Antagonistas de receptores de progesterona (PRA) y moduladores selectivos de receptores de progesterona (SPRM): aplicaciones en ginecología y obstetricia
DOI:
https://doi.org/10.18597/rcog.428Palabras clave:
receptores de progesterona, antiprogestina, mifepristone, asoprisnil, aborto, miomatosis, endometriosis, anticoncepción de emergenciaResumen
Dos décadas de estudio bioquímico, farmacológico y clínico han permitido la síntesis de antagonistas del receptor de la progesterona (PRA) y moduladores selectivos de receptores de progesterona (SPRM).El receptor de progesterona (PR) comparte la estructura de los receptores esteroideos que al ser estimulados sufren un cambio conformacional y subsecuentemente activan la transcripción genética en un tejido específico. Dicho proceso depende, particularmente en el PR, del equilibrio existente entre coactivadores y correpresores que ya han sido identificados. El mifepristone ha sido catalogado como PRA, mientras que el asoprisnil es el clásico SPRM agonista-antagonista. Múltiples estudios experimentales y clínicos han evidenciado la utilidad de los PRA y los SPRM en escenarios clínicos tan comunes como la miomatosis uterina, la endometriosis, la terminación del embarazo y la anticoncepción. Sin embargo, aún no existe la molécula ideal y faltan estudios que respalden la seguridad y eficacia de mifepristone y asoprisnil a largo plazo. El objetivo del presente documento es revisar la farmacodinamia y usos clínicos de estos medicamentos en ginecología y obstetricia.Biografía del autor/a
Diana Marcela Suárez-Calderón
Ivonne Díaz-Yamal
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Derechos de autor 2016 Revista Colombiana de Obstetricia y Ginecología
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