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Tuesday 16 March 2010
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Reason to cheer
Dr Leelavathi Devadas

It’s really hard to believe that many of the medicines we need are produced in our own body.

A good example of this is insulin, but there are umpteen others like prostaglandins. The discovery of this versatile arrow in our therapeutic quiver is in its 75th year now.

One day, Von Euler of Sweden was in his research laboratory. While he was intently watching a piece of colonic tissue dipped into a receptacle containing human seminal fluid, the genius was taken aback. He observed the tiny blood vessels in the tissue exhibiting rhythmic contractions and relaxations.

‘Surely there must be some special chemical in the semen which is provoking these reactions in those blood vessels,’ he thought. He then promptly proceeded to isolate it, and when he did, named the new substance, prostaglandin, mistakenly thinking it to be produced in the prostate gland.

This wrong impression was later corrected, but the original name stuck.

Thirty years elapsed before scientists found out that prostaglandins were the end product-fatty acids in the chain of events starting from linoleic acid and passing on to arachidonic acid.

There is a host of subtypes in prostaglandins; the semen itself contains more than 15 of them.

Prostaglandins are ubiquitous in our body — there is no organ without them. But, they don’t get accumulated anywhere except in semen. Whenever there is any stimulus anywhere in the body, the cells there promptly produce prostaglandins in their cell walls. Prostaglandins can easily be branded ‘local hormones’!

How they help

But then, why do we need prostaglandins at all? Read on:

Human serum collects prostaglandins in sizeable quantities. There they play a momentous role in the movement of sperm. Prostaglandins are also needed for testosterone (male hormone) production. Their most significant function is in helping a sperm unite successfully with the ovum (egg).The woman is likely to remain childless if prostaglandin level is low in her male partner.

The big question facing us, namely, why and how labour pains start at a particular moment, has almost found an answer now. It has been proved that prostaglandins indirectly have a hand in initiating labour contractions. They also help in softening the cervix (neck of the uterus), a process which is absolutely essential for normal progress of labour.

Prostaglandins are necessary for the production of antibodies. These enable us to fight against harmful germs and infections.

There cannot be normal coagulation (clotting) of blood sans prostaglandins.
Prostaglandins have the capacity to dilate blood vessels, thereby lowering the blood pressure in the individual.

Indeed, this wonderful family of prostaglandins has octopus-like capabilities which help us in various ways:

1. We utilise prostaglandins while treating cases of infertility.

2. Whenever labour pains do not start naturally on time, prostaglandins are exhibited to initiate them.

3. When the uterine contractions get into a state of inertia, progress halts and the health of the mother and child is in jeopardy. In order to subvert this danger, prompt use of prostaglandins, in selected cases, will be life-saving.

4. In order to facilitate satisfactory dilatation of the uterine cervix, this part of the womb must get soft and dilatable. When this does not happen for various reasons, prostaglandins are either placed in the vagina in the form of pessaries or they are injected into the cervical wall.

5. Prostaglandins have saved the lives of countless women by controlling the profuse bleeding from the uterus after the delivery of the baby. This dangerous complication is an emergency and can be reined in by using prostaglandins. The lax uterus is thus made to contract and constrict the blood vessels running through its network of muscle fibres. This invariably makes the bleeding stop.

6. Prostaglandins like Misopristol are used along with Mifepristone (RU486) in terminating unwanted pregnancies.

Prostaglandins are indeed a generous gift to women at large. But, as in all drugs, we should remember that prostaglandins are to be judiciously used and in proper dosage. Only experts must handle them.
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