see appendix). It should be emphasized that the compilation of information presented here is far from complete. It represents a brief overview of the current status of Ethology in only five Latin American countries, and therefore it should be updated continuously with new data from the countries treated here as well as supplemented with data from other countries. Such a constantly updated list would facilitate the creation of networks that should increase collaborations among researchers working within the ethological framework in Latin America.(AU)
Presentamos brevemente el estado de la Etología en cinco países de América Latina. En general, con respecto a la investigación en laboratorios y temas de estudio la situación es prometedora: la comunidad es numerosa, activa, y los temas abarcan todos los aspectos del comportamiento animal, especialmente en países grandes como Brasil y Argentina. La Etología como disciplina de grado, por lo general es una subcategoría de la Biología, siendo impartida principalmente en cursos de Zoología /Psicología/ Ecología/Agricultura, y en las facultades de Medicina Veterinaria frecuentemente como disciplina opcional. No es frecuente que la Etología sea un programa formal de Posgrado, lo cual está principalmente restringido a Brasil. Se realizan encuentros regulares de Etología en Argentina, Brasil y Uruguay. En Chile y Venezuela se encuentran comunidades pequeñas pero muy activas, ligadas a la Etología. Los estudios de comportamiento animal se realizan frecuentemente en áreas distintas de la Biología, y hay una clara superposición de intereses respecto a los principales tópicos de la Etología. La ecología comportamental, la conservación, el manejo y el bienestar animal son prioridades en muchos países, lo que probablemente refleja una preocupación general respecto a las especies y hábitats amenazados en el continente. Aquí presentamos un informe preliminar orientado a crear una red que aumente la colaboración entre los investigadores que trabajan en el marco de la Etología en América Latina. El IV Simposio de Etología de América Latina, titulado "Desarrollo de la Etología en Latinoamérica:¿hacia un futuro regional?" se realizó en Noviembre de 2013, como parte del XXXI Encontro Anual de Etologia (EAE), en São Paulo, SP, Brasil. Invitados de cinco países -Argentina, Brasil, Chile, Uruguay y Venezuela- presentaron información sobre el estado del arte del comportamiento animal en sus naciones y las presentaciones fueron guiadas por un cuestionario de seis preguntas: 1) ¿Cuáles son los principales temas de estudio y laboratorios de Etología en su país? - 2) ¿Hay programas de grado o posgrado en las principales universidades? - 3) ¿Hay una sociedad de Comportamiento Animal? ¿Qué tan interesada está la comunidad en establecer vínculos estrechos entre institutos o laboratorios en otros lugares de América Latina? - 4) ¿Hay un sitio de internet, una revista o un en una red social para contacto, comunicación y divulgación de datos originales? - 5) ¿Qué tan activa es la comunidad respecto a la organización de congresos, simposios, encuentros, talleres y cursos on-line referidos a Etología? - 6) ¿Hay agencias de financiamiento para sostener programas de intercambio e investigación en Etología? Adicionalmente se recolectaron datos de los últimos dos EAE concerniente a los investigadores en América Latina que asistieron a los mismos y se compiló una lista de nombres y laboratorios.(AU)
Asunto(s)
Etología , Conducta Animal , América LatinaRESUMEN
The state of the art of Ethology in five Latin America countries is briefly presented here. The overall outlook regarding research laboratories and themes is promising: the community is numerous, active and there are topics addressing all aspects of animal behavior, especially in large countries like Brazil and Argentina. Ethology as an undergraduate discipline is generally a sub-category of Biology, being taught mainly at Zoology/ Psychology/ Ecology/ Agriculture Courses and at Medical Veterinary Schools, often as an eligible discipline. Ethology as a formal major Graduate Program is rare and mainly restricted to Brazil. Regular Ethology meetings are held in Argentina, Brazil and Uruguay. In Chile and Venezuela there is a small but very active community. Studies of animal behavior are often carried out in other areas than Biology, and there is a clear overlap of interest regarding the major topics of Ethology. Behavioral ecology, conservation, management and animal welfare are a priority in most countries, probably reflecting a general concern regarding endangered species and habitats of the continent. Here we present information aiming to create a network that will increase collaborations among researchers working within the ethological framework in Latin America. The IV Simpósio de Etologia na América Latina, entitled "Desarrollo de la Etología en Latinoamérica:¿ hacia un futuro regional ?" was held in November, 2013, as part of the XXXI Encontro Anual de Etologia (EAE), in São Paulo, SP, Brazil. The state of art of Animal Behavior in Argentina, Brazil, Chile, Uruguay and Venezuela were presented there and a set of six questions guided the presentations: 1).
Presentamos brevemente el estado de la Etología en cinco países de América Latina. En general, con respecto a la investigación en laboratorios y temas de estudio la situación es prometedora: la comunidad es numerosa, activa, y los temas abarcan todos los aspectos del comportamiento animal, especialmente en países grandes como Brasil y Argentina. La Etología como disciplina de grado, por lo general es una subcategoría de la Biología, siendo impartida principalmente en cursos de Zoología /Psicología/ Ecología/Agricultura, y en las facultades de Medicina Veterinaria frecuentemente como disciplina opcional. No es frecuente que la Etología sea un programa formal de Posgrado, lo cual está principalmente restringido a Brasil. Se realizan encuentros regulares de Etología en Argentina, Brasil y Uruguay. En Chile y Venezuela se encuentran comunidades pequeñas pero muy activas, ligadas a la Etología. Los estudios de comportamiento animal se realizan frecuentemente en áreas distintas de la Biología, y hay una clara superposición de intereses respecto a los principales tópicos de la Etología. La ecología comportamental, la conservación, el manejo y el bienestar animal son prioridades en muchos países, lo que probablemente refleja una preocupación general respecto a las especies y hábitats amenazados en el continente. Aquí presentamos un informe preliminar orientado a crear una red que aumente la colaboración entre los investigadores que trabajan en el marco de la Etología en América Latina. El IV Simposio de Etología de América Latina, titulado "Desarrollo de la Etología en Latinoamérica:¿hacia un futuro regional?" se realizó en Noviembre de 2013, como parte del XXXI Encontro Anual de Etologia (EAE), en São Paulo, SP, Brasil. Invitados de cinco países -Argentina, Brasil, Chile, Uruguay y Venezuela- presentaron información sobre el estado del arte del comportamiento animal en sus naciones y las presentaciones fueron guiadas por un cuestionario de seis preguntas: 1) .
Asunto(s)
Animales , Conducta Animal , Etología , América LatinaRESUMEN
Chlamydia trachomatis, serovar L2, is the causative agent of lymphogranuloma venereum (LGV), which during recent years has been responsible for various outbreaks reported among men who have sex with men (MSM) in Western Europe, America, Canada and Australia. Samples from nine patients with chronic proctitis, seen at a local hospital were sent to us for identification of C. trachomatis serovar L2. The presence of C. trachomatis serovar L DNA was identified by realtime polymerase chain reaction (PCR) in two patients. They both had high positive C. trachomatis antibody titres (>/=10,000) and were found to be infected with serovar L2b by sequencing after amplification of the omp 1 gene by a nested PCR technique. These two individuals met the diagnostic criteria for LGV serovar L2b infection and, to our knowledge, these are the first cases described in Portugal.
Asunto(s)
Chlamydia trachomatis/clasificación , Chlamydia trachomatis/aislamiento & purificación , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/microbiología , Proctitis/microbiología , Adulto , Anticuerpos Antibacterianos/sangre , Chlamydia trachomatis/inmunología , ADN Bacteriano/análisis , Infecciones por VIH/complicaciones , Homosexualidad Masculina , Humanos , Incidencia , Linfogranuloma Venéreo/epidemiología , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Portugal , Proctitis/diagnóstico , Proctitis/epidemiología , Enfermedades del Recto/diagnóstico , Enfermedades del Recto/epidemiología , Enfermedades del Recto/microbiología , SerotipificaciónRESUMEN
INTRODUCTION: Excessive body weight gain (BWG), hyperglycemia and dyslipidemia are important side effects of olanzapine. We assessed the effects of rosiglitazone on BWG, the insulin resistance index (HOMA-IR), lipids, glycated hemoglobin and fibrinogen in olanzapine-treated schizophrenia patients. METHODS: Thirty patients taking olanzapine (10-20 mg daily for 8 months) were randomly allocated to rosiglitazone (n=15; 4 to 8 mg daily) or placebo (n=15) in a 12-week double-blind protocol. Anthropometric and biochemical variables were evaluated at baseline, weeks 6 and 12. RESULTS: The rosiglitazone and placebo groups gained 3.2+/-4.5 and 2.2+/-2.3 kg, respectively (p=0.65). Insulin and the HOMA-IR significantly decreased after rosiglitazone (p<0.05). Rosiglitazone did not improve the lipid profile, fibrinogen and Hb1c levels. DISCUSSION: The positive impact of rosiglitazone was limited to improved glycemic control. It cannot be recommended for metabolic control during olanzapine treatment.
Asunto(s)
Antipsicóticos/efectos adversos , Benzodiazepinas/efectos adversos , Hipoglucemiantes/uso terapéutico , Enfermedades Metabólicas/inducido químicamente , Enfermedades Metabólicas/tratamiento farmacológico , Tiazolidinedionas/uso terapéutico , Adulto , Índice de Masa Corporal , Peso Corporal/efectos de los fármacos , Método Doble Ciego , Femenino , Fibrinógeno/metabolismo , Hemoglobinas/metabolismo , Humanos , Resistencia a la Insulina , Metabolismo de los Lípidos/efectos de los fármacos , Masculino , Persona de Mediana Edad , Olanzapina , Proyectos Piloto , Rosiglitazona , Esquizofrenia/tratamiento farmacológico , Estadística como AsuntoRESUMEN
We describe two cases of lymphogranuloma venereum (LGV) in men who have sex with men in Portugal in 2008. These first two confirmed cases of LGV L2b proctitis in Portugal highlight the need for an enhanced surveillance programme in Portugal.
Asunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Linfogranuloma Venéreo/epidemiología , Vigilancia de la Población , Enfermedades del Recto/epidemiología , Humanos , Incidencia , Masculino , Portugal/epidemiología , Factores de RiesgoRESUMEN
The antipsychotic drugs (APDs) are fundamental tools in current psychiatric practice. A new generation of agents, the atypical APDs, represents an important progress in the treatment of psychotic disorders. Unfortunately, some of them induce excessive body weight gain (BWG), obesity, hyperglycemia and dyslipidemia in the following order: clozapine approximately equal to olanzapine > quetiapine > risperidone > ziprasidone = aripiprazole. Appetite stimulation is probably the main mechanism of BWG and this is strongly correlated with the APD affinity for H1 (histaminergic) and alpha1 (adrenergic) receptors. A composed ratio of the APD affinity for diverse neurotransmitters involved in food intake (FI) regulation correlates with BWG as well. Endocrine/metabolic mechanisms, such as the activation of the hypothalamus-pituitary-adrenal axis, changes in insulin sensitivity (by conventional and atypical agents), hyperprolactinemia and gonadal dysfunction (by conventional APDs and risperidone) may also be involved. Importantly, patients with schizophrenia may have a genetically-based predisposition to appetite dysregulation, insulin resistance and endocrine imbalance involving gonadal steroids. Excessive BWG must be prevented or attenuated by proper drug selection, combining or switching agents, nutritional assistance and physical exercise. Amantadine. metformin and reboxetine proved to significantly lessen APD-induced BWG. Notwithstanding this, novel strategies are necessary to treat this side effect in a clinical population particularly prone to poor compliance and under a high risk of negative drug interaction.
Asunto(s)
Antipsicóticos/efectos adversos , Aumento de Peso/efectos de los fármacos , Animales , Antipsicóticos/metabolismo , Antipsicóticos/uso terapéutico , Apetito/efectos de los fármacos , Ensayos Clínicos como Asunto , Femenino , Humanos , Masculino , Enfermedades Metabólicas/inducido químicamente , Enfermedades Metabólicas/metabolismo , Enfermedades Metabólicas/fisiopatología , Obesidad/etiologíaRESUMEN
AIMS: The objective of this study is to survey present and future antidepressant drug therapy based on the progress made in the field of biotechnology. DEVELOPMENT: The simplistic and mistaken view that one single system of neurotransmission is altered in depression and that there is, therefore, just one single treatment has changed. Molecular biology and Genetics have enabled us to determine other possible chemical alterations in the brain, beyond the sole participation of the monoaminergic modulation systems, which is the classical hypothesis. In this paper we describe the evidence for the relations between depression and the therapeutic effect the classical antidepressants have on: 1. The peptidergic system of the corticotropin-releasing hormone, cortisol and the functional state of its receptors; 2. Intracellular signalling systems such as cAMP on transcription factors like CREB and neurotrophins; 3. The immune system and cytosines; 4. Glutamate transmission; and 5. The neuropeptidergic system of substance P, neuroactive steroids and the neuroglia. This has allowed other biochemical hypotheses about depression and the possibility of new treatments to be put forward. CONCLUSIONS: We are still not certain about the exact cause or the processes that determine mental illnesses such as depression or how improvements are achieved with the antidepressants we currently have available. Nevertheless, biotechnology is expected to be a great help in advancing towards a better understanding of the interrelations between the nervous, immune and endocrine systems, with their intracellular cascades and final outcomes in genetic expression and protein function, in depression. This will enable more efficient, more selective and faster-acting drugs to be developed and, in the future and with the help of psychogenomics, even make it possible to produce tailor-made medication for each patient.
Asunto(s)
Antidepresivos/uso terapéutico , Depresión/tratamiento farmacológico , Depresión/fisiopatología , Neurobiología , Monoaminas Biogénicas/metabolismo , Hormona Liberadora de Corticotropina/metabolismo , AMP Cíclico/metabolismo , Proteína de Unión a Elemento de Respuesta al AMP Cíclico , Citocinas/inmunología , Citocinas/metabolismo , Depresión/metabolismo , Humanos , Receptores de Glutamato/metabolismo , Receptores de Esteroides/metabolismo , Sistemas de Mensajero Secundario/fisiologíaRESUMEN
Objetivo. Revisar la terapéutica farmacológica antidepresiva presente y futura basada en los avances de la biotecnología. Desarrollo. La visión simplista y errónea de un único sistema neurotransmisor alterado en la depresión y, por tanto, un único tratamiento, ha cambiado. Las técnicas de la biología molecular y la genética han permitido conocer otras posibles alteraciones químicas en el cerebro, más allá de la única participación de los sistemas moduladores monoaminérgicos, la hipótesis clásica. Se describen las evidencias acerca de las relaciones entre la depresión y el efecto terapéutico de los antidepresivos clásicos con: a) El sistema peptidérgico de la hormona liberadora de la corticotropina, el cortisol y el estado funcional de sus receptores; b) Los sistemas de señalización intracelular como el AMPc sobre factores de transcripción como CREB y las neurotrofinas; c) El sistema inmune y las citocinas; d) La transmisión glutamatérgica, y e) El sistema neuropeptidérgico de la sustancia P, los esteroides neuroactivos y la glía. Esto ha permitido la emergencia de otras hipótesis bioquímicas sobre la depresión y la posibilidad de nuevos tratamientos. Conclusiones. Aunque hoy se sigue sin conocer con certeza la causa exacta ni los procesos que determinan las enfermedades mentales como la depresión, ni cómo se produce la mejoría con los antidepresivos disponibles, hay una gran esperanza de que, con la ayuda de la biotecnología, se avanzará hacia un mejor conocimiento de las interrelaciones entre los sistemas nervioso, inmune y endocrino, con sus cascadas intracelulares y sus consecuencias finales en la expresión genética y la función proteica en la depresión; ello permitirá desarrollar fármacos más efectivos, rápidos y selectivos que, en el futuro, con la ayuda de la psicogenómica, podrán incluso diseñarse para cada paciente (AU)
Aims. The objective of this study is to survey present and future antidepressant drug therapy based on the progress made in the field of biotechnology. Development. The simplistic and mistaken view that one single system of neurotransmission is altered in depression and that there is, therefore, just one single treatment has changed. Molecular biology and Genetics have enabled us to determine other possible chemical alterations in the brain, beyond the sole participation of the monoaminergic modulation systems, which is the classical hypothesis. In this paper we describe the evidence for the relations between depression and the therapeutic effect the classical antidepressants have on: 1. The peptidergic system of the corticotropin-releasing hormone, cortisol and the functional state of its receptors; 2. Intracellular signalling systems such as cAMP on transcription factors like CREB and neurotrophins; 3. The immune system and cytosines; 4. Glutamate transmission; and 5. The neuropeptidergic system of substance P, neuroactive steroids and the neuroglia. This has allowed other biochemical hypotheses about depression and the possibility of new treatments to be put forward. Conclusions. We are still not certain about the exact cause or the processes that determine mental illnesses such as depression or how improvements are achieved with the antidepressants we currently have available. Nevertheless, biotechnology is expected to be a great help in advancing towards a better understanding of the interrelations between the nervous, immune and endocrine systems, with their intracellular cascades and final outcomes in genetic expression and protein function, in depression. This will enable more efficient, more selective and faster-acting drugs to be developed and, in the future and with the help of psychogenomics, even make it possible to produce tailor-made medication for each patient (AU)
Asunto(s)
Humanos , Neurobiología , Monoaminas Biogénicas , Citocinas , Sistemas de Mensajero Secundario , Receptores de Glutamato , Receptores de Esteroides , Antidepresivos , Depresión , Hormona Liberadora de Corticotropina , AMP Cíclico , Proteína de Unión a Elemento de Respuesta al AMP CíclicoRESUMEN
Excessive body weight gain (BWG) is a common side effect of some typical and atypical antipsychotic drugs (APs). Convergent evidence suggests a hierarchy in the magnitude of BWG that may be induced by diverse agents, being very high for clozapine and olanzapine; high for quetiapine, zotepin, chlorpromazine, and thioridazine; moderate for risperidone and sertindole; and low for ziprazidone, amisulpiride, haloperidol, fluphenazine, pimozide, and molindone. BWG may be related to increased appetite that is due to drug interaction with the brain monoaminergic and cholinergic systems and to the metabolic/endocrine effects of hyperprolactinemia. Subjects with schizophrenia and bipolar disorders manifested a significantly high prevalence of diabetes, even before the introduction of atypical APs. However, clozapine and olanzapine appear to display a high propensity to induce glucose dysregulation and dyslipidemia. Sudden BWG, insulin resistance, increased appetite, and related endocrine changes also may be involved in the development of glucose intolerance and dyslipidemia in predisposed individuals. Patients should be informed of these side effects in order to prevent excessive BWG, and their blood glucose and lipids should be monitored before treatment and then at regular intervals. Nutritional advice must be given and regular physical exercise recommended. An appropriate selection of APs ought to be based on drug efficacy for specific patients and assessment of relevant risk factors such as propensity to gain weight; family or personal history of diabetes or hyperlipidemia; and elevated fasting serum glucose, lipid, or insulin levels. At present, there is no standardized pharmacological treatment for AP-induced BWG. Some studies have assessed the effects of agents such as amantadine, orlistat, metformin, nizatidine, and topiramate on AP-induced BWG. Further studies will provide tools to identify patients at high risk for obesity and metabolic abnormalities during AP administration. Excessive body weight gain (BWG), glucose intolerance, and dyslipidemia during treatment with antipsychotic drugs (APs) were reported in the late 1950s [14,101]. However, after 1990, interest in these problems increased noticeably, mainly because of the high propensity of some new atypical APs to induce these side effects (Fig.1). The APs are currently used in diverse mental disorders. Hence, excessive BWG and metabolic dysfunction are not exclusive of subjects with schizophrenia. In the case of bipolar disorders, AP-induced BWG may be additive to that induced by mood stabilizers [14,48,101]. The clinical features [2,14,24,133,139,140] and mechanisms [14,34,68,87,93,101,130] of BWG and metabolic dysfunction have been previously reviewed. In this article, we focus on a unified theory to explain these side effects, based on the interaction of APs with brain neurotransmitters involved in appetite regulation. This review comprises the following sections: 1) the clinical features of AP-induced BWG; 2) the effects of APs on carbohydrate and lipid metabolism in humans and experimental animals; 3) mechanisms involved in BWG, glucose, and lipid dysregulation; 4) strategies for prevention and treatment of these side effects; and 5) research perspectives in the field. The following sources were consulted: MEDLINE, Cochrane database system, and PsychINFO. Numerous articles referred to in leading articles also were consulted. The literature on this subject has increased so rapidly that it was impossible to include all the data recently published. For the first two sections, references that illustrate current controversies in the field were selected.
Asunto(s)
Antipsicóticos/efectos adversos , Enfermedades Metabólicas/inducido químicamente , Obesidad/etiología , Aumento de Peso/efectos de los fármacos , Animales , Antipsicóticos/administración & dosificación , Antipsicóticos/farmacología , Metabolismo de los Hidratos de Carbono , Sistema Endocrino/efectos de los fármacos , Sistema Endocrino/metabolismo , Humanos , Metabolismo de los Lípidos , Enfermedades Metabólicas/metabolismo , Neurotransmisores/metabolismoAsunto(s)
Antipsicóticos/efectos adversos , Hipoglucemiantes/uso terapéutico , Metformina/uso terapéutico , Obesidad/inducido químicamente , Obesidad/tratamiento farmacológico , Esquizofrenia/tratamiento farmacológico , Adulto , Atención Ambulatoria , Antipsicóticos/uso terapéutico , Área Bajo la Curva , Glucemia/análisis , Índice de Masa Corporal , Escalas de Valoración Psiquiátrica Breve/estadística & datos numéricos , Enfermedad Crónica , Femenino , Prueba de Tolerancia a la Glucosa/estadística & datos numéricos , Humanos , Hipoglucemiantes/farmacología , Insulina/sangre , Resistencia a la Insulina/fisiología , Metformina/farmacología , Persona de Mediana Edad , Obesidad/sangre , Proyectos Piloto , Placebos , Esquizofrenia/sangre , Esquizofrenia/diagnóstico , Pérdida de Peso/efectos de los fármacosAsunto(s)
Antipsicóticos/efectos adversos , Obesidad/inducido químicamente , Animales , Femenino , Humanos , MasculinoRESUMEN
In this study, the authors assessed the endocrine system and glucose tolerance in obese and non-obese women chronically treated with typical antipsychotic drugs (AP). In particular, we tested the hypotheses that these subjects display hypogonadism and increased insulin resistance compared to healthy weight-matched controls, as these abnormalities create a tendency towards excessive body weight gain. Twenty-six AP-treated women were matched with 26 healthy women by age, body mass index and day of the menstrual cycle. The following serum variables were evaluated in each subject: glucose tolerance after an oral glucose overload, insulin, leptin, beta-endorphin, reproductive hormones, adrenal steroids and lipids. Compared to controls, AP-treated women displayed significantly higher levels of basal glucose, insulin after 60 min of the glucose overload, prolactin, thyroid stimulating hormone and beta-endorphin, with lower levels of C-Peptide, progesterone, 17-OH progesterone, androstenedione and high-density lipoprotein cholesterol. The levels of estradiol, estrone and leptin did not differ between the groups. Thus, women treated with typical AP appeared to display more insulin resistance than healthy controls, predisposing them to excessive weight gain. Insulin sensitivity might be further impaired when the subject switches to atypical AP administration. Metformin and related agents may reduce body weight in these subjects. The high levels of the opiate beta-endorphin suggest that opiate antagonists such as naloxone and naltrexone might be useful as well. Even though the luteal phase of the menstrual cycle appears to be severely disturbed, the normal serum levels of estradiol and estrone do not support the proposal derived from animal experimental studies about the use of estrogens or tamoxifen to counteract AP-induced obesity.
Asunto(s)
Antipsicóticos/efectos adversos , Sistema Endocrino/metabolismo , Hipogonadismo/inducido químicamente , Obesidad/inducido químicamente , Glándulas Suprarrenales/metabolismo , Adulto , Glucemia/metabolismo , Péptido C/sangre , Femenino , Hormonas Esteroides Gonadales/sangre , Humanos , Hipogonadismo/metabolismo , Insulina/sangre , Resistencia a la Insulina , Leptina/sangre , Lípidos/sangre , Análisis Multivariante , Obesidad/metabolismo , Prolactina/sangre , Globulina de Unión a Hormona Sexual/metabolismo , Hormonas Tiroideas/sangre , betaendorfina/sangreAsunto(s)
Antipsicóticos/efectos adversos , Peso Corporal/fisiología , Insulina/sangre , Leptina/sangre , Síndrome Metabólico/fisiología , Obesidad/inducido químicamente , Pirenzepina/análogos & derivados , Pirenzepina/efectos adversos , Trastornos Psicóticos/tratamiento farmacológico , Benzodiazepinas , Femenino , Humanos , Masculino , OlanzapinaRESUMEN
OBJECTIVES: To correlate the anthropometric indexes (Body Mass Index [BMI] and Waist-Hip ratio [WHR]) with the serum prolactin levels in a heterogeneous population of patients treated with typical antipsychotic (AP) drugs. METHODS: We evaluated BMI, WHR, and fasting serum prolactin of inpatients (n = 105) and outpatients (n = 122) treated with APs, in outpatients receiving other psychotropic drugs (OPDs) (n = 77), and in drug-free subjects (n = 33). Outpatients had free access to food, whereas the inpatient sample comprised people with a monotonous diet of approximately 2000 Kcal daily. RESULTS: Prolactin correlated positively with the BMI in the whole group of AP-treated outpatient men (P = 0.03) and with the WHR in AP-treated inpatient men (P = 0.053). Regarding treatment duration, prolactin and BMI correlated positively in men consecutively treated for more than 1 year (P = 0.023). By contrast, a trend toward a negative correlation between prolactin and BMI was observed in AP-treated outpatient women (P = 0.08). No significant correlation, or even a trend, was observed in the other groups. CONCLUSIONS: Prolactin may be involved in AP-induced weight gain, particularly in men. Future studies should characterize the period of maximal prolactin impact on body weight during AP treatment. Specific populations particularly sensitive to hyperprolactinemia might be identified as well. The negative correlation between prolactin and BMI detected in AP-treated women resembles the dampened prolactin response observed in severe primary obesity.