Lactóxeno placentario humano

Estrutura cristalina do HPL.[1]

O lactóxeno placentario humano (HPL) ou somatomamotropina coriónica humana, é unha hormona polipeptídica producida pola placenta.[2] A súa estrutura é similar á hormona do crecemento humana. A súa función consiste en modificar o metabolismo das mulleres durante o embarazo para facilitar a subministración de enerxía ao feto.[2] O HPL ten propiedades anti-insulina.[3] Catro horas despois do parto e expulsión da placenta, o HPL no plasma sanguíneo volve a valores indetectables.[4]

Estrutura

O lactóxeno placentario humano está formado por 190 aminoácidos que establecen entre eles dúas pontes disulfuro e contén 8 hélices.[3] O seu peso molecular é de 22.125 Da. Como a hormona do crecemento, o HPL é codificado por xenes situados no cromosoma 17 (locus 17q22-24). A súa vida media é de 15 minutos. A hormona describiuse por primeira vez en 1963.[5] A estrutura cristalina do HPL foi determinada por difracción de raios X a unha resolución de 2,0 Å.[6]

Niveis

É secretado polo sincitiotrofoblasto e placenta. O lactóxeno placentario humano só está presente durante o embarazo e os niveis sanguíneos son proporcionais ao crecemento do feto e a placenta. Os niveis máximos atínguense cara ao final da xestación, usualmene con valores de 5–7 mg/L. En embarazos múltiples os niveis desta hormona son máis elevados. Pequenas cantidades penetran na circulación fetal.

Funcións

En ensaios biolóxicos o HPL imita a acción da prolactina, pero aínda non está claro se posúe un papel na lactación.

O HPL afecta o metabolismo da xestante; produce un aumento da resistencia ao efecto da insulina,[3] aumentado os niveis sanguíneos de glicosa, con diminución da captación desta polo organismo da nai, o que produce unha maior dispoñibilidade de glicosa para a nutrición fetal.[2] O HPL induce a lipólise coa liberación de ácidos graxos. Por medio deste mecanismo a nai utiliza como combustible, en parte, os ácidos graxos en lugar de glicosa, entanto que o feto ten á súa disposición unha maior proporción relativa de glicosa. Os corpos cetónicos produto do metabolismo dos ácidos graxos poden pasar a barreira placentaria e poden ser usados polo feto. Estes axustes permiten garantir a nutrición fetal aínda en casos de malnutrición materna.

Esta hormona ten unha acción semellante á da hormona do crecemento na formación de proteínas, aínda que a acción é feble, requiríndose 100 veces máis cantidade de HPL para igualar o efecto da hormona do crecemento.[7]

Uso clínico

Os niveis de HPL utilizáronse como indicador dun crecemento correcto e benestar fetal; porén, outros métodos de avaliación máis modernos demostraron ser máis fiables. Hai informes de embarazos normais con niveis maternos indetectables de HPL.

Demostrouse que o lactóxeno placentario humano pode servir como marcador tumoral debido a que as células se tinguen ben para o HPL.[8]

Notas

  1. Walsh ST, Kossiakoff AA (2006). "Crystal structure and site 1 binding energetics of human placental lactogen". J. Mol. Biol. 358 (3): 773–84. PMID 16546209. doi:10.1016/j.jmb.2006.02.038. 
  2. 2,0 2,1 2,2 W. D. Larsen, W. J. Larsen (2002). Embriología humana. Elsevier, España. p. 490. ISBN 848174655X. 
  3. 3,0 3,1 3,2 G. Avery, Mary Ann Flechter (2001). Neonatologia- Fisiopatologia (5ta ed.). Ed. Médica Panamericana. p. 132. ISBN 848174655X. 
  4. Ramsay, Margaret M. (2001). Guía de valores normales durante el embarazo. Elsevier, España. p. 60. ISBN 8481745731. 
  5. Josimovich JB, Atwood BL, Goss DA (1963). "Luteotrophic, Immunologic and Electrophoretic Properties of Human Placental Lactogen.". Endocrinology (1963) Vol. 73, No. 4 410-420 73: 410. doi:10.1210/endo-73-4-410. 
  6. PDB 1Z7C; Walsh ST, Kossiakoff AA (May 2006). "Crystal structure and site 1 binding energetics of human placental lactogen". J. Mol. Biol. 358 (3): 773–84. doi:10.1016/j.jmb.2006.02.038. PMID 16546209
  7. Guyton and Hall (2005). Textbook of Medical Physiology (en inglés) (11 ed.). Philadelphia: Saunders. p. 1033. ISBN 81-8147-920-3. 
  8. A. Celorio, Calero A. Armas (1986). Fundamentos de oncología ginecológica. Ediciones Díaz de Santos. p. 453. ISBN 8486251494. 

Véxase tamén

Bibliografía

  • Speroff L, Glass RH, Kase NG. Clinical Gynecologic Endocrinology and Infertility. Sixth edition. Lippincott Williams & Wilkins, Baltimore, MD 1999. ISBN 0-683-30379-1.

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