Background. We investigated the occluded essential vessel tributaries, both arterial and venous, occluded superior mesenteric vein and artery in rats, consequent noxious syndrome, peripherally and ...centrally. As therapy, we hypothesized the rapidly activated alternative bypassing pathways, arterial and venous, and the stable gastric pentadecapeptide BPC 157 since it rapidly alleviated venous occlusion syndromes. Methods. Assessments were performed for 30 min (gross recording, venography, ECG, pressure, microscopy, biochemistry, and oxidative stress), including portal hypertension, caval hypertension, aortal hypotension, and centrally, the superior sagittal sinus hypertension; systemic arterial and venous thrombosis, ECG disturbances, MDA-tissue increase, the multiple organs lesions, heart, lung, liver, kidney and gastrointestinal tract, including brain (swelling, and cortex (cerebral, cerebellar), hypothalamus/thalamus, hippocampus lesions). Rats received BPC 157 medication (10 µg/kg, 10 ng/kg) intraperitoneally at 1 min ligation-time. Results. BPC 157 rapidly activated collateral pathways. These collateral loops were the superior mesenteric vein-inferior anterior pancreaticoduodenal vein-superior anterior pancreaticoduodenal vein-pyloric vein-portal vein pathway, an alternative pathway toward inferior caval vein via the united middle colic vein and inferior mesenteric vein through the left colic vein, and the inferior anterior pancreaticoduodenal artery and inferior mesenteric artery. Consequently, BPC 157 counteracted the superior sagittal sinus, portal and caval hypertension, aortal hypotension, progressing venous and arterial thrombosis peripherally and centrally, ECG disturbances attenuated. Markedly, the multiple organs lesions, heart, lung, liver, kidney, and gastrointestinal tract, in particular, as well as brain lesions, and oxidative stress in tissues were attenuated. Conclusions. BPC 157 therapy rapidly recovered rats, which have complete occlusion of the superior mesenteric vein and artery.
Gastric pentadecapeptide BPC 157 therapy counteracts multiple organ dysfunction syndrome in rats, which have permanent occlusion of the superior mesenteric artery close to the abdominal aorta. ...Previously, when confronted with major vessel occlusion, its effect would rapidly activate collateral vessel pathways and resolve major venous occlusion syndromes (Pringle maneuver ischemia, reperfusion, Budd–Chiari syndrome) in rats. This would overwhelm superior mesenteric artery permanent occlusion, and result in local, peripheral, and central disturbances. Methods: Assessments, for 30 min (gross recording, angiography, ECG, pressure, microscopy, biochemistry, and oxidative stress), included the portal hypertension, caval hypertension, and aortal hypotension, and centrally, the superior sagittal sinus hypertension; systemic arterial and venous thrombosis; ECG disturbances; MDA-tissue increase; and multiple organ lesions and disturbances, including the heart, lung, liver, kidney, and gastrointestinal tract, in particular, as well as brain (cortex (cerebral, cerebellar), hypothalamus/thalamus, hippocampus). BPC 157 therapy (/kg, abdominal bath) (10 µg, 10 ng) was given for a 1-min ligation time. Results: BPC 157 rapidly recruits collateral vessels (inferior anterior pancreaticoduodenal artery and inferior mesenteric artery) that circumvent occlusion and ascertains blood flow distant from the occlusion in the superior mesenteric artery. Portal and caval hypertension, aortal hypotension, and, centrally, superior sagittal sinus hypertension were attenuated or eliminated, and ECG disturbances markedly mitigated. BPC 157 therapy almost annihilated venous and arterial thrombosis. Multiple organ lesions and disturbances (i.e., heart, lung, liver, and gastrointestinal tract, in particular, as well as brain) were largely attenuated. Conclusions: Rats with superior mesenteric artery occlusion may additionally undergo BPC 157 therapy as full counteraction of vascular occlusion-induced multiple organ dysfunction syndrome.
Background. Gastric pentadecapeptide BPC 157 therapy in rats compensated irremovable occlusion of various vessels and counteracted the consequent multiorgan dysfunction syndromes by activation of the ...corresponding collateral bypassing loops. Thus, we used BPC 157 therapy against the irremovable occlusion of the end of the superior mesenteric vein. Methods. Assessments, for 30 min (gross recording, venography, ECG, pressure, microscopy, biochemistry, and oxidative stress) include the portal and caval hypertension, aortal hypotension, and centrally, the superior sagittal sinus hypertension, systemic arterial and venous thrombosis, ECG disturbances, MDA-tissue increase, and heart, lung, liver, kidney and gastrointestinal tract, in particular, and brain (cortex (cerebral, cerebellar), hypothalamus/thalamus, hippocampus) lesions. Rats received BPC 157 medication (10 µg/kg, 10 ng/kg) intraperitoneally at 1 or 15 min ligation time. Results. BPC 157 rapidly activated the superior mesenteric vein–inferior anterior pancreati-coduodenal vein–superior anterior pancreaticoduodenal vein–pyloric vein–portal vein pathway, reestablished superior mesenteric vein and portal vein connection and reestablished blood flow. Simultaneously, toward inferior caval vein, an additional pathway appears via the inferior mesenteric vein united with the middle colic vein, throughout its left colic branch to ascertain alternative bypassing blood flow. Consequently, BPC 157 acts peripherally and centrally, and counteracted the intracranial (superior sagittal sinus), portal and caval hypertension, aortal hypotension, ECG disturbances attenuated, abolished progressing venous and arterial thrombosis. Additionally, BPC 157 counteracted multiorgan dysfunction syndrome, heart, lung, liver, kidney and gastrointestinal tract, and brain lesions, and oxidative stress in tissues. Conclusion. BPC 157 therapy may be specific management also for the superior mesenteric vein injuries.
Metabolic Dysfunction-associated Liver Disease (MASLD) represents a spectrum of conditions from simple fat accumulation to non-alcoholic steatohepatitis. The possible role of the intestinal ...microbiome on MASLD development has been in focus. Our study aimed to examine the effects of synbiotics on the liver steatosis, inflammation, and stool microbiome.
A double-blind, placebo-controlled study was conducted involving 84 MASLD patients, defined by an elastometric attenuation coefficient (ATT) greater than 0.63 dB/cm/MHz with an alanine aminotransferase level above 40 U/L for men and 35 U/L for women. The patients were divided into an intervention group treated with a synbiotic with 64x10
CFU of
and
and 6.4g of inulin and a control group treated with a placebo.
Using synbiotics for 12 weeks significantly decreased liver steatosis (ΔATT -0.006±0.023 vs -0.016±0.021 dB/cm/MHz, p=0.046). The group of patients treated with synbiotics showed a significant decrease in the level of high-sensitive C-reactive protein (Δhs-CRP 0 vs -0.7 mg/L, p≤0.001). Synbiotics enriched the microbiome of patients in the intervention group with the genera
, and
, by 81%, 55%, 51%, and 40%, respectively, with a reduction of
and
by 35% and 40%. Synbiotic treatment significantly shortened the gut transition time (ΔGTT -5h vs. -10h, p=0.031).
Synbiotics could be an effective and safe option that could have place in MASLD treatment.
The C-reactive protein is generally considered a marker of inflammation, and it is widely used in clinical practice as a minimally invasive index of any ongoing inflammatory response. Alpha-lipoic ...acid (ALA) supplementation can be beneficial for human health, especially in the sense of its anti-inflammatory action. The aim of this meta-analysis was to, based on the currently available highest level of evidence (prospective, randomized, double-blind, and placebo-controlled data), investigate the effect of ALA supplementation on CRP levels. Prospective, randomized, double-blind, and placebo-controlled clinical trials were extracted after a systematic search of PubMed, the Cochrane Library, the Web of Science, EMBASE, and the Scopus databases. A random effect model was used in this meta-analysis to investigate the influence of ALA on the blood CRP level. The subgroup analysis and meta-regression were used to identify the source of heterogeneity. This meta-analysis provided evidence of the positive effect of ALA on the reduction of the blood CRP level. The subgroup analysis and meta-regression results indicated that ALA can reduce the CRP level when administrated at a 600 mg dose, and not in higher or lower doses. Also, a shorter duration of study positively correlates with the reduction of CRP after ALA supplementation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Armolipid Plus
is a multi-constituent nutraceutical that claims to improve lipid profiles. The aim of this PRISMA compliant systematic review and meta-analysis was to globally evaluate the efficacy ...and safety of Armolipid Plus
on the basis of the available randomized, blinded, controlled clinical trials (RCTs). A systematic literature search in several databases was conducted in order to identify RCTs assessing the efficacy and safety of dietary supplementation with Armolipid Plus
. Two review authors independently identified 12 eligible studies (1050 included subjects overall) and extracted data on study characteristics, methods, and outcomes. Meta-analysis of the data suggested that dietary supplementation with Armolipid Plus
exerted a significant effect on body mass index (mean difference (MD) = -0.25 kg/m
,
= 0.008) and serum levels of total cholesterol (MD = -25.07 mg/dL,
< 0.001), triglycerides (MD = -11.47 mg/dL,
< 0.001), high-density lipoprotein cholesterol (MD = 1.84 mg/dL,
< 0.001), low-density lipoprotein cholesterol (MD = -26.67 mg/dL,
< 0.001), high sensitivity C reactive protein (hs-CRP, MD = -0.61 mg/L,
= 0.022), and fasting glucose (MD = -3.52 mg/dL,
< 0.001). Armolipid Plus
was well tolerated. This meta-analysis demonstrates that dietary supplementation with Armolipid Plus
is associated with clinically meaningful improvements in serum lipids, glucose, and hs-CRP. These changes are consistent with improved cardiometabolic health.
Abstract
Background and Aims
Microvascular lesions (MVL) can be found in the kidneys of lupus nephritis (LN) patients and might be associated with worse outcomes. There are very few studies which ...evaluated MVLs in these patients and we aimed to provide a comprehensive evaluation of all MVLs, their frequency, characteristics and association with renal outcomes one year after kidney biopsy.
Method
We have conducted a retrospective cohort study to evaluate the characteristics and prognostic significance of MVLs in the kidney of subjects with LN. We have collected data on demographics, clinical and laboratory parameters and histopathology (light, immunofluorescent and electron microsopy). MVLs were characterized according to previous classifications. SLE was diagnosed using the American College of Rheumatology criteria.
Results
A total of 56 patients with biopsy-proven LN were followed up for at least one year after kidney biopsy (79% women, mean age at biopsy 38±13 years). Forty patients (71%) had MVLs in the kidney. The most common MVLs were arteriolar endotheliocyte swelling (54%), arteriolar hyalinosis (25%) and endothelialitis (8%) and the frequency distribution of all microvascular lesions is shown in Figure. Median number of lesions in the MVL group was 1 (interquartile range 1 to 2) and subjects had up to 6 MVLs. There was no difference in the median number of MVLs across LN classes (p>0.05). Proteinuria was highest in class V (5.5 g/day, p = 0.06 vs. all other classes). Subjects with MVLs had lower baseline proteinuria compared with those with no lesions (3.6 vs. 5.4 g/day, p = 0.037), but there was no difference in serum creatinine (92 vs. 119 umol/L, p = 0.25). There were no differences in the occurrence or number of MVLs across LN classes (p = 0.63). The number of MVLs was not correlated with proteinuria (p>0.05). There was no difference in the frequency of proliferative lupus between MVL and no MVL groups (79% vs. 60%, p = 0.15). A total of 48% of subjects achieved complete response (CR), 27% achieved partial response (PR) and 25% had no response (NR). MVLs were not associated with response (defined as CR or PR) in a multivariate regression model (OR 3.5 0.5, 24.6).
Conclusion
MVLs are common in LN. They were associated with lower baseline proteinuria, but not with proliferative LN or renal outcomes. The association with proteinuria warrants further research.
Abstract
Background and Aims
Hepatocyte growth factor (HGF) is a pleiotropic factor derived from mesenchymal cells and is considered a humoral mediator in the interaction of epithelium and ...mesenchyme. The concentration of HGF in the serum is related to blood pressure (BP), but also to serum glucose concentration. Patients with type 1 and 2 diabetes have significantly higher HGF values, especially those with developed atherosclerotic disease and diabetic retinopathy. Moreover, the concentration of serum HGF in patients with diabetes is higher than that in healthy subjects, regardless of their blood pressure (BP) levels. Our aim was to determine the correlation between serum HGF levels and serum glucose levels in subjects with optimal blood pressure and untreated hypertensives.
Method
The subjects were divided into two groups based on the BP values. There were 295 subjects with optimal blood pressure (OBP, BP<120/80 mmHg) and 268 subjects with untreated arterial hypertension (AH, BP>140/90 mmHg). Blood pressure was measured according to ESH/ESC guidelines. Fasting blood samples were drawn, serum glucose and HGF levels were measured using commercial tests.
Results
The average blood pressure was 110/72 mmHg in the OBP group vs 151/92 mmHg in the AH group (p<0,001). Subjects with AH had significantly higher glucose levels than subjects with OBP (4,8±0,5 mmol/l vs. 5,7±1,6 mmol/l, respectively, p<0,001). Serum HGF concentration showed a significant positive correlation to serum glucose levels in the AH group (correlation coefficient = 0,195, p<0,05), but not in the OBP group (correlation coefficient = 0,045, p = 0,06). Serum HGF concentration did not show a significant correlation to blood pressure levels in both groups (all p>0,05).
Conclusion
Serum HGF concentration is associated with glucose levels in subjects with untreated arterial hypertension.
Abstract
Background and Aims
Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disorder that is characterized by formation of benign tumors of the brain, kidney, eyes, heart, ...lung, liver and skin. The disease is frequently associated with adverse pregnancy outcomes. Our aim is to present two cases of Tuberous sclerosis complex in pregnancy which might be illustrative in the management of these patients.
Method
The first patient was a 32-year-old woman with a history of renal angiomyolipoma (AML) and pulmonic lymphangiomyomathosis (LAM) due to Tuberous sclerosis complex diagnosed at a young age. In the 35th gestational week she had an emergency Cesarean section due to acute retroperitoneal bleeding from angiomyolipoma of the right kidney and gave birth to a preterm male infant (birth mass 2077 g, Apgar 4/6). The patient did not take any medications during the course of pregnancy. Since 2015 she is being treated with everolimus (5 mg/day) due to complications for pulmonic lymphangiomyomathosis, subependymomas and epilepsy and AMLs. After eight years of treatment renal AMLs and LAM and subependymomas show no dynamic in size or number. The second patient was a 29-year-old nulliparous woman who has presented with seizures at the age of 2 and was diagnosed with TSC. At 37th gestational week of a twin pregnancy she gave birth to one male neonate (birth mass 2660 g, Apgar 8/9), while the other fetus died in utero. During the course of the pregnancy she was treated with phenobarbital, folic acid and iron supplementation. Her epilepsy is well-controlled and AMLs show no dynamic in size or number.
Results:
Conclusion
We have showed two cases with relatively good outcomes which have long-term stable disease. Female patients with TSC have increased risk of hemorrhagic complications of AMLs during pregnancy and it can be complicated by intrauterine growth restriction. A multidisciplinary approach is needed in the planning and monitoring pregnancies in these patients to achieve optimal outcomes.
Alpha-lipoic acid (ALA) is a natural short-chain fatty acid that has attracted great attention in recent years as an antioxidant molecule. However, some concerns have been recently raised regarding ...its safety profile. To address the issue, we aimed to assess ALA safety profile through a systematic review of the literature and a meta-analysis of the available randomized placebo-controlled clinical studies. The literature search included EMBASE, PubMed Medline, SCOPUS, Google Scholar, and ISI Web of Science by Clarivate databases up to 15th August 2020. Data were pooled from 71 clinical studies, comprising 155 treatment arms, which included 4749 subjects with 2558 subjects treated with ALA and 2294 assigned to placebo. A meta-analysis of extracted data suggested that supplementation with ALA was not associated with an increased risk of any treatment-emergent adverse event (all p > 0.05). ALA supplementation was safe, even in subsets of studies categorized according to smoking habit, cardiovascular disease, presence of diabetes, pregnancy status, neurological disorders, rheumatic affections, severe renal impairment, and status of children/adolescents at baseline.
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