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International Journal of Endocrinology
Volume 2011 (2011), Article ID 350546, 8 pages
http://dx.doi.org/10.1155/2011/350546
Review Article

The Oxytocin-Oxytocin Receptor System and Its Antagonists as Tocolytic Agents

12nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens Medical School, 11526 Athens, Greece
21st Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens Medical School, 11526 Athens, Greece
3Department of Obstetrics and Gynaecology, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece

Received 31 July 2011; Accepted 25 September 2011

Academic Editor: A. Marette

Copyright © 2011 Nikolaos Vrachnis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Oxytocin, a hormone involved in numerous physiologic processes, plays a central role in the mechanisms of parturition and lactation. It acts through its receptor, which belongs to the G-protein-coupled receptor superfamily, while Gq/phospholipase C (PLC)/inositol 1,4,5-triphosphate (InsP3) is the main pathway via which it exerts its action in the myometrium. Changes in receptor levels, receptor desensitization, and locally produced oxytocin are factors that influence the effect of oxytocin on uterine contractility in labor. Activation of oxytocin receptor causes myometrial contractions by increasing intracellular Ca+2 and production of prostaglandins. Since oxytocin induces contractions, the inhibition of its action has been a target in the management of preterm labor. Atosiban is today the only oxytocin receptor antagonist that is available as a tocolytic. However, the quest for oxytocin receptor antagonists with a better pharmacological profile has led to the synthesis of peptide and nonpeptide molecules such as barusiban, retosiban, L-368,899, and SSR-126768A. Many of these oxytocin receptor antagonists are used only as pharmacological tools, while others have tocolytic action. In this paper, we summarize the action of oxytocin and its receptor and we present an overview of the clinical and experimental data of oxytocin antagonists and their tocolytic action.