Folia medica Cracoviensia
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Folia medica Cracoviensia · Jan 2005
[The role of melanocortin peptides in the cardiovascular regulation in haemorrhagic shock].
The central neuronal systems associated with cardiovascular regulation in haemorrhagic shock can be functionally divided into two groups. The first one includes opioid peptides, which inhibit the activity of cardiovascular centre neurones and initiate the sympathoinhibitory phase of regulation in hypovolaemia. The second group consists of non-opioid systems demonstrating anti-shock properties, such as the melanocortinergic. cholecystokininergic, thyreoliberinergic, cholinergic and histaminergic systems. ⋯ The mechanisms of their action include centrally mediated activation of the sympathetic nervous system and the "cholinergic anti-inflammatory pathway". which leads to an increase in the peripheral resistance and suppression of the transcription nuclear factor appaB-dependent systemic inflammatory response. respectively. Moreover, acting peripherally, the melanocortins stimulate secretion of glucocorticoids, normalise the blood levels of nitric oxide and inhibit free radical generation in haemorrhagic shock. Further clinical studies are needed to confirm the usefulness of the melanocortins in the treatment of haemorrhagic shock in humans.