title: Drug-induced activation of the nervous control of inflammation: a novel possibility for the treatment of hypoxic damage.
abstract: Together with undernutrition and, on the opposite, overeating and obesity, sudden tissue hypoperfusion is the most important cause of mortality and disability worldwide. Tissue hypoperfusion/hypoxia rapidly triggers an unrestrained inflammatory cascade that is the main responsible for the severity of the eventual outcome. The brain plays a key role in inflammation, either through activation of the hypothalamic-pituitary-adrenal humoral response or through activation of the vagal "cholinergic anti-inflammatory pathway". Both humoral and nervous brain responses to inflammation are under the regulatory control of melanocortins, which have moreover a direct anti-inflammatory effect on inflammatory cells. Abundant experimental and clinical evidence indicates that MC(3)/MC(4) melanocortin receptor agonists and cholinergic receptor agonists (mainly at the α7-nicotinic subtype) should by now be considered as completely innovative, effective drugs for the treatment of hypoxic conditions; melanocortin agonists being practically devoid of harmful side effects.
authors.affiliation: Division of Clinical Pharmacology, Department of Diagnostic Services, School of Medicine, University of Modena and Reggio Emilia, Largo del Pozzo 71, 41100 Modena, Italy. alfio.bertolini@unimore.it
authors.forename: Alfio
authors.initials: A
authors.lastname: Bertolini
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects* / Q000502:physiology; D018679:Cholinergic Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy* / Q000503:physiopathology*; D007249:Inflammation / Q000188:drug therapy*; D018836:Inflammation Mediators / Q000502:physiology; D053486:Melanocortins / Q000494:pharmacology / Q000627:therapeutic use*; D044101:Receptors, Melanocortin / Q000819:agonists; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology
chemical_list: D000893:Anti-Inflammatory Agents; D018679:Cholinergic Agonists; D018836:Inflammation Mediators; D053486:Melanocortins; D044101:Receptors, Melanocortin