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1.
Pain ; 114(1-2): 195-202, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15733645

RESUMO

Metabotropic glutamate receptors (mGluRs) have previously been shown to play a role in pain transmission during inflammatory or neuropathic pain states. However, the role of mGluR5 in post-operative pain remains to be fully investigated. The present study was conducted to characterize analgesic activity of 2-methyl-6-(phenylethynyl)-pyridine (MPEP) in the skin-incision-induced post-operative pain model in rats. MPEP is a potent and selective mGluR5 antagonist with high affinity (K(i)=6.3+/-0.9 nM) in rat cortex using [(3)H]-MPEP as a radioligand, while not competing with the mGluR1-selective radioligand [(3)H]-R214127 (K(i)>10,000 nM) in rat cerebellum. Post-operative pain was examined 2 h following surgery using weight-bearing (WB) difference between injured and uninjured paws as a measure of non-evoked pain. In this model, MPEP, as morphine, showed dose-dependent effects and full efficacy after systemic administration (ED(50)=15 mg/kg, i.p. for MPEP, ED(50)=1.3 mg/kg, s.c. for morphine). In addition, intrathecal (i.t.) and intracerebroventricular (i.c.v.) MPEP reduced WB difference (ED(50)=65 microg/rat i.t. and ED(50)=200 microg/rat i.c.v.). Interestingly, intraplantar (i.pl.) injection of MPEP either before or after surgery induced a similar reduction in WB difference (ED(50)=90 microg/rat, i.pl.) while contralateral i.pl. MPEP injection did not produce any effect. These results demonstrate that both peripheral and central mGluR5 receptors play a role in nociceptive transmission observed during post-operative pain. In addition, the data suggest that mGluR5 antagonists could offer a new therapeutic approach to the treatment of post-operative pain.


Assuntos
Dor Pós-Operatória/metabolismo , Receptores de Glutamato Metabotrópico/fisiologia , Animais , Relação Dose-Resposta a Droga , Masculino , Morfina/farmacologia , Morfina/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Ligação Proteica/efeitos dos fármacos , Ligação Proteica/fisiologia , Piridinas/metabolismo , Piridinas/farmacologia , Ratos , Ratos Sprague-Dawley , Receptor de Glutamato Metabotrópico 5 , Receptores de Glutamato Metabotrópico/antagonistas & inibidores
2.
Neurosci Biobehav Rev ; 26(8): 907-23, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12667496

RESUMO

Laboratory conditions in biobehavioral experiments are commonly assumed to be 'controlled', having little impact on the outcome. However, recent studies have illustrated that the laboratory environment has a robust effect on behavioral traits. Given that environmental factors can interact with trait-relevant genes, some have questioned the reliability and generalizability of behavior genetic research designed to identify those genes. This problem might be alleviated by the identification of the most relevant environmental factors, but the task is hindered by the large number of factors that typically vary between and within laboratories. We used a computational approach to retrospectively identify and rank sources of variability in nociceptive responses as they occurred in a typical research laboratory over several years. A machine-learning algorithm was applied to an archival data set of 8034 independent observations of baseline thermal nociceptive sensitivity. This analysis revealed that a factor even more important than mouse genotype was the experimenter performing the test, and that nociception can be affected by many additional laboratory factors including season/humidity, cage density, time of day, sex and within-cage order of testing. The results were confirmed by linear modeling in a subset of the data, and in confirmatory experiments, in which we were able to partition the variance of this complex trait among genetic (27%), environmental (42%) and genetic x environmental (18%) sources.


Assuntos
Comportamento/fisiologia , Meio Ambiente , Genética , Animais , Arquivos , Biologia Computacional , Processamento Eletrônico de Dados , Feminino , Genótipo , Laboratórios , Masculino , Camundongos , Camundongos Endogâmicos , Modelos Genéticos , Medição da Dor , Característica Quantitativa Herdável , Estações do Ano , Especificidade da Espécie
3.
Pain ; 106(3): 325-335, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14659515

RESUMO

The antiepileptic drug, gabapentin, and another structurally related compound, pregabalin, are increasingly employed in the pharmacotherapy of chronic pain states, although their primary mechanism of action remains a topic of active study. A genomic approach to the study of these drugs may elucidate their potentially novel mechanisms. We examined the heritability of sensitivity to analgesia from gabapentin and pregabalin as a precursor to linkage mapping efforts. Accordingly, 11 inbred mouse strains were tested for inhibition of nociception by gabapentin or pregabalin (50-300 mg/kg, i.p.) in two different preclinical assays of inflammatory pain, the formalin test (5% formalin; 20 microl) and zymosan thermal hyperalgesia on the paw-withdrawal test (3 mg/ml zymosan; 20 microl). Significant strain-dependence of drug action was noted in each case, indicating that sensitivity to these analgesics is heritable. Furthermore, the pattern of strain sensitivities to gabapentin and pregabalin were mostly similar, supporting the notion that they act via similar genetic and physiological mechanisms. However, there was virtually no correlation between strain sensitivities to pregabalin inhibition of formalin nociception and zymosan thermal hyperalgesia. In light of previous data from our laboratory and others regarding morphine analgesia, we now establish and empirically demonstrate the general principle that pharmacogenetic mechanisms underlying analgesic sensitivity are specific to the type of pain being inhibited. This has considerable implications for ongoing pharmacogenetic investigations and, more generally, for the choices of preclinical models of pain used in drug development.


Assuntos
Acetatos/uso terapêutico , Aminas , Ácidos Cicloexanocarboxílicos , Dor/tratamento farmacológico , Dor/genética , Farmacogenética/métodos , Ácido gama-Aminobutírico/análogos & derivados , Ácido gama-Aminobutírico/uso terapêutico , Acetatos/farmacologia , Analgesia/métodos , Animais , Relação Dose-Resposta a Droga , Feminino , Gabapentina , Genótipo , Masculino , Camundongos , Camundongos Endogâmicos AKR , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos CBA , Camundongos Endogâmicos DBA , Medição da Dor/efeitos dos fármacos , Medição da Dor/métodos , Pregabalina , Especificidade da Espécie , Ácido gama-Aminobutírico/farmacologia
4.
Pain ; 97(1-2): 75-86, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12031781

RESUMO

We and others have previously demonstrated that nociception in the mouse is heritable. A genetic correlation analysis of 12 common measures of nociception among a common set of inbred strains revealed three major clusters (or 'types') of nociception in this species. In the present study, we re-evaluated the major types of nociception and their interrelatedness using ten additional assays of nociception and hypersensitivity, including: three thermal assays (tail withdrawal from 47.5 degrees C water or -15 degrees C ethanol; tail flick from radiant heat), two chemical assays of spontaneous nociception (bee venom test; capsaicin test) and their subsequent thermal hypersensitivity states (including contralateral hypersensitivity in the bee venom test), a mechanical nociceptive assay (tail-clip test), and a mechanical hypersensitivity assay (intrathecal dynorphin). Confirming our earlier findings, the results demonstrate distinct thermal and chemical nociceptive types. It is now clear that mechanical hypersensitivity and thermal hypersensitivity are genetically dissociable phenomena. Furthermore, we now see at least two distinct types of thermal hypersensitivity: afferent-dependent, featuring a preceding significant period of spontaneous nociceptive behavior associated with afferent neural activity, and non-afferent-dependent. In conclusion, our latest analysis suggests that there are at least five fundamental types of nociception and hypersensitivity: (1) baseline thermal nociception; (2) spontaneous responses to noxious chemical stimuli; (3) thermal hypersensitivity; (4) mechanical hypersensitivity; and (5) afferent input-dependent hypersensitivity.


Assuntos
Hiperalgesia/genética , Nociceptores/fisiologia , Dor/genética , Animais , Venenos de Abelha , Capsaicina , Carragenina , Dinorfinas/farmacologia , Hiperalgesia/induzido quimicamente , Injeções Espinhais , Masculino , Camundongos , Camundongos Endogâmicos AKR , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos CBA , Camundongos Endogâmicos DBA , Análise Multivariada , Inflamação Neurogênica/induzido quimicamente , Inflamação Neurogênica/genética , Dor/induzido quimicamente , Medição da Dor , Especificidade da Espécie , Cauda
5.
Pain ; 96(3): 385-391, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11973013

RESUMO

Sensitivity to pain is widely variable, and much of this variability is genetic in origin. The specific genes responsible have begun to be identified, but only for thermal nociception. In order to facilitate the identification of polymorphic, pain-related genes with more clinical relevance, we performed quantitative trait locus (QTL) mapping studies of the most common assay of inflammatory nociception, the formalin test. QTL mapping is a technique that exploits naturally occurring variability among inbred strains for the identification of genomic locations containing genes contributing to that variability. An F2 intercross was constructed using inbred A/J and C57BL/6J mice as progenitors, strains previously shown to display resistance and sensitivity, respectively, to formalin-induced nociception. Following phenotypic testing (5% formalin, 25 microl intraplantar injection), mice were genotyped at 90 microsatellite markers spanning the genome. We provide evidence for two statistically significant formalin test QTLs - chromosomal regions whose inheritance is associated with trait variability - on distal mouse chromosomes 9 and 10. Identification of the genes underlying these QTLs may illuminate the basis of individual differences in inflammatory pain, and lead to novel analgesic treatment strategies.


Assuntos
Nociceptores/fisiologia , Dor/genética , Animais , Mapeamento Cromossômico , Cromossomos , Meio Ambiente , Feminino , Masculino , Camundongos , Camundongos Endogâmicos A , Camundongos Endogâmicos C57BL , Repetições de Microssatélites , Inflamação Neurogênica/genética , Medição da Dor , Característica Quantitativa Herdável , Especificidade da Espécie
6.
Eur J Pharmacol ; 506(2): 107-18, 2004 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-15588730

RESUMO

Preclinical data, performed in a limited number of pain models, suggest that functional blockade of metabotropic glutamate (mGlu) receptors may be beneficial for pain management. In the present study, effects of 2-methyl-6-(phenylethynyl)-pyridine (MPEP), a potent, selective mGlu5 receptor antagonist, were examined in a wide variety of rodent nociceptive and hypersensitivity models in order to fully characterize the potential analgesic profile of mGlu5 receptor blockade. Effects of 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP), as potent and selective as MPEP at mGlu5/mGlu1 receptors but more selective than MPEP at N-methyl-aspartate (NMDA) receptors, were also evaluated in selected nociceptive and side effect models. MPEP (3-30 mg/kg, i.p.) produced a dose-dependent reversal of thermal and mechanical hyperalgesia following complete Freund's adjuvant (CFA)-induced inflammatory hypersensitivity. Additionally, MPEP (3-30 mg/kg, i.p.) decreased thermal hyperalgesia observed in carrageenan-induced inflammatory hypersensitivity without affecting paw edema, abolished acetic acid-induced writhing activity in mice, and was shown to reduce mechanical allodynia and thermal hyperalgesia observed in a model of post-operative hypersensitivity and formalin-induced spontaneous pain. Furthermore, at 30 mg/kg, i.p., MPEP significantly attenuated mechanical allodynia observed in three neuropathic pain models, i.e. spinal nerve ligation, sciatic nerve constriction and vincristine-induced neuropathic pain. MTEP (3-30 mg/kg, i.p.) also potently reduced CFA-induced thermal hyperalgesia. However, at 100 mg/kg, i.p., MPEP and MTEP produced central nerve system (CNS) side effects as measured by rotarod performance and exploratory locomotor activity. These results suggest a role for mGlu5 receptors in multiple nociceptive modalities, though CNS side effects may be a limiting factor in developing mGlu5 receptor analgesic compounds.


Assuntos
Dor/fisiopatologia , Receptores de Glutamato Metabotrópico/efeitos dos fármacos , Ácido Acético , Animais , Carragenina , Sistema Nervoso Central/fisiologia , Constrição Patológica/patologia , Edema/induzido quimicamente , Formaldeído , Hiperalgesia/induzido quimicamente , Masculino , Camundongos , Camundongos Endogâmicos ICR , Atividade Motora/efeitos dos fármacos , Dor/induzido quimicamente , Dor/psicologia , Medição da Dor/efeitos dos fármacos , Dor Pós-Operatória/patologia , Desempenho Psicomotor/efeitos dos fármacos , Piridinas/farmacologia , Ratos , Ratos Sprague-Dawley , Receptor de Glutamato Metabotrópico 5 , Receptores de Glutamato Metabotrópico/fisiologia , Nervos Espinhais/patologia , Tiazóis/farmacologia , Vincristina/farmacologia
7.
J Pain ; 3(3): 181-9, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-14622771

RESUMO

The formalin test is commonly used as a model of persistent pain. Besides producing pain behavior, hind paw formalin injection induces the expression of the immediate-early gene, c-fos. A current controversy is whether noxious stimulus-induced Fos protein immunoreactivity can be considered a proxy (biomarker) of nociception in the spinal cord. We investigated this issue by exploiting our recent demonstration of genotype-dependent behavioral differences in response to formalin injection among inbred mouse strains. Accordingly, 6 inbred and 2 outbred strains were administered formalin (5% in 25 microL) into the ventral hind paw, monitored for licking behavior, and then sacrificed at 90 minutes after injection for Fos protein immunocytochemistry. Significant strain differences were observed in both licking behavior and Fos counts in superficial and deep laminae. We observed a significant correlation among strains between licking behavior in the late phase (10 to 60 minutes) of the formalin test and Fos expression in laminae V-VI (but not laminae I-II) of the dorsal horn (r = 0.94). These findings reinforce the use of the Fos technique to study the neuronal processing underlying pain but suggest that Fos labeling reliably reflects tonic pain behavior only in neurons located in the neck of the dorsal horn in mice.

9.
Horm Behav ; 46(4): 467-73, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15465533

RESUMO

There is a qualitative sex difference in the neurochemical mediation of stress-induced and kappa-opioid analgesia; these phenomena are dependent on N-methyl-d-aspartic acid (NMDA) receptors in males but not females. Progesterone modulation of this sex difference was examined in mice. Analgesia against thermal nociception was produced by forced cold water swim or by systemic administration of the kappa-opioid agonist, U50,488. As seen previously, the NMDA receptor antagonist MK-801 blocked both forms of analgesia in male but not female mice. Also as in previous studies, this sex difference was found to be dependent on ovarian hormones such that ovariectomy induced female mice to "switch" to the male-like, NMDAergic system. We now demonstrate that a single injection of progesterone (50 microg), systemically administered 30 min before analgesia assessment, is sufficient to restore female-specific mediation of analgesia (i.e., insensitivity to MK-801 blockade) in ovariectomized female mice. The rapidity of this neurochemical "switching" action of progesterone suggests mediation via cell surface receptors or the action of neuroactive steroid metabolites of progesterone.


Assuntos
Analgesia , Dor/fisiopatologia , Progesterona/fisiologia , Caracteres Sexuais , Estresse Psicológico/fisiopatologia , (trans)-Isômero de 3,4-dicloro-N-metil-N-(2-(1-pirrolidinil)-ciclo-hexil)-benzenoacetamida/farmacologia , Analgésicos não Narcóticos/farmacologia , Análise de Variância , Animais , Química Encefálica/efeitos dos fármacos , Castração , Maleato de Dizocilpina/farmacologia , Esquema de Medicação , Antagonistas de Aminoácidos Excitatórios/farmacologia , Feminino , Masculino , Camundongos , Ovariectomia , Progesterona/administração & dosagem , Tempo de Reação/efeitos dos fármacos , Receptores de N-Metil-D-Aspartato/antagonistas & inibidores , Receptores Opioides kappa/efeitos dos fármacos , Natação/psicologia
10.
J Urol ; 170(3): 1008-12, 2003 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12913760

RESUMO

PURPOSE: Existing animal models of visceral pain in the mouse are of limited practical usefulness since they are labor intensive or not visceral specific. Recently a rat model of cyclophosphamide (CP) cystitis was developed that requires only intraperitoneal injection and features inflammation confined to the bladder. We adapted this model for use in multiple mouse strains to investigate the genetic basis of variability in visceral nociception. MATERIALS AND METHODS: Outbred CD-1 mice and 12 inbred mouse strains were tested for behavioral changes induced by CP (0 to 300 mg/kg intraperitoneally). RESULTS: We noted that despite the absence of postural changes or abdominal crises in CD-1 mice, CP produced dose dependent decreases in voluntary locomotor activity unaccompanied by ataxia measured on the rotarod test; referred hyperalgesia of the tail base region but not of the hind paw, which was inhibited in dose dependent fashion by morphine (0 to 20 mg/kg); and bladder inflammation corresponding to these behavioral indices. Furthermore, the extent of hypolocomotion was genotype dependent across 12 inbred strains. CONCLUSIONS: The simple and automatable nature of CP cystitis using hypolocomotion as a dependent measure renders it an attractive model in which to investigate the genetic and physiological bases of visceral pain. Comparison of strain sensitivity to CP induced hypolocomotion with other nociceptive assays suggests that genes specific to visceral nociception may exist.


Assuntos
Cistite/fisiopatologia , Dor/fisiopatologia , Animais , Ciclofosfamida/efeitos adversos , Cistite/induzido quimicamente , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Masculino , Camundongos , Camundongos Endogâmicos , Medição da Dor
11.
J Pharmacol Exp Ther ; 305(2): 755-64, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12606637

RESUMO

Chromosomal loci containing genes affecting antinociceptive sensitivity to morphine have been identified, but virtually nothing is known about the genetic mediation of sensitivity to over-the-counter analgesics. Such knowledge would be of great clinical interest, as prodigious interindividual variability has been noted in the efficacy of these ubiquitously used drugs. In the present study, we assessed heritability and genetic correlations among three over-the-counter analgesics in mice of 12 inbred mouse strains on the 0.9% acetic acid (i.p.) writhing test. Analgesics included the centrally acting analgesic, acetaminophen (150 mg/kg, s.c.), and the nonsteroidal anti-inflammatory drugs (NSAIDs), indomethacin (40 mg/kg, s.c.) and lysine-acetylsalicylic acid (800 mg/kg, s.c.). Significant strain differences in sensitivity to each of the drugs were observed, with narrow-sense heritability estimates ranging from 23 to 45%. Similar strains were sensitive and resistant, respectively, to the two NSAIDs (r(s) = 0.64). In contrast, a completely different pattern of sensitivities was observed for acetaminophen, implying genetic dissociation (r(s) = 0.29 and 0.02) compared with the NSAIDs. Additional experiments were performed on two strains, C57BL/6 and DBA/2, with extreme sensitivities to acetaminophen. Plasma acetaminophen levels in these strains were not significantly different during the time of antinociception assessment, suggesting the existence of genetic factors affecting acetaminophen pharmacodynamics rather than pharmacokinetics.


Assuntos
Acetaminofen/farmacologia , Analgésicos não Narcóticos/farmacologia , Aspirina/análogos & derivados , Aspirina/farmacologia , Indometacina/farmacologia , Lisina/análogos & derivados , Lisina/farmacologia , Nociceptores/efeitos dos fármacos , Acetaminofen/farmacocinética , Ácido Acético , Analgésicos não Narcóticos/farmacocinética , Animais , Relação Dose-Resposta a Droga , Feminino , Temperatura Alta , Indometacina/farmacocinética , Masculino , Camundongos , Camundongos Endogâmicos , Medição da Dor/efeitos dos fármacos , Farmacogenética , Tempo de Reação/efeitos dos fármacos , Especificidade da Espécie
12.
J Pharmacol Exp Ther ; 304(2): 547-59, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12538806

RESUMO

The heritability of nociception and antinociception has been well established in the mouse. The pharmacogenetics of morphine analgesia are fairly well characterized, but far less is known about other analgesics. The purpose of this work was to begin the systematic genetic study of non-mu-opioid analgesics. We tested mice of 12 inbred mouse strains for baseline nociceptive sensitivity (49 degrees C tail-withdrawal assay) and subsequent antinociceptive sensitivity to systemic administration of (trans)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)-cyclohexyl]benzeneacetamide methane-sulfonate hydrate (U50,488; 10-150 mg/kg), a kappa-opioid receptor agonist; (R)-(+)-[2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]-1,4-benzoxazin-6-yl]-1-naphthalenylmethanone (WIN55,212-2; 0.5-480 mg/kg), a synthetic cannabinoid receptor agonist; epibatidine (7.5-150 microg/kg), a nicotinic receptor agonist; clonidine (0.1-5 mg/kg), an alpha(2)-adrenergic receptor agonist; and, for purposes of comparison, the prototypic mu-opioid receptor agonist, morphine (5-200 mg/kg). Robust interstrain variability was observed in nociceptive sensitivity and in the antinociceptive effects of each of the drugs, with extreme-responding strains exhibiting antinociceptive potencies differing up to 37-fold. Unexpectedly, we observed moderate-to-high genetic correlations of strain sensitivities to the five drugs (r = 0.39-0.77). We also found moderate-to-high correlations between baseline nociceptive sensitivity and subsequent analgesic response to each drug (r = 0.33-0.68). The generalizability of these findings was established in follow-up experiments investigating morphine and clonidine inhibition of formalin test nociception. Despite the fact that each drug activates a unique receptor, our results suggest that the potency of each drug is affected by a common set of genes. However, the genes in question may affect antinociception indirectly, via a primary action on baseline nociceptive sensitivity.


Assuntos
Analgésicos/farmacologia , Analgésicos/uso terapêutico , Medição da Dor/efeitos dos fármacos , Dor/genética , Analgésicos/química , Animais , Relação Dose-Resposta a Droga , Feminino , Masculino , Camundongos , Camundongos Endogâmicos A , Camundongos Endogâmicos AKR , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos CBA , Camundongos Endogâmicos DBA , Dor/tratamento farmacológico , Farmacogenética , Caracteres Sexuais , Especificidade da Espécie
13.
Proc Natl Acad Sci U S A ; 100(8): 4867-72, 2003 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-12663858

RESUMO

Sex specificity of neural mechanisms modulating nociceptive information has been demonstrated in rodents, and these qualitative sex differences appear to be relevant to analgesia from kappa-opioid receptor agonists, a drug class reported to be clinically effective only in women. Via quantitative trait locus mapping followed by a candidate gene strategy using both mutant mice and pharmacological tools, we now demonstrate that the melanocortin-1 receptor (Mc1r) gene mediates kappa-opioid analgesia in female mice only. This finding suggested that individuals with variants of the human MC1R gene, associated in our species with red hair and fair skin, might also display altered kappa-opioid analgesia. We found that women with two variant MC1R alleles displayed significantly greater analgesia from the kappa-opioid, pentazocine, than all other groups. This study demonstrates an unexpected role for the MC1R gene, verifies that pain modulation in the two sexes involves neurochemically distinct substrates, and represents an example of a direct translation of a pharmacogenetic finding from mouse to human.


Assuntos
Analgesia , Dor/genética , Receptores da Corticotropina/genética , Adolescente , Adulto , Alelos , Analgésicos Opioides/farmacologia , Animais , Feminino , Variação Genética , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Camundongos Mutantes , Dor/fisiopatologia , Pentazocina/farmacologia , Receptores da Corticotropina/fisiologia , Receptores de Melanocortina , Receptores Opioides kappa/efeitos dos fármacos , Caracteres Sexuais
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