RESUMEN
OBJECTIVE: To investigate patient reported prosexual side effects of the aminoketone antidepressant bupropion (INN, amfebutamone) and to compare directly the sexual side effects of bupropion and the selective serotonin reuptake inhibitor (SSRI) antidepressants fluoxetine, paroxetine, and sertraline. METHODS: One hundred seven psychiatric outpatient respondents receiving current treatment with one of the above antidepressants anonymously completed questionnaires that allowed reporting of both decreases and increases in sexual function. The main outcome measures were antidepressant-associated changes in libido, arousal, duration of time from arousal to orgasm, intensity of orgasm, and duration of orgasm relative to that experienced before the onset of the patients' psychiatric illnesses. RESULTS: Bupropion-treated patients reported significant increases in libido, level of arousal, intensity of orgasm, and duration of orgasm beyond levels experienced premorbidly. The three SSRIs to an equal degree significantly decreased libido, arousal, duration of orgasm, and intensity of orgasm below levels experienced premorbidly. Overall, 27% of the SSRI-treated patients had no adverse sexual side effects; in contrast, 86% of patients treated with bupropion had no adverse sexual effects, and 77% of bupropion-treated patients reported at least one aspect of heightened sexual functioning. CONCLUSIONS: SSRI-induced adverse sexual effects appear to be the rule rather than the exception and may be substantially underreported unless patients are specifically asked about the effects of these medications on various aspects of sexual function. In contrast, prosexual effects were reported by the majority of patients treated with bupropion. The findings are reviewed in light of the neurochemistry of these agents and the sexual response.
Asunto(s)
1-Naftilamina/análogos & derivados , Antidepresivos de Segunda Generación/farmacología , Bupropión/farmacología , Inhibidores de Captación de Dopamina/farmacología , Fluoxetina/farmacología , Paroxetina/farmacología , Inhibidores Selectivos de la Recaptación de Serotonina/farmacología , Conducta Sexual/efectos de los fármacos , 1-Naftilamina/farmacología , Adulto , Anciano , Análisis de Varianza , Femenino , Humanos , Masculino , Persona de Mediana Edad , Orgasmo/efectos de los fármacos , Sertralina , Encuestas y CuestionariosRESUMEN
The extracellular matrix (ECM) of fetal rabbit wounds contains an abundance of the glycosaminoglycan hyaluronic acid (HA) but is devoid of excessive collagen. Thus, fetal wounds heal without scarring, such that tissue repair grossly resembles regeneration. To obtain further insight into the process of fetal wound healing, the ECM of normal fetal rabbit skin was analyzed, thus providing a comparative endpoint for the ECM of healing fetal wounds. Similarities between the matrices would support the theory of healing by regeneration. The glycosaminoglycan (GAG) component of fetal rabbit skin from 24- and 29-day gestational age fetuses was extracted and then quantitated using an alcian blue binding assay. The extracted GAG was characterized by cellulose acetate electrophoresis and HA was identified by its selective digestion by Streptomyces hyaluronidase. The mean GAG content, measured as ng GAG per mg dry weight skin, was 260 +/- 200 for the 24-day group (n = 28) and 280 +/- 220 for the 29-day group (n = 26). The only GAG identified at both times of gestation was HA. This study has demonstrated that HA is the predominant GAG present in fetal rabbit skin and its quantity is stable during the period studied late in gestation. A major component of the ECM of both wounded and normal fetal skin is HA, indicating a close compositional similarity. These observations provide biochemical support for the hypothesis that the reparative process of injured tissue in the fetal rabbit proceeds in an attempt to reconstitute normality, i.e. regeneration.
Asunto(s)
Matriz Extracelular/fisiología , Ácido Hialurónico/análisis , Regeneración , Fenómenos Fisiológicos de la Piel , Cicatrización de Heridas , Animales , Matriz Extracelular/efectos de los fármacos , Matriz Extracelular/ultraestructura , Feto , Glicosaminoglicanos/análisis , Glicosaminoglicanos/aislamiento & purificación , Ácido Hialurónico/fisiología , Hialuronoglucosaminidasa/farmacología , Conejos , Piel/fisiopatología , Piel/ultraestructuraRESUMEN
Fetal response to injury has been characterized by the deposition of a matrix that is not primarily collagen. This study was designed to identify this matrix, in order to better understand the fetal mechanism of tissue repair. Silastic/polyvinyl alcohol sponge (PVA) wound implants were placed paravertebrally in 24-day gestation (31 days = term) fetal (n = 65) and adult (n = 43) rabbits and then harvested from one hour to 6 days post-wounding. Histologic analysis of the fetal wound matrix deposited in the PVA implants suggested the presence of glycosaminoglycans (GAG) rather than the collagen found in adult wound implants. To further analyze the fetal wound matrix, the GAG content was quantitated using an Alcian Blue dye-binding assay. Results showed significantly increased (p less than 0.05) GAG deposition on days 2-6 in the fetal wound compared to the adult wound. Fetal GAG levels were approximately three times those of the adult during this period. Separation of individual GAG species by cellulose acetate electrophoresis demonstrated that the GAG matrix of the fetal wound was composed predominantly of hyaluronic acid. This finding was confirmed by selective enzymatic digestion of separated GAG species using highly specific polysaccharidases. These observations of hyaluronic acid deposition in the fetal wound may be ascribed an important physiologic role by providing a more fluid and malleable matrix rather than a restrictive matrix composed of collagen. This new evidence coupled with earlier findings of the lack of an acute inflammatory response in the fetus further supports the hypothesis that the fetal response to injury is significantly different from the adult response.
Asunto(s)
Glicosaminoglicanos/fisiología , Cicatrización de Heridas , Azul Alcián , Animales , Colorimetría , Electroforesis en Acetato de Celulosa , Femenino , Feto , Polisacárido Liasas , Polisacáridos/metabolismo , Alcohol Polivinílico , Prótesis e Implantes , ConejosRESUMEN
Acetylcholine receptor-rich membranes from the electric organ of Torpedo californica are enriched in the four subunits (alpha, beta, gamma, delta) of the acetylcholine receptor (AChR) and for polypeptides at 43 kd and 270 kd. Reaction of these membranes with 3H-N-ethylmaleimide (3H-NEM) demonstrates that most of the available free sulfhydryls reside on the 43 kd protein. Cross-linking reagents that contain NEM as one reactive group, and N-hydroxysuccinimide as the other, were used to study the topography of the 43 kd protein in AChR-rich membranes. Proteins from cross-linked membranes were resolved by SDS-PAGE and the composition of crosslinked products was determined by Western blots and monoclonal antibodies. A crosslinked product at 110 kd was labeled by a monoclonal antibody to the beta-subunit and by a monoclonal antibody to the 43 kd protein, but not by monoclonal antibodies to the alpha, gamma, or delta subunits. The 110 kd crosslink was not produced in the presence of 10 mM lithium diiodosalicylate, which dissociates the 43 kd protein from the membrane. Thus the 43 kd protein is intimately associated with the AChR and in close proximity to the beta-subunit.