ANALIZAN LA INFLUENCIA DE LA OXITOCINA SOBRE EL TRACTO GASTROINTESTINAL

ANALIZAN LA INFLUENCIA DE LA OXITOCINA SOBRE EL TRACTO GASTROINTESTINAL

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La oxitocina es liberada en los sujetos sanos en respuesta a la ingesta grasa y está presente a lo largo del tracto gastrointestinal. Los pacientes con diabetes mellitus y paresia gástrica tienen una secreción insuficiente de oxitocina posprandial y la administración de antagonistas de los receptores de oxitocina junto con una comida retrasa el vaciado gástrico. Debido a ello el papel de la oxitocina en la regulación fisiológica del vaciado gástrico y su impacto en la paresia gástrica merece nuevas investigaciones.
ohlsson9.jpg Autor:
Bodil Ohlsson
Columnista Experto de SIIC

Institución:
Department of Clinical Sciences, Division of Gastroenterology, Malmö University Hospital, Lund University


Artículos publicados por Bodil Ohlsson
Recepción del artículo
29 de Noviembre, 2008
Aprobación
28 de Abril, 2009
Primera edición
2 de Noviembre, 2009
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La observación clínica de la mejoría en la constipación crónica durante la lactancia materna dio lugar a la hipótesis de que la oxitocina podría estar involucrada en la fisiología y la fisiopatología gastrointestinal. En primer lugar se evaluó la concentración de oxitocina en plasma mediante radioinmunoensayo, antes y después de una ingesta. Se examinó la presencia de oxitocina y su receptor en el tracto gastrointestinal mediante PCR e inmunofluorescencia. La tasa de vaciado gástrico se evaluó mediante ultrasonografía, y el peristaltismo del colon, con un método barostático. Se realizó una evaluación a doble ciego para examinar el papel de la oxitocina en la constipación crónica refractaria. Los resultados mostraron una liberación de oxitocina en respuesta a la ingesta de grasa en sujetos saludables de ambos sexos. Por el contrario, los pacientes que presentaban paresia gástrica no tenían liberación posprandial de oxitocina. Además, si a los sujetos sanos se les administraba un antagonista de los receptores de oxitocina junto con la comida la tasa de vaciado gástrico se prolongaba. Si bien el ARNm tanto de la oxitocina como de su receptor estaba presente a lo largo del tracto gastrointestinal, sólo la oxitocina se traducía en una proteína totalmente expresada en el sistema nervioso entérico. La administración intravenosa de oxitocina aumentó el peristaltismo en mujeres sanas. Cuando se lo hizo por inhalación nasal no se observó ningún efecto sobre la constipación crónica, pero el dolor abdominal se redujo y se experimentó un incremento en el bienestar psicológico.

Palabras clave
peristaltismo del colon, vaciado gástrico, oxitocina, receptores de oxitocina


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Abstract
The clinical observation of improvement of chronic constipation during breast feeding raised the hypothesis that oxytocin may be involved in gastrointestinal physiology and pathophysiology. Firstly, the concentration of oxytocin in plasma before and after a meal was assessed by radioimmunoassay. Then, the presence of oxytocin and its receptor in the gastrointestinal tract was examined by PCR and immunofluorescence. The gastric emptying rate was evaluated by ultrasonography and the colonic peristalsis by a barostat method. A double-blind, placebo-control trial was performed to evaluate the role of oxytocin on chronic, refractory constipation. The results showed that oxytocin was released in response to a fatty meal in both sexes in healthy subjects. By contrast, patients suffering from gastro paresis had no postprandial release of oxytocin. Further, if an oxytocin receptor antagonist was administered together with the meal in healthy subjects, the gastric emptying rate was prolonged. Although mRNA for both oxytocin and its receptor was present throughout the gastrointestinal tract, only oxytocin is translated into a fully expressed protein, and was present in the enteric nervous system. Pharmacological administration of intravenous oxytocin led to increased peristalsis in healthy women. When administered by nasal inhalation, no effect was observed on chronic constipation, but abdominal pain decreased and an increased psychological well-being was experienced.

Key words
colonic peristalsis, gastric emptying, gastrointestinal tract, oxytocin, oxytocin receptor


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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Gastroenterología
Relacionadas: Anatomía Patológica, Bioquímica, Endocrinología y Metabolismo, Farmacología, Medicina Interna, Obstetricia y Ginecología



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Enviar correspondencia a:
Bodil Ohlsson, Department of Medicine, Malmö University Hospital, Entrance 35, S-205 02, Malmö, Suecia
Patrocinio y reconocimiento:
Estas investigaciones recibieron becas de Knut y Alice Wallenberg's Foundation, Åke Wibergs Foundation, Tore Nilsson Foundation, Magnus Bergwall Foundation, Ernold Lundström Foundation, Malmö Diabetes Association, Swedish Medical Association, de las compañías farmacéuticas Novo Nordic y Tika Pharmacy y de la Development Foundation de la región de Skåne.
Bibliografía del artículo

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