RESUMEN
Melanocortin therapy by using adrenocorticotropic hormone (ACTH) or non-steroidogenic melanocortin peptides attenuates proteinuria and glomerular injury in experimental glomerular diseases and induces remission of nephrotic syndrome in patients with diverse glomerulopathies, even those resistant to steroids. The underlying mechanism remains elusive, but the role of melanocortin 1 receptor (MC1R) has been implicated and was examined here. Four patients with congenital red hair color and nephrotic syndrome caused by idiopathic membranous nephropathy or focal segmental glomerulosclerosis were confirmed by gene sequencing to bear dominant-negative MC1R mutations. Despite prior corticosteroid resistance, all patients responded to ACTH monotherapy and ultimately achieved clinical remission, inferring a steroidogenic-independent and MC1R-dispensable anti-proteinuric effect of melanocortin signaling. In confirmatory animal studies, the protective effect of [Nle(4), D-Phe(7)]-α-melanocyte stimulating hormone (NDP-MSH), a potent non-steroidogenic pan-melanocortin receptor agonist, on the lipopolysaccharide elicited podocytopathy was completely preserved in MC1R-null mice, marked by reduced albuminuria and diminished histologic signs of podocyte injury. Moreover, in complementary in vitro studies, NDP-MSH attenuated the lipopolysaccharide elicited apoptosis, hypermotility and impairment of filtration barrier function equally in primary podocytes derived from MC1R-null and wild-type mice. Collectively, our findings suggest that melanocortin therapy confers a proteinuria reducing and podoprotective effect in proteinuric glomerulopathies via MC1R-independent mechanisms.
Asunto(s)
Glomérulos Renales/efectos de los fármacos , Melanocortinas/administración & dosificación , Proteinuria/tratamiento farmacológico , Receptor de Melanocortina Tipo 1/genética , Hormona Adrenocorticotrópica/administración & dosificación , Hormona Adrenocorticotrópica/metabolismo , Animales , Glomeruloesclerosis Focal y Segmentaria/tratamiento farmacológico , Glomeruloesclerosis Focal y Segmentaria/genética , Glomeruloesclerosis Focal y Segmentaria/patología , Humanos , Glomérulos Renales/lesiones , Glomérulos Renales/patología , Melanocortinas/genética , Ratones , Síndrome Nefrótico/tratamiento farmacológico , Síndrome Nefrótico/genética , Síndrome Nefrótico/patología , Podocitos/efectos de los fármacos , Proteinuria/genética , Proteinuria/metabolismo , Proteinuria/patología , Transducción de Señal/efectos de los fármacos , alfa-MSH/administración & dosificaciónRESUMEN
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease resulting in loss of self-tolerance with multiple organs, such as the kidney, skin, joints, and the central nervous system (CNS), being targeted. Numerous immunosuppressant therapies are currently being used for the treatment of SLE, but their clinical utility is somewhat variable because of the clinical heterogeneity. Melanocortins are a family of peptides derived from the common precursor protein pro-opiomelanocortin. These multifunctional peptides activate five subtypes of melanocortin receptors expressed on immune, skin, muscle, bone, and kidney cells and cells within the CNS. Melanocortin peptides have demonstrated a variety of biologic actions including immunomodulation, melanogenesis, and renoprotection. This review aims to introduce the melanocortin system and explore the mechanisms by which they may be beneficial in diseases such as SLE.
Asunto(s)
Sistemas de Liberación de Medicamentos/tendencias , Lupus Eritematoso Sistémico/metabolismo , Melanocortinas/metabolismo , Receptores de Melanocortina/metabolismo , Animales , Humanos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Melanocortinas/administración & dosificación , Péptidos/administración & dosificación , Péptidos/metabolismoRESUMEN
RATIONALE: The mesolimbic dopamine system is an important component of the neural circuitry controlling reward-related behavior. We have recently shown that the melanocortin peptides decrease normal homeostatic feeding through actions in the ventral tegmental area. It is unknown, however, whether melanocortin peptides can also act on dopamine pathways to regulate hedonic, reward-related aspects of feeding. OBJECTIVES: In these studies, we tested whether injection of melanocortin receptor agonists directly into the ventral tegmental area (VTA) affected the intake of appetizing and rewarding sugar solutions in two-bottle choice tests. METHODS: Varying doses of the melanocortin receptor agonist, MTII, were injected into the VTA, and the intake of different sugar solutions was measured in two-bottle choice tests to distinguish between potential effects on homeostatic versus hedonic aspects of feeding. In addition, 24-h food intake was measured throughout the experiments. RESULTS: Injection of MTII into the VTA dose dependently decreased the intake of 1 and 2 % sucrose solutions and 0.2 % saccharin solutions and decreased 24-h food intake in each study. Although MTII also decreased the intake of a 10 % sucrose solution, MTII appeared to be less potent in rats exposed to 10 % sucrose, as only the highest dose of MTII tested was effective at reducing 10 % sucrose intake and food intake in these rats. CONCLUSIONS: These studies demonstrate that melanocortins can act directly in the VTA to control reward-related feeding. Thus, these studies add to the growing body of evidence showing that melanocortins can interact with the mesolimbic dopamine system to regulate multiple reward-related behaviors.
Asunto(s)
Ingestión de Alimentos/efectos de los fármacos , Melanocortinas/administración & dosificación , Recompensa , Sacarosa/administración & dosificación , Área Tegmental Ventral/efectos de los fármacos , Animales , Conducta de Elección/efectos de los fármacos , Conducta de Elección/fisiología , Relación Dosis-Respuesta a Droga , Ingestión de Alimentos/fisiología , Inyecciones Intraventriculares , Masculino , Ratas , Ratas Sprague-Dawley , Área Tegmental Ventral/fisiologíaRESUMEN
We previously reported that melanocortins afford cardioprotection in conditions of experimental myocardial ischemia/reperfusion, with involvement of the janus kinases (JAK), extracellular signal-regulated kinases (ERK) and signal transducers and activators of transcription (STAT) signalings. We investigated the influence of the melanocortin analog [Nle(4), D-Phe(7)]α-melanocyte-stimulating hormone (NDP-α-MSH) on short-term detrimental responses to cardiac arrest (CA) induced in rats by intravenous (i.v.) administration of potassium chloride, followed by cardiopulmonary resuscitation (CPR) plus epinephrine treatment. In CA/CPR rats i.v. treated with epinephrine (0.1 mg/kg) and returned to spontaneous circulation (48%) we recorded low values of mean arterial pressure (MAP) and heart rate (HR), alteration of hemogasanalysis parameters, left ventricle low expression of the cardioprotective transcription factors pJAK2 and pTyr-STAT3 (JAK-dependent), increased oxidative stress, up-regulation of the inflammatory mediators tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and down-regulation of the anti-inflammatory cytokine IL-10, as assessed at 1h and 3h after CPR. On the other hand, i.v. treatment during CPR with epinephrine plus NDP-α-MSH (340 µg/kg) almost completely restored the basal conditions of MAP and HR, reversed metabolic acidosis, induced left ventricle up-regulation of pJAK2, pTyr-STAT3 and IL-10, attenuated oxidative stress, down-regulated TNF-α and IL-6 levels, and improved survival rate by 81%. CA/CPR plus epinephrine alone or in combination with NDP-α-MSH did not affect left ventricle pSer-STAT3 (ERK1/2-dependent) and pERK1/2 levels. These results indicate that melanocortins improve return to spontaneous circulation, reverse metabolic acidosis, and inhibit heart oxidative stress and inflammatory cascade triggered by CA/CPR, likely via activation of the JAK/STAT signaling pathway.
Asunto(s)
Cardiotónicos/farmacología , Paro Cardíaco/tratamiento farmacológico , alfa-MSH/análogos & derivados , Animales , Apoptosis/efectos de los fármacos , Dióxido de Carbono/sangre , Reanimación Cardiopulmonar , Cardiotónicos/administración & dosificación , Citocinas/metabolismo , Epinefrina/administración & dosificación , Epinefrina/farmacología , Paro Cardíaco/patología , Paro Cardíaco/fisiopatología , Hemodinámica/efectos de los fármacos , Mediadores de Inflamación/metabolismo , Janus Quinasa 2/metabolismo , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Masculino , Melanocortinas/administración & dosificación , Melanocortinas/farmacología , Melanocortinas/fisiología , Estrés Oxidativo/efectos de los fármacos , Oxígeno/sangre , Ratas , Ratas Sprague-Dawley , Factor de Transcripción STAT3/metabolismo , Transducción de Señal/efectos de los fármacos , alfa-MSH/administración & dosificación , alfa-MSH/farmacologíaRESUMEN
Recently discovered anti-inflammatory and immunomodulatory properties of melanocortin peptides led to the conclusion that they might serve as new anti-inflammatory therapeutics. The purpose of this work was to examine the effectiveness of ß-melanocortin (ß-MSH) in two experimental models: ethanol-induced gastric lesions and TNBS (2,4,6-trinitrobenzenesulfonic acid)-induced colitis in male Wistar rats. Three progressive doses of ß-MSH were used: 0.125, 0.250 and 0.500 mg/kg. Our results suggest that ß-MSH acts as a protective substance in the gastric lesions model, which can be seen as a statistically significant reduction of hemorrhagic lesions at all three doses, compared to the control group. The most efficient dose was 0.250 mg/kg. Statistically significant reduction in mucosal surface affected by necrosis and the reduction of overall degree of inflammation in the colitis model indicates an anti-inflammatory effect of ß-MSH at a dose of 0.250 mg/kg. The results justify further research on ß-MSH peptide and its derivates in the inflammatory gastrointestinal diseases, and point out the possibility of using ß-MSH in studies of digestive system pharmacology.
Asunto(s)
Tracto Gastrointestinal/efectos de los fármacos , Melanocortinas/farmacología , Sustancias Protectoras/farmacología , Animales , Antiinflamatorios/administración & dosificación , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Colitis/inducido químicamente , Colitis/tratamiento farmacológico , Colitis/patología , Colon/efectos de los fármacos , Colon/patología , Modelos Animales de Enfermedad , Gastritis/inducido químicamente , Gastritis/tratamiento farmacológico , Gastritis/patología , Inflamación/tratamiento farmacológico , Inflamación/patología , Masculino , Melanocortinas/administración & dosificación , Melanocortinas/uso terapéutico , Necrosis/tratamiento farmacológico , Necrosis/patología , Sustancias Protectoras/administración & dosificación , Sustancias Protectoras/uso terapéutico , Ratas , Ratas WistarRESUMEN
Several centrally acting agents have shown potential to improve erectile function in men with ED. They still lack adequate data in efficacy and tolerability. Nasal formulations of apomorphine and bremelanotide seem to be the most likely candidates for future approval. They may play a role, specifically in men who fail phosphodiesterase 5 (PDE5) therapy, are unable to take PDE5 inhibitors because of side effects, or are on nitrate therapy. This article reviews the centrally acting agents and the data on their efficacy.
Asunto(s)
Apomorfina/uso terapéutico , Fármacos del Sistema Nervioso Central/uso terapéutico , Agonistas de Dopamina/uso terapéutico , Disfunción Eréctil/tratamiento farmacológico , Melanocortinas/uso terapéutico , Erección Peniana/efectos de los fármacos , Péptidos Cíclicos/uso terapéutico , alfa-MSH/uso terapéutico , Aminoácidos/administración & dosificación , Aminoácidos/uso terapéutico , Apomorfina/administración & dosificación , Fármacos del Sistema Nervioso Central/administración & dosificación , Disfunción Eréctil/fisiopatología , Humanos , Masculino , Melanocortinas/administración & dosificación , Óxido Nítrico/administración & dosificación , Óxido Nítrico/uso terapéutico , Péptidos Cíclicos/administración & dosificación , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Inhibidores Selectivos de la Recaptación de Serotonina/administración & dosificación , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , alfa-MSH/administración & dosificaciónRESUMEN
Forebrain ventricular delivery of melanocortin receptor (MC3/4R) agonist increases energy expenditure and decreases food intake (FI). Because forebrain ventricular delivery provides ligand to various anatomically distributed MC3/4R-bearing nuclei, it is unclear which of the receptor subpopulations contributes to the feeding suppression and the sympathetic-thermogenic effects observed. The literature indicates that reexpression of MC4R in the paraventricular nucleus (PVH) affects the feeding but not the energetic phenotype of the MC4R knockout, suggesting that divergent MC4R populations mediate energy expenditure (hindbrain) and FI (hypothalamus) effects of stimulation. Not consistent with this view are data indicating that PVH sympathetic projection neurons express MC4Rs and that feeding effects are induced from hindbrain MC4R sites. Therefore, we hypothesize an opposing perspective: that stimulation of anatomically diverse MC3/4R-bearing nuclei triggers energetic as well as feeding effects. To test this hypothesis, ventricle subthreshold doses of MC3/4R agonist (5 and 10 pmol) were applied in separate experiments to six hindbrain and hypothalamic sites; core temperature (Tc), heart rate (HR), spontaneous activity (SPA), and FI were measured in behaving rats. Nucleus tractus solitarius and PVH stimulation increased Tc, HR, and SPA and decreased FI. Rostral ventrolateral medulla, parabrachial nucleus, and retrochiasmatic area stimulation increased Tc, HR, but not SPA, and decreased FI. The response profile differed to some extent for each nucleus tested, suggesting differential output circuitries for the measured parameters. Data are consistent with the view that energetic and feeding responses are not controlled by regionally divergent MC3/4Rs and can be elicited from multiple, anatomically distributed MC3/4R populations.
Asunto(s)
Ingestión de Alimentos/fisiología , Frecuencia Cardíaca/fisiología , Melanocortinas/farmacología , Receptores de Melanocortina/metabolismo , Análisis de Varianza , Animales , Temperatura Corporal/fisiología , Fenómenos Fisiológicos Cardiovasculares , Relación Dosis-Respuesta a Droga , Hipotálamo/efectos de los fármacos , Hipotálamo/metabolismo , Hipotálamo/fisiología , Inyecciones , Masculino , Melanocortinas/administración & dosificación , Actividad Motora/fisiología , Ratas , Ratas Sprague-Dawley , Receptor de Melanocortina Tipo 3 , Receptor de Melanocortina Tipo 4/metabolismo , Rombencéfalo/efectos de los fármacos , Rombencéfalo/metabolismo , Rombencéfalo/fisiologíaRESUMEN
Functional disruption of either MC3R or MC4R results in obesity, implicating both in the control of energy homeostasis. The ligands for these receptors are derived from the prohormone proopiomelancortin (POMC), which is posttranslationally processed to produce a set of melanocortin peptides with a range of activities at the MC3R and MC4R. The relative importance of each of these peptides alpha-MSH, gamma3-MSH, gamma2-MSH, gamma-lipotropin (gamma-LPH) and, in man but not in rodents, beta-MSH] in the maintenance of energy homeostasis is, as yet, unclear. To investigate this further, equimolar amounts (2 nmol) of each peptide were centrally administered to freely feeding, corticosterone-supplemented, Pomc null (Pomc-/-) mice. After a single dose at the onset of the dark cycle, alpha-MSH had the most potent anorexigenic effect, reducing food intake to 35% of sham-treated animals. beta-MSH, gamma-LPH, and gamma3- and gamma2-MSH all reduced food intake but to a lesser degree. The effects of peptide administration over 3 d were also assessed. Only alpha-MSH significantly reduced body weight, affecting both fat and lean mass. Other peptides had no significant effect on body weight. Pair-feeding of sham-treated mice to those treated with alpha-MSH resulted in identical changes in total weight, fat and lean mass indicating that the effects of alpha-MSH were primarily due to reduced food intake rather than increased energy expenditure. Although other melanocortins can reduce food intake in the short-term, only alpha-MSH can reduce the excess fat and lean mass found in Pomc-/- mice, mediated largely through an effect on food intake.