Effects of Clonidine on Blood Pressure, Noradrenaline, Cortisol, Growth Hormone, and Prolactin Plasma Levels in High and Low Intestinal Tone Depressed Patients

Lechín, Fuad; Dijs, Bertha van der; Jakubowicz, Daniela; Camero, Rheyna; Villa, Simón; Arocha, Luis; Lechin, Alex E.

doi:10.1159/000124174

Cited by 42 publications

(12 citation statements)

References 23 publications

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“…The above phenomena are registered during the spastic colon period of the IBS. The fact that clonidine, a CNS-acting alpha-2 agonist that suppresses both neural and adrenal sympathetic overactivities by acting at the A5-NA and/or C1-Ad CNS nuclei, supports our postulation [87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102]. Both CNS nuclei are crowded by alpha-2 inhibitory receptors; hence, the drug would act at the hyperactive, but not at the hypoactive nucleus.…”

Section: Malignant Diseases Xsupporting

confidence: 62%

“…Finally, it should be known that both serotonergic nuclei interchange inhibitory axons. Summarizing the above, it has been established that whereas the DR-5HT + C1-Ad hyperactivity is responsible for the uncoping stress syndrome, the MR-5HT + A5-NA binomial predominates in patients affected by endogenous depression as well as in patients affected by neural sympathetic overactivity (essential hypertension, hyperinsulinism, rheumatoid arthritis, and all TH-1 autoimmune diseases) [3,24,[101][102][103][104][105]. At the gastrointestinal level, patients with reflux esophagitis [81,82] Figs.…”

Section: Malignant Diseases Xmentioning

confidence: 99%

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Central Nervous System Plus Autonomic Nervous System Disorders Responsible for Gastrointestinal and Pancreatobiliary Diseases

Lechín

Dijs

2008

Dig Dis Sci

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Clinical digestive disorders depend on the nonadequate coupling of functioning of the gastrointestinal tract with that of its affluent systems, namely, the pancreatic exocrine and the hepato-biliary secretions. The secretion of gastrointestinal hormones is monitored by the peripheral autonomic nervous system. However, the latter is regulated by the central nervous system (CNS) circuitry localized at the medullary pontine segment of the CNS. In turn, both parasympathetic and adrenergic medullary circuitries are regulated by the pontine A5 noradrenergic (NA) and the dorsal raphe serotonergic nuclei, respectively. DR-5HT is positively correlated with the C1-Ad medullary nuclei (responsible for adrenal gland secretion), whereas the MR-5HT nucleus is positively correlated with the A5-NA pontomedullary nucleus. The latter is responsible for neural sympathetic activity (sympathetic nerves). Both types of sympathetic activities maintain an alternation with the peripheral parasympathetic branch, which is positively correlated with the enterochromaffin cells that secrete serotonin. Serotonin displays hormonal antagonism to the circulating catecholamines.

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Section: Malignant Diseases Xsupporting

confidence: 62%

Section: Malignant Diseases Xmentioning

confidence: 99%

Central Nervous System Plus Autonomic Nervous System Disorders Responsible for Gastrointestinal and Pancreatobiliary Diseases

Lechín

Dijs

2008

Dig Dis Sci

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“…In effect, they present maximal GH increases as well as maximal CRT and diastolic blood pressure reductions when challenged with this alphas ago nist. This profile of response to clonidine is observed in stressed mammals and in humans [187][188][189].…”

Section: Plasma Neurotransm Ittersmentioning

confidence: 62%

Benzodiazepines: Tolerability in Elderly Patients

Lechín

Dijs

Benaim³

1996

Psychother Psychosom

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Aging is a physiological process that shares many behavioral, biochemical and neuroendocrine phenomena with the pathophysiological situation of unresolved stress, as well as with a pharmacologically induced snydrome resulting from chronic benzodiazepine (BZ) consumption. Behavioral findings include symptoms such as drowsiness, ataxia, fatigue, confusion, weakness, dizziness, vertigo, syncope, reversible dementia, depression, impairment of intellectual, psychomotor and sexual function, agitation, auditory and visual hallucinations, paranoid ideation, panic, delirium, depersonalization, sleepwalking, aggressivity, orthostatic hypotension, and insomnia. Neuroendocrine findings include: central depletion of noradrenaline (NA), dopamine, adrenaline (AD), and serotonin (5-HT); reduction in the ratio of circulating NA/AD as well as platelet 5-HT and increase of AD, plasma free 5-HT and cortisol. These disturbances together with the increased platelet aggregability observed in the three groups are typical of unresolved-stress situations. Immunological findings include significant reduction of peripheral T lymphocytes (CD3, CD4, CD8) and the CD4/CD8 ratio, CD 16 and gamma-delta cells. On the other hand, the three groups (elderly subjects, subjects faced with unresolved stress, and BZ consumers) show increase of the CD57 lymphocyte subset as well as natural killer cytotoxicity. Alterations of several biological markers have also been found, specifically in the oral glucose tolerance test, the intramuscular clonidine test, and the supine/orthostasis/exercise test. From a clinical point of view, the three groups appear to be more susceptible to the appearance and progression of many acute and chronic diseases (infectious and malignant diseases). As a result, chronic consumption of BZs should be avoided in both the elderly and subjects in unresolved-stress situations.

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“…Other neuroendocrinological findings demonstrated that whereas DR-5HT neurons are responsible for the acute release of prolactin, MR-5HT hyperactivity is found in mammals affected by hyperprolactinemia [90, 91]. This neuroendocrine disorder is responsible for mammary and ovary cysts, frequently observed in women affected by hyperinsulinism [92] and depression [93].…”

Section: Cns Circuitry Underlying the Hyperinsulinism Syndromementioning

confidence: 99%

Central Nervous System Circuitry Involved in the Hyperinsulinism Syndrome

Lechín¹,

Dijs²

2006

Neuroendocrinology

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Raised plasma levels of insulin, glucose and glucagon are found in patients affected by ‘hyperinsulinism’. Obesity, hypertension, mammary plus ovary cysts and rheumatic symptoms are frequently observed in these patients. Sleep disorders and depression are also present in most subjects affected by this polysymptomatic disorder. The simultaneous increases of glucose, insulin and glucagon plasma levels seen in these patients indicate that the normal crosstalk between A cells, B cells and D cells is disrupted. With respect to this, it is well known that glucose excites B cells (which secrete insulin) and inhibits A cells (which secrete glucagon), which in turn excites D cells (which secrete somatostatin). Gastrointestinal hormones (incretins) modulate this crosstalk both directly and indirectly throughout pancreatic and hepatobiliary mechanisms. The above factors depend on autonomic nervous system mediation. For instance, acetylcholine released from parasympathetic nerves excites both B and A cells. Noradrenaline released from sympathetic nerves and adrenaline secreted from the adrenal glands inhibit B cells and excite A cells, which are crowded with β₂- and α₂-receptors, respectively. Noradrenaline released from sympathetic nerves also excites A cells by acting at α₁-receptors located at this level. According to this, the excessive release of noradrenaline from these nerves should provoke an enhancement of glucagon secretion which will result in overexcitation of insulin secretion from B cells. That is the disorder seen in the so-called ‘hyperinsulinism’, in which raised plasma levels of glucose, insulin and glucagon coexist. Taking into account that neural sympathetic activity is positively correlated to the A5 noradrenergic nucleus and median raphe serotonergic neurons, and negatively correlated to the A6 noradrenergic, the dorsal raphe serotonergic and the C1 adrenergic neurons, we postulate that this unbalanced central nervous system circuitry is responsible for the hyperinsulinism syndrome.

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Effects of Clonidine on Blood Pressure, Noradrenaline, Cortisol, Growth Hormone, and Prolactin Plasma Levels in High and Low Intestinal Tone Depressed Patients

Cited by 42 publications

References 23 publications

Central Nervous System Plus Autonomic Nervous System Disorders Responsible for Gastrointestinal and Pancreatobiliary Diseases

Central Nervous System Plus Autonomic Nervous System Disorders Responsible for Gastrointestinal and Pancreatobiliary Diseases

Benzodiazepines: Tolerability in Elderly Patients

Central Nervous System Circuitry Involved in the Hyperinsulinism Syndrome

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