Unveiling a novel memory center in human brain: neurochemical identification of the nucleus incertus, a key pontine locus implicated in stress and neuropathology.

BACKGROUND: The nucleus incertus (NI) was originally described by Streeter in 1903, as a midline region in the floor of the fourth ventricle of the human brain with an 'unknown' function. More than a century later, the neuroanatomy of the NI has been described in lower vertebrates, but not in humans. Therefore, we examined the neurochemical anatomy of the human NI using markers, including the neuropeptide, relaxin-3 (RLN3), and began to explore the distribution of the NI-related RLN3 innervation of the hippocampus. METHODS: Histochemical staining of serial, coronal sections of control human postmortem pons was conducted to reveal the presence of the NI by detection of immunoreactivity (IR) for the neuronal markers, microtubule-associated protein-2 (MAP2), glutamic acid dehydrogenase (GAD)-65/67 and corticotrophin-releasing hormone receptor 1 (CRHR1), and RLN3, which is highly expressed in NI neurons in diverse species. RLN3 and vesicular GABA transporter 1 (vGAT1) mRNA were detected by fluorescent in situ hybridization. Pons sections containing the NI from an AD case were immunostained for phosphorylated-tau, to explore potential relevance to neurodegenerative diseases. Lastly, sections of the human hippocampus were stained to detect RLN3-IR and somatostatin (SST)-IR. RESULTS: In the dorsal, anterior-medial region of the human pons, neurons containing RLN3- and MAP2-IR, and RLN3/vGAT1 mRNA-positive neurons were observed in an anatomical pattern consistent with that of the NI in other species. GAD65/67- and CRHR1-immunopositive neurons were also detected within this area. Furthermore, RLN3- and AT8-IR were co-localized within NI neurons of an AD subject. Lastly, RLN3-IR was detected in neurons within the CA1, CA2, CA3 and DG areas of the hippocampus, in the absence of RLN3 mRNA. In the DG, RLN3- and SST-IR were co-localized in a small population of neurons. CONCLUSIONS: Aspects of the anatomy of the human NI are shared across species, including a population of stress-responsive, RLN3-expressing neurons and a RLN3 innervation of the hippocampus. Accumulation of phosphorylated-tau in the NI suggests its possible involvement in AD pathology. Further characterization of the neurochemistry of the human NI will increase our understanding of its functional role in health and disease.

Knee Laxities Changes with Sex-steroids throughout the Menstrual Cycle Phases in Athlete and Non-athlete Females / Mudanças na flacidez do joelho com esteroides sexuais durante as fases do ciclo menstrual em mulheres atletas e não atletas

Abstract Objective: Our study investigated changes of knee laxities in athletes and non-athletes females and relationship between knee laxity and sex-steroid at menstrual cycle phases. Methods: Forty six healthy females, twenty four athletes and twenty two non-athletes not on hormone contraceptive pills, had no previous knee injuries and with regular menstrual cycles for 3 consecutive months, participated in the study. Medial and lateral knee laxities were determined by varus-valgus tests at follicular, ovulatory and luteal phases. Serum level of relaxin, estrogen, progesterone and testosterone were determined by ELISA and radioimmunoassay. Results: Knee laxities in athletes and non-athletes at 0° and 20° flexion were the highest in luteal phase with non-athletes possess greater laxity than athletes. Positive correlation between progesterone and relaxin levels with knee laxities were observed. Meanwhile, the levels of both hormones were highest in the luteal phase. Conclusion: Increased medial and lateral knee laxities in athletes and non-athletes associated with high serum progesterone and relaxin levels in luteal phase may contribute toward increased risk of non-contact knee injury. However, lower knee laxity in athletes than non-athletes suggest that exercise could be a protective factor.

Resumo Objetivo: Nosso estudo investigou alterações na lassidão do joelho em atletas e não atletas do sexo feminino e a relação entre a lassidão do joelho e esteroides sexuais nas fases do ciclo menstrual. Métodos: Quarenta e seis mulheres saudáveis, vinte e quatro atletas e vinte e duas não atletas, sem uso de pílulas anticoncepcionais hormonais, sem lesões anteriores no joelho e com ciclos menstruais regulares por 3 meses consecutivos, participaram do estudo. A lassidão medial e lateral do joelho foi determinada por testes de varo-valgo nas fases folicular, ovulatória e lútea. Os níveis séricos de relaxina, estrógeno, progesterona e testosterona foram determinados por ensaio imunoenzi mático (ELISA) e radioimunoensaio. Resultados: A lassidão do joelho em atletas e não atletas em 0° e 20° de flexão foi maior na fase lútea; as não atletas apresentavam maior lassidão do que as atletas. Houve uma correlação positiva entre os níveis de progesterona e relaxina e a lassidão do joelho. Além disso, os níveis desses dois hormônios foram maiores na fase lútea. Conclusão: O aumento da lassidão medial e lateral do joelho em atletas e não atletas, associado a altos níveis séricos de progesterona e relaxina na fase lútea, pode contribuir para o aumento do risco de lesão sem contato no joelho. No entanto, a menor lassidão do joelho em atletas do que em não atletas sugere que o exercício pode ser um fator protetor.

Relaxin treatment stimulates the differentiation of mesenchymal stem cells into osteoblasts.

Background/purpose: Several studies have determined that relaxin stimulates differentiation and regulates the activity of mature osteoclasts, but little is known about its effect on the differentiation of mesenchymal cells towards the osteogenic lineage. Therefore, this study aimed to determine the effect of relaxin on the proliferation and differentiation of the osteoblastic lineage of mesenchymal cells derived from human dental pulp (hDPSC). Materials and methods: In this in vitro study, hDPSC were characterized and treated with relaxin at different doses (10-80 ng/ml) and times (1-21 days). Morphology was assessed by microscopy, and proliferation was assessed using a resazurin assay. Osteoblastic differentiation was evaluated by Alizarin Red staining, alkaline phosphatase (ALP) labeling, and changes in the expression of the osteoblastic differentiation genes RUNX2 and BMP2. Results: Relaxin treatment did not induce changes in the proliferation or viability of hDPSCs; however, larger cells and increased cytoplasmic prolongation were observed. Relaxin treatment (20 and 80 ng/ml) significantly increased calcified nodule formation on days 14 and 21. The cytochemical signals for ALP, RUNX2, and BMP2 gene expression were significantly (P < 0.05) increased by the relaxin treatment. Conclusion: Relaxin treatment does not induce changes in hDPSC proliferation but induces morphological changes, increases ALP detection, calcified nodule formation, and increases expression of RUNX2 and BMP2, suggesting the induction of osteoblastic differentiation of hDPSC.

Relaxin-2 during pregnancy according to glycemia, continence status, and pelvic floor muscle function.

INTRODUCTION AND HYPOTHESIS: To investigate relaxin-2 concentration comparing gestational diabetes mellitus (GDM) and non-GDM patients during pregnancy according to urinary incontinence (UI) and pelvic function status. METHODS: This is a cross-sectional study evaluating 282 pregnant women from 24 weeks of gestation. The participants were divided into two groups, non-GDM and GDM, according to American Diabetes Association's diabetes mellitus gestational threshold. In addition, according to subanalysis, both groups were subdivided according to the presence of pregnancy-specific urinary incontinence: non-GDM continent, non-GDM incontinent, GDM continent, and GDM incontinent. All participants filled in questionnaires on clinical, obstetric, and urinary continence status (International Consultation on Incontinence Questionnaire-Short Form, ICIQ-SF, and Incontinence Severity Index, ISI), followed by pelvic floor muscle evaluation by the PERFECT scheme in which strength, endurance, and speed of contractions were evaluated. RESULTS: Serum relaxin-2 concentrations were significantly lower in pregnant women with pregnancy-specific urinary incontinence in both non-GDM and GDM patients, but GDM showed the lowest concentration. In addition, the stratification of the groups according to pelvic floor muscle strength showed that pregnant patients with GDM and modified Oxford scale 0-2 had significantly lower levels than those who were non-GDM and GDM with Modified Oxford Scale 3-5. Relaxin-2 level was much lower in GDM incontinent pregnant women with MOS 0-2 compared to the other three groups. CONCLUSIONS: Lower relaxin-2 concentration was associated with the presence of pregnancy-specific urinary incontinence, but the combination of GDM, pregnancy-specific urinary incontinence, and lower levels of pelvic floor strength led to lower levels of relaxin-2 compared to the other three groups.

Preventive and therapeutic effects of relaxin on bisphosphonate related osteonecrosis of the jaw: an experimental study in rats / Efeitos preventivos e terapêuticos da relaxina na osteonecrose da mandíbula relacionada a bisfosfonatos: um estudo experimental em ratos

Objective: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a challenging complication of chronic bisphosphonate (BP) use. The hormone relaxin is able to induce the multistep differentiation process of human osteoclastogenesis, exhibits antifibrotic and anti-inflammatory actions, and promotes vasodilatation, wound healing, and angiogenesis. The present study aimed to evaluate the effects of relaxin in the prevention and management of BRONJ. Material and Methods: Thirty-six male Sprague Dawley rats were randomly divided into four groups. Rats in group 1 (n = 10) received relaxin and BP simultaneously for 12 weeks. Rats in group 2 (n = 10) received injections of BP for 12 weeks, followed by relaxin for another 12 weeks. Rats in group 3 (n = 10) received only BP injections, and those in group 4 (control, n = 6) received only saline. Necrosis and inflammation in the rats' mandibles were evaluated as indicators of BRONJ. Results: Necrosis and inflammation were not detected in group 1 (BP + relaxin). In group 3 (BP only), incidence rates of necrosis and inflammation were 90% and 60%, respectively. Conclusions: Our findings suggest that relaxin may be potently effective in preventing BRONJ and have some benefit in the treatment of existing BRONJ (AU)

Objetivo: A osteonecrose da mandíbula relacionada ao bisfosfonato (BRONJ) é uma desafiadora complicação do uso crônico de bisfosfonato (BP). O hormônio relaxina é capaz de induzir o processo múltiplo de diferenciação da osteoclastogênese humana, exibe ações anti-fibróticas e anti-inflamatórias e promove vasodilatação, cicatrização de feridas e angiogênese. O presente estudo teve como objetivo avaliar os efeitos da relaxina na prevenção e tratamento do BRONJ. Material e Métodos: Trinta e seis ratos Sprague Dawley machos foram divididos aleatoriamente em quatro grupos. Os ratos do grupo 1 (n = 10) receberam relaxina e BP simultaneamente por 12 semanas. Os ratos do grupo 2 (n = 10) receberam injeções de BP por 12 semanas, seguidos de relaxina por mais 12 semanas. Os ratos do grupo 3 (n = 10) receberam apenas injeções de BP e os do grupo 4 (controle, n = 6) receberam apenas solução salina. Necrose e inflamação nas mandíbulas dos ratos foram avaliadas como indicadores de BRONJ. Resultados: Necrose e inflamação não foram detectadas no grupo 1 (BP + relaxina). No grupo 3 (somente BP), as taxas de incidência de necrose e inflamação foram de 90% e 60%, respectivamente. Conclusões: Nossos resultados sugerem que a relaxina pode ser potentemente eficaz na prevenção do BRONJ e ter algum benefício no tratamento do BRONJ existente.(AU)

Placental contribution to the endocrinology of gestation and parturition.

In addition to many other functions, the placenta is a source of a vast number of autocrine, paracrine and endocrine factors. However, the spectrum of placental regulatory factors, their concentrations, gestational profiles and roles may differ considerably even between phylogenetically closely related species. Depending on the species, placental regulatory factors of a broad range of molecule classes have been found including (glyco-)proteins, peptides, steroids and prostaglandins. Local placental regulatory factors are especially important for the dialogue between the fetal and the maternal compartment immediately at the feto-maternal borderline and for the control of growth, differentiation and functions of the placenta itself. Moreover, placental hormones in a proper sense may also have effects in more remote targets within the maternal compartment, serving functions such as pregnancy-specific adaptations of maternal circulation, provision of hemotrophe to the fetus or the development and function of the mammary gland. Functions of placental hormones in the fetus proper are less clear but may be especially important before the establishment of a functional fetal endocrine system and near term within the highly species-specific networks of signals preparing and initiating parturition. This review takes a comparative view on the situation in different domestic animals focusing on ruminants and on placental hormones occurring at significant concentrations in the maternal circulation.

Placental contribution to the endocrinology of gestation and parturition

In addition to many other functions, the placenta is a source of a vast number of autocrine, paracrine and endocrine factors. However, the spectrum of placental regulatory factors, their concentrations, gestational profiles and roles may differ considerably even between phylogenetically closely related species. Depending on the species, placental regulatory factors of a broad range of molecule classes have been found including (glyco- )proteins, peptides, steroids and prostaglandins. Local placental regulatory factors are especially important for the dialogue between the fetal and the maternal compartment immediately at the feto-maternal borderline and for the control of growth, differentiation and functions of the placenta itself. Moreover, placental hormones in a proper sense may also have effects in more remote targets within the maternal compartment, serving functions such as pregnancy-specific adaptations of maternal circulation, provision of hemotrophe to the fetus or the development and function of the mammary gland. Functions of placental hormones in the fetus proper are less clear but may be especially important before the establishment of a functional fetal endocrine system and near term within the highly species-specific networks of signals preparing and initiating parturition. This review takes a comparative view on the situation in different domestic animals focusing on ruminants and on placental hormones occurring at significant concentrations in the maternal circulation.(AU)

Placental contribution to the endocrinology of gestation and parturition

In addition to many other functions, the placenta is a source of a vast number of autocrine, paracrine and endocrine factors. However, the spectrum of placental regulatory factors, their concentrations, gestational profiles and roles may differ considerably even between phylogenetically closely related species. Depending on the species, placental regulatory factors of a broad range of molecule classes have been found including (glyco- )proteins, peptides, steroids and prostaglandins. Local placental regulatory factors are especially important for the dialogue between the fetal and the maternal compartment immediately at the feto-maternal borderline and for the control of growth, differentiation and functions of the placenta itself. Moreover, placental hormones in a proper sense may also have effects in more remote targets within the maternal compartment, serving functions such as pregnancy-specific adaptations of maternal circulation, provision of hemotrophe to the fetus or the development and function of the mammary gland. Functions of placental hormones in the fetus proper are less clear but may be especially important before the establishment of a functional fetal endocrine system and near term within the highly species-specific networks of signals preparing and initiating parturition. This review takes a comparative view on the situation in different domestic animals focusing on ruminants and on placental hormones occurring at significant concentrations in the maternal circulation.

Evolution of the relaxin/insulin-like gene family in anthropoid primates.

The relaxin/insulin-like gene family includes signaling molecules that perform a variety of physiological roles mostly related to reproduction and neuroendocrine regulation. Several previous studies have focused on the evolutionary history of relaxin genes in anthropoid primates, with particular attention on resolving the duplication history of RLN1 and RLN2 genes, which are found as duplicates only in apes. These studies have revealed that the RLN1 and RLN2 paralogs in apes have a more complex history than their phyletic distribution would suggest. In this regard, alternative scenarios have been proposed to explain the timing of duplication, and the history of gene gain and loss along the organismal tree. In this article, we revisit the question and specifically reconstruct phylogenies based on coding and noncoding sequence in anthropoid primates to readdress the timing of the duplication event giving rise to RLN1 and RLN2 in apes. Results from our phylogenetic analyses based on noncoding sequence revealed that the duplication event that gave rise to the RLN1 and RLN2 occurred in the last common ancestor of catarrhine primates, between ∼ 44.2 and 29.6 Ma, and not in the last common ancestor of apes or anthropoids, as previously suggested. Comparative analyses based on coding and noncoding sequence suggests an event of convergent evolution at the sequence level between co-ortholog genes, the single-copy RLN gene found in New World monkeys and the RLN1 gene of apes, where changes in a fraction of the convergent sites appear to be driven by positive selection.

Cultura de células da granulosa humanas com fenótipo de fase folicular: influência do sistema quimicamente definido na morfologia, ultraestrutura, secreção de esteroides e relaxina / Culture of human granulosa cells with follicular phase phenotype:influence of chemically defined system on morphology, ultrastructure,secretion of steroids and relaxin

Está bem descrito na literatura o padrão de cultivo de células da granulosa (CG) humanas que perpetua a luteinização, simulando a fase lútea do ciclo. Nesse sistema, há redução na secreção de estradiol (E2) e aumento na síntese de progesterona (P4) e relaxina (RLN). Objetivamos padronizar um sistema de cultura livre de soro, com o intuito de reverter o processo de luteinização de CG obtidas em ciclos de fertilização in vitro (FIV), pré-luteinizadas pela gonadotrofina coriônica humana (hCG), para aplicação na maturação in vitro de folículos ovarianos pré-antrais. Foi feito estudo experimental com GC obtidas de 10 mulheres em tratamento de reprodução assistida. As CG foram cultivadas em α-MEM contendo IGF-I, ITS, androstenediona, PVP-40 (meio quimicamente definido) ou TCM-199 contendo FSH/soro. Após 48, 96 e 144 horas, foram avaliados: morfologia das culturas, produção de E2, P4 (Quimioluminescência/Immulite), RLN (Elisa) e ultraestrutura (Microscopia Eletrônica). Os dados foram analisados por Anova e regressão linear com efeitos mistos (SAS versão 9.0). Células cultivadas em α-MEM apresentam alta capacidade estrogênica e padrão de produção hormonal característico da fase folicular, mantendo características morfológicas/ultraestruturais semelhantes a células in vivo. No sistema de cultura padronizado, as CG não completam in vitro o processo de luteinização deflagrado pela hCG, assumindo fenótipo de fase folicular.

It is well described in the literature the granulosa cells (GC) culture pattern that perpetuates human luteinizing simulating the luteal phase of the cycle. In this system, there is a reduction in the secretion of estradiol (E2) and increased synthesis of progesterone (P4) and relaxin (RLN). We aim to standardize a serum-free culture system, in order to reverse the luteinization process of GC obtained in IVF cycles, pre-luteinized by hCG, for use in in vitro maturation of preantral ovarian follicles. An experimental study was conducted with GC obtained from10 women undergoing treatment for assisted reproduction. The GC were cultured in α-MEM containing IGF-I, STI, androstenedione, PVP-40 (chemically defined medium) or TCM-199 containing FSH/serum. After 48, 96 and 144 h were analyzed: culture morphology, concentrations of E2, P4 (Chemioluminescence/Immulite), and RLN (Elisa), and ultrastructure (ElectronMicroscopy). Data were analyzed by Anova and linear mixed-effects regression (SAS version9.0). Cells cultured in α-MEM present estrogenic capacity and pattern of hormone production characteristic of the follicular phase, maintaining morphological/ultrastructural features similar that in vivo cell. In standard culture system, the CG not completes in vitro luteinization process triggered by hCG, assuming follicular phase phenotype.

Avaliação clínica de uma formulação de uso tópico como auxiliar na prevenção de estrias na gestação / Clinical evaluation of a topical formulation to help prevent stretch marks during pregnancy

Introdução: As estrias ocorrem pelo rápido estiramento da pele, típico da gestação. Tratamentos tópicos vêm sendo estudados para prevenir seu aparecimento. Objetivo: avaliar a eficácia preventiva de estrias de uma formulação tópica. Métodos: Avaliaram-se 75 gestantes entre 18 e 40 anos. A área tratada foi o abdome, e a área-controle, a face interna do antebraço, com e sem o produto de teste, avaliando-se: maciez, hidratação e elasticidade além de medidas biofísicas para elasticidade e hidratação. Resultados: Das 75 gestantes, 52 finalizaram o estudo; destas, 9,6% apresentaram estrias na área abdominal tratada. Houve melhora significativa em os todos parâmetros clínicos avaliados (p<0,001). Nas medidas instrumentais, houve melhora significativa da hidratação e elasticidade na área abdominal, superior à da área-controle; quanto ao antebraço, também houve melhora significativa da área tratada em relação ao controle para ambos os parâmetros avaliados (p = 0,001). Comentários e Conclusão: A associação dos ingredientes da formulação (ácido láctico e lactato de sódio em emulsão com triglicerídeos do ácido caprílico e cáprico) foi capaz de aumentar os níveis de elasticidade e hidratação, reduzindo a incidência de estrias em comparação ao relatado em literatura.

Introduction: Stretch marks occur due to the rapid stretching of the skin, which is typical in pregnancy. Several topical treatments to prevent them have been studied.Objective: To evaluate the effectiveness of a topical formulation (lactic acid and sodium lactate in an emulsion with caprylic and capric acids' triglycerides) in the prevention of stretch marks.Methods: Seventy-five pregnant women aged 18-40 were assessed. The treated area was the abdomen and the control area was the inner forearm, with and without the application of the tested product. Softness, hydration, and elasticity ­ and biophysical measurements for hydration and elasticity ­ were evaluated. Results: Of the 52 women who completed the study, 9.6% presented stretch marks in the treated abdominal area. There was a significant improvement in all clinical parameters assessed (p < 0.001). There was a significant improvement ­ compared the control area ­ in the instrumental measurements of hydration and elasticity in the abdomen. A significant improvement was also verified in the treated forearm area compared to the untreated forearm area for both parameters evaluated (p = 0.001).Conclusions: The formulation improved the skin's elasticity and hydration, reducing the striae incidence more than previously reported in the literature.

Relaxin in the male reproductive system

xin (RLN) belong s to a family of hormones structurally related to insulin and presents a broad spectrum of actions. H umans have three forms of RLN , encoded by three different genes ( RLN1 , RLN2 and RLN3 ) , but nonprimate vertebrate s have only two forms of relaxin (RLN1 and RLN3) . RLN1 of these animals is encoded by Rln1 , orthologous to the h uman RLN 2 gene , and both genes , Rln1 and human RLN2 , encode the major form of relaxin found in the male reproductive system . In the reproductive tract of human male s , RLN is mainly produced by the prostate and secreted into the seminal fluid, where it seems to play a role in sperm function. R LN may also play a role in prostate cancer progression. A lack of RLN in animal models impairs male fertili ty , and RLN knockout mice display decreased sperm maturation . T he precise role of RLN in the male reproductive system , however , is still far from clear. RLN actio n is due to its interaction with the G - protein coupled receptor RXFP1. Studies from our labora tory have shown that RLN and RXFP1 are e x pressed in rat Sertoli cells, and e x ogenous RLN stimulates Sertoli cell proliferation. RLN receptors can also be detected in rat germ cells at different stages of development, suggesting that RLN may play a direct r ole in spermatogenesis. The distribution of RLN/RXFP1 , however , appears to be species - dependent, because i n the boar testis RLN production seems restricted to the Leydig cells, whereas RXFP1 is found in Leydig, Sertoli and germ cells. The co - expression of RLN and RXFP1 in several regions of the male reproductive system suggest s that the peptide may act in an autocrine/paracrine fashion.

Relaxin in the male reproductive system

xin (RLN) belong s to a family of hormones structurally related to insulin and presents a broad spectrum of actions. H umans have three forms of RLN , encoded by three different genes ( RLN1 , RLN2 and RLN3 ) , but nonprimate vertebrate s have only two forms of relaxin (RLN1 and RLN3) . RLN1 of these animals is encoded by Rln1 , orthologous to the h uman RLN 2 gene , and both genes , Rln1 and human RLN2 , encode the major form of relaxin found in the male reproductive system . In the reproductive tract of human male s , RLN is mainly produced by the prostate and secreted into the seminal fluid, where it seems to play a role in sperm function. R LN may also play a role in prostate cancer progression. A lack of RLN in animal models impairs male fertili ty , and RLN knockout mice display decreased sperm maturation . T he precise role of RLN in the male reproductive system , however , is still far from clear. RLN actio n is due to its interaction with the G - protein coupled receptor RXFP1. Studies from our labora tory have shown that RLN and RXFP1 are e x pressed in rat Sertoli cells, and e x ogenous RLN stimulates Sertoli cell proliferation. RLN receptors can also be detected in rat germ cells at different stages of development, suggesting that RLN may play a direct r ole in spermatogenesis. The distribution of RLN/RXFP1 , however , appears to be species - dependent, because i n the boar testis RLN production seems restricted to the Leydig cells, whereas RXFP1 is found in Leydig, Sertoli and germ cells. The co - expression of RLN and RXFP1 in several regions of the male reproductive system suggest s that the peptide may act in an autocrine/paracrine fashion.(AU)

Métodos farmacológicos de indução do trabalho de parto: qual o melhor? / Pharmacological methods for induction of labor: what's the best?

A indução do parto consiste em estimular artificialmente as contrações uterinas coordenadas e efetivas antes de seu início espontâneo, levando ao desencadeamento do trabalho de parto em mulheres que ultrapassaram a 22ª semana de gravidez. A antecipação do parto pode ser necessária em diversas situações obstétricas, como gestação prolongada, diabetes, ruptura prematura das membranas e pré-eclâmpsia. Estima-se que mais de 15% de todas as gestantes apresentem alguma indicação de indução do parto. Vários métodos de indução do parto são propostos, tanto naturais como artificiais e, dentre estes, os métodos farmacológicos merecem especial destaque. Realizou-se uma revisão da literatura baseada nos melhores níveis de evidências e considerando os graus de recomendação. De acordo com a literatura, a utilização de estrogênio, propranolol, relaxina, mefepristone e hialuronidade não deve ser estimulada por não existirem evidências suficientes para a sua recomendação. O seu uso, portanto, deve ser limitado a protocolos de pesquisas. Ocitocina é um método de indução efetivo que pode ser usado em pacientes com ruptura das membranas amnióticas. Prostaglandinas (PG) e misoprostol (um éster sintético da PGE1) são efetivos para a indução do parto independentemente da integridade das membranas. Prostaglandinas devem ser administradas preferencialmente por via vaginal. Habitualmente, o misoprostol é preferido devido a questões práticas, como o baixo custo e a facilidade de administração e estocagem. Doses baixas de misoprostol devem ser utilizadas e a atualmente recomendada é de 25 g a cada 4 ou 6 horas. Tanto a via oral como a via vaginal podem ser utilizadas.

Induction of labor consists of stimulation of effective and coordinated uterine contractions before their spontaneous onset for the purpose of bring on labor in women who have surpassed the 22nd week of pregnancy. In several obstetrical situations, such as prolonged pregnancy, diabetes, premature rupture of membranes and preeclampsia, anticipation of labor and delivery may be necessary. It is estimated that more than 15% of all pregnant women eventually present any indication for induction of labor. Several natural and artificial methods for induction are proposed. Among them, pharmacological methods are the most relevant. A literature review was carried out based on the highest levels of evidence and on the grade of recommendations. According to the literature, the use of estrogens, relaxin, mifepristone and hyaluronidade should not be stimulated because there are not enough evidences for their recommendation, so their utilization should be limited to research protocols. Oxytocin is an effective method for induction of labor that may be used in patients with ruptured membranes. On the other hand, prostaglandins and misoprostol (a prostaglandin E1 analog) are effective for induction of labor independently on the membrane integrity. Vaginal administration should be preferred for prostaglandins. Misoprostol is habitually preferred due to practical questions, such as low cost and facility for storage and administration. Low doses of misoprostol should be used, and the currently recommended dose is 25 g every four or six hours. Both vaginal and oral routes of administration can be used.

Gestação e predisposição ao aparecimento de estrias: correlação com as propriedades biomecânicas da pele / Pregnancy and predisposition to striae: correlation with the skin's biomechanical properties

Introdução: O aparecimento de estrias na gestação está relacionado à ruptura de fibras colágenas e elásticas, devido à distensão da pele.As estruturas dérmicas que promovem a distensão e se rompem causando o aparecimento de estrias são também as responsáveis pelas propriedades biomecânicas da pele, como firmeza e elasticidade.A gestação parece propiciar a modificação desses parâmetros, com a finalidade de facilitar a distensão da pele, gerando, portanto, correlação entre esses parâmetros e a possibilidade de formação de estrias durante a gravidez. Objetivo: Detectar a correlação entre a ocorrência de estrias e a capacidade de aumentar a elasticidade dérmica. Métodos: Foram acompanhadas 60 gestantes visando investigar o aparecimento de estrias, bem como medir a firmeza e elasticidade da pele com o equipamento Cutometer® MPA 580.Resultados: Foi observada correlação positiva entre o aumento de elasticidade e a não ocorrência de estrias. Conclusões: Existe possível correlação entre o aparecimento de estrias e a capacidade de aumentar a elasticidade dérmica.

Introduction: Striae in pregnancy are caused by the rupture of collagen and elastic fibers, due to the distension of the skin.The dermal structures that allow the skin to expand – being responsible for the biomechanical properties of the skin such as firmness and elasticity – when ruptured, cause striae. Since pregnancy seems to change these properties in order to facilitate skin distension, there is a correlation between those parameters and the occurrence of striae during pregnancy. Objective: To investigate the correlation between the occurrence of striae and the skin's capacity to increase its elasticity. Methods: Skin firmness and elasticity was measured with a Cutometer MPA 580® device in order to investigate the occurrence of striae in 60 pregnant women. Results: A positive correlation between increased elasticity and the absence of striae was observed. Conclusions: There is a possible correlation between the occurrence of striae and the skin's capacity to increase dermal elasticity.

Expression and function of G-protein-coupled receptorsin the male reproductive tract

This review focuses on the expression and function of muscarinic acetylcholine receptors (mAChRs), α1-adrenoceptors and relaxin receptors in the male reproductive tract. The localization and differential expression of mAChR and α1-adrenoceptor subtypes in specific compartments of the efferent ductules, epididymis, vas deferens, seminal vesicle and prostate of various species indicate a role for these receptors in the modulation of luminal fluid composition and smooth muscle contraction, including effects on male fertility. Furthermore, the activation of mAChRs induces transactivation of the epidermal growth factor receptor (EGFR) and the Sertoli cell proliferation. The relaxin receptors are present in the testis, RXFP1 in elongated spermatids and Sertoli cells from rat, and RXFP2 in Leydig and germ cells from rat and human, suggesting a role for these receptors in the spermatogenic process. The localization of both receptors in the apical portion of epithelial cells and smooth muscle layers of the vas deferens suggests an involvement of these receptors in the contraction and regulation of secretion.

Esta revisão enfatiza a expressão e a função dos receptores muscarínicos, adrenoceptores α1 e receptores para relaxina no sistema reprodutor masculino. A expressão dos receptores muscarínicos e adrenoceptores α1 em compartimentos específicos de dúctulos eferentes, epidídimo, ductos deferentes, vesícula seminal e próstata de várias espécies indica o envolvimento destes receptores na modulação da composição do fluido luminal e na contração do músculo liso, incluindo efeitos na fertilidade masculina. Além disso, a ativação dos receptores muscarínicos leva à transativação do receptor para o fator crescimento epidermal e proliferação das células de Sertoli. Os receptores para relaxina estão presentes no testículo, RXFP1 nas espermátides alongadas e células de Sertoli de rato e RXFP2 nas células de Leydig e germinativas de ratos e humano, sugerindo o envolvimento destes receptores no processo espermatogênico. A localização de ambos os receptores na porção apical das células epiteliais e no músculo liso dos ductos deferentes de rato sugere um papel na contração e na regulação da secreção.