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Interview with Peter Staats, MD, Physician, MBA. 访谈医学博士、内科医生、工商管理硕士 Peter Staats。
Q3 Medicine Pub Date : 2024-07-01
Sheldon Baker
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引用次数: 0
Hypothesis: 2 Major Environmental and Pharmaceutical Factors-Acetaminophen Exposure and Gastrointestinal Overgrowth of Clostridia Bacteria Induced By Ingestion of Glyphosate-Contaminated Foods-Dysregulate the Developmental Protein Sonic Hedgehog and Are Major Causes of Autism. 假设:两种主要的环境和药物因素--对乙酰氨基酚暴露和摄入草甘膦污染食品引起的胃肠道梭状芽孢杆菌过度生长--会调节发育蛋白音速刺猬蛋白,是导致自闭症的主要原因。
Q3 Medicine Pub Date : 2024-07-01
William Shaw

Epidemiological studies have found 2 significant factors associated with the increased incidence of autism spectrum disorder (ASD): the increased use of acetaminophen in the 1970s when this drug largely replaced the use of aspirin for many patients because of a fear of Reye syndrome, and the agricultural use in the 1990s of the herbicide glyphosate on crops that were genetically modified (GM) to tolerate glyphosate. The incidence of autism in the United States, where acetaminophen is widely available, is more than 1000 times greater than in Cuba, where acetaminophen is available only by prescription. Metabolites of both glyphosate and acetaminophen likely alter the function of the developmental protein sonic hedgehog (SHH). Glyphosate likely affects SHH indirectly by decreasing the beneficial flora of the gastrointestinal tract and increasing pathogenic Clostridia bacteria, which are resistant to glyphosate. The marked increase of certain Clostridia species caused by glyphosate results in Clostridia production of large amounts of 3-(3-hydroxyphenyl)-3-hydroxypropionate (HPHPA) and 4-cresol (p-cresol). The 4-cresol metabolite 4-methyl-o-hydroquinone and the acetaminophen metabolite N-acetyl-p-benzoquinone imine (NAPQI) likely react with the sulfhydryl group of the N-terminal cysteine of SHH, blocking the function of this critical amino acid required for the activation of SHH. HPHPA and 4-cresol also inhibit dopamine β-hydroxylase, resulting in overproduction of dopamine and its toxic metabolites, such as aminochrome, that cause biochemical damage to mitochondria and structural proteins in brain cells. Elevated amounts of these Clostridia products in body fluids in people with autism and in animals with autistic signs have been documented in laboratories throughout the world. The synthesis of the HPHPA molecule in extremely large quantities depletes the body of free coenzyme A, which is needed for the palmitoylation of SHH. SHH covalently coupled to palmitic acid is 30 times more active than SHH without palmitic acid. These possible modifications of SHH help to explain the significantly altered quantities of SHH in the blood serum of patients with autism. The severity of autism is related to the degree of SHH abnormality. The spread of pathogenic Clostridia worldwide from soil to food animals to humans, which may be promoted by glyphosate use, is a great public health concern, not only for autism but perhaps for all the neuropsychiatric diseases that appear to be related to gastrointestinal Clostridia overgrowth These diseases include seizures, tremors, tic disorders, Parkinson disease, chronic fatigue syndrome, obsessive compulsive disorder, schizophrenia, bipolar and unipolar depression, ADHD, and anorexia nervosa.

流行病学研究发现,有两个重要因素与自闭症谱系障碍(ASD)发病率的增加有关:一是 20 世纪 70 年代对乙酰氨基酚使用量的增加,当时许多患者因担心出现雷氏综合征而基本上不再使用阿司匹林;二是 20 世纪 90 年代在农业上使用除草剂草甘膦对转基因作物进行处理,使其能够耐受草甘膦。在对乙酰氨基酚广泛供应的美国,自闭症的发病率比对乙酰氨基酚只能凭处方购买的古巴高出 1000 多倍。草甘膦和对乙酰氨基酚的代谢物可能会改变发育蛋白声波刺猬(SHH)的功能。草甘膦可能会通过减少胃肠道的有益菌群和增加对草甘膦有抗药性的致病性梭状芽孢杆菌来间接影响 SHH。草甘膦导致某些梭状芽孢杆菌明显增加,导致梭状芽孢杆菌产生大量 3-(3-羟基苯基)-3-羟基丙酸酯(HPHPA)和 4-甲酚(p-甲酚)。4- 甲酚代谢物 4-甲基-邻对苯二酚和对乙酰氨基酚代谢物 N-乙酰对苯醌亚胺(NAPQI)可能会与 SHH N 端半胱氨酸的巯基发生反应,从而阻断 SHH 激活所需的这一关键氨基酸的功能。HPHPA 和 4-甲酚还能抑制多巴胺 β-羟化酶,导致多巴胺及其毒性代谢物(如氨基铬)过量产生,从而对线粒体和脑细胞中的结构蛋白造成生化损伤。世界各地的实验室都记录了自闭症患者和有自闭症症状的动物体液中这些梭菌产物含量升高的情况。大量合成 HPHPA 分子会消耗体内的游离辅酶 A,而游离辅酶 A 正是 SHH 进行棕榈酰化所必需的。与棕榈酸共价偶联的 SHH 的活性是不含棕榈酸的 SHH 的 30 倍。这些可能的 SHH 修饰有助于解释自闭症患者血清中 SHH 数量的显著变化。自闭症的严重程度与 SHH 异常的程度有关。致病性梭状芽孢杆菌在全球范围内从土壤到食用动物再到人类的传播(草甘膦的使用可能会促进这种传播)是一个重大的公共卫生问题,这不仅关系到自闭症,还可能关系到所有似乎与胃肠道梭状芽孢杆菌过度生长有关的神经精神疾病,这些疾病包括癫痫发作、震颤、抽搐症、帕金森病、慢性疲劳综合征、强迫症、精神分裂症、双相抑郁症和单相抑郁症、多动症和神经性厌食症。
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引用次数: 0
Continuing the Conversation About Arsenic. 继续关于砒霜的对话。
Q3 Medicine Pub Date : 2024-07-01
Joseph Pizzorno

Chronic low-level arsenic exposure is a significant contributor to ill health and disease. However, at this time, quantification of the effects of this exposure appears virtually impossible. In a continuation of my editorial on arsenic published earlier this year, this editorial looks at arsenic's mechanisms of damage, more disease correlations, sources of exposure, and early signs for detection of arsenic toxicity.

长期接触低浓度砷是导致健康不良和疾病的一个重要因素。然而,目前对这种暴露的影响进行量化似乎几乎是不可能的。作为我今年早些时候发表的关于砷的社论的延续,这篇社论探讨了砷的损害机制、更多疾病的相关性、接触源以及检测砷中毒的早期征兆。
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引用次数: 0
Interview Everest Goldstein, M.ED, MSN, APRN, PMHNP-BC, IFMCP, Nurse Practitioner, Everest Functional Psychiatry and Wellness. 采访 Everest Goldstein,教育学硕士、MSN、APRN、PMHNP-BC、IFMCP,执业护士,Everest Functional Psychiatry and Wellness。
Q3 Medicine Pub Date : 2024-07-01
Sheldon Baker
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引用次数: 0
The Microbiome: A Foundation for Integrative Medicine. 微生物组:中西医结合医学的基础。
Q3 Medicine Pub Date : 2024-07-01
Shawn Manske

Context: No organ system better integrates interconnectivity across specialties and disciplines than the microbiome. Scientific focus is shifting from microbes as harbingers of disease toward microbes as symbiotic, balanced, commensal ecologies.

Objective: The study intended to discuss and examine the human microbiome, including its development in early life; its impact on various physiological processes that occur throughout the body; and its relationship to dysbiosis; and to investigate microbial mechanisms with clinical applicability across medical specialties.

Setting: The study took place at Biocidin Botanicals in Watsonville CA, USA.

Results: Accumulating research upholds the human microbiome as both a predictive biomarker for disease risk and a viable treatment option for modulating the course of illness. Prebiotic and probiotic interventions continue to demonstrate clinical utility, particularly for gastrointestinal, dermatological, inflammatory, metabolic, and mental-health disorders.

Conclusions: Just as germ theory revolutionized infection control in the twentieth century, microbiome systems science stands to transform the conceptualization of health as the balanced coexistence of human and microbial cells in the twenty-first century.

背景:没有哪个器官系统能比微生物组更好地整合各专业和学科之间的相互联系。科学界的关注点正从微生物作为疾病的先兆转向微生物作为共生、平衡、共存的生态:该研究旨在讨论和研究人类微生物组,包括其在生命早期的发展;其对全身各种生理过程的影响;其与菌群失调的关系;以及研究各医学专科具有临床适用性的微生物机制:研究在美国加利福尼亚州沃森维尔的 Biocidin Botanicals 进行:不断积累的研究表明,人类微生物组既是疾病风险的预测性生物标志物,也是调节病程的可行治疗方案。益生菌和益生菌干预措施继续显示出临床效用,特别是在胃肠道、皮肤病、炎症、代谢和精神疾病方面:正如细菌理论在 20 世纪彻底改变了感染控制一样,微生物组系统科学也将在 21 世纪改变人类与微生物细胞平衡共存的健康概念。
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引用次数: 0
Interview with Megan Barnett, MS, CNS. 采访梅根-巴奈特(Megan Barnett),医学硕士,CNS。
Q3 Medicine Pub Date : 2024-07-01
Sheldon Baker
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引用次数: 0
Pro-cancer and conditional anti-cancer effects of TCA cycle breaks. TCA 循环断裂的促癌作用和条件性抗癌作用。
Q3 Medicine Pub Date : 2024-05-01
Samuel F Yanuck
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引用次数: 0
New Long-Covid Randomized Controlled Study Offers Hope to Patients. 新的 Long-Covid 随机对照研究为患者带来了希望。
Q3 Medicine Pub Date : 2024-05-01
Sheldon Baker
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引用次数: 0
Oxalates: Dietary Oxalates and Kidney Inflammation: A Literature Review. 草酸盐膳食中的草酸盐与肾脏炎症:文献综述。
Q3 Medicine Pub Date : 2024-05-01
Tammera Karr, Leena S Guptha, Kathleen Bell, Julie Thenell

This literature review explores the role of dietary oxalate in the development of chronic inflammatory kidney disease in middle-aged and older individuals. The authors pose the following questions: Is oxalate produced endogenously? If food sources contribute to chronic kidney disease and inflammation, what are those foods? What role do cultural food preparation and cooking play in denaturing food oxalates? The concentration of oxalates found within the body at any particular time is not limited to edible plants; normal human metabolic processes of breaking down ascorbic acid may create up to 30 mg of oxalate daily. Research supports urolithiasis as a common urologic disease in industrialized societies. Approximately 80% of kidney stones are composed of calcium oxalate, resulting in hyperoxaluria. Exogenous (originating outside the cell or organism) oxalate sources include ascorbic acid, amino acids, and glyoxal metabolism. Additional research estimates the daily endogenous (produced within the cell or organism) production of oxalate to be 10-25 mg. Suboptimal colonization of oxalate-degrading bacteria and malabsorptive disease are also contributing factors to the development of chronic kidney disease. Oxalate transcellular processes, though poorly understood, rely on multifunctional anion exchangers, and are currently being investigated. A review of research showed that normal human metabolic processes, including the breakdown of ascorbic acid, account for 35-55% of circulating oxalates and can create ≤30 mg of circulating serum oxalate daily. Glyoxylic acid accounts for 50-70% of circulating urinary oxalate in compromised individuals with liver glycation, bacterial insufficiencies, malabsorption, and anion exchange challenges. For persons with a family history of kidney stones, consumption of foods high in oxalates may be consumed in moderation, provided there is adequate calcium intake in the diet to decrease the absorption of oxalates from the meal ingested.

这篇文献综述探讨了膳食草酸盐在中老年人慢性炎症性肾病发病过程中的作用。作者提出了以下问题:草酸盐是内源性生成的吗?如果食物来源导致慢性肾病和炎症,那么这些食物是什么?食物的文化制备和烹饪在使食物中的草酸盐变性方面起什么作用?在任何特定时间体内发现的草酸盐浓度并不局限于可食用植物;人体分解抗坏血酸的正常代谢过程每天可能产生多达 30 毫克的草酸盐。研究表明,泌尿系统结石是工业化社会中常见的泌尿系统疾病。约 80% 的肾结石由草酸钙组成,导致高草酸尿症。草酸盐的外源性(源自细胞或生物体外)来源包括抗坏血酸、氨基酸和乙二醛代谢。其他研究估计,草酸盐的内源性(在细胞或生物体内产生)日产量为 10-25 毫克。草酸盐降解菌定植不理想和吸收不良也是导致慢性肾病的因素。虽然对草酸盐跨细胞过程了解不多,但它依赖于多功能阴离子交换器,目前正在对其进行研究。研究综述显示,正常人体代谢过程(包括抗坏血酸的分解)占循环草酸盐的 35-55%,每天可产生≤30 毫克的循环血清草酸盐。在肝糖化、细菌缺乏、吸收不良和阴离子交换困难的受损人群中,乙醛酸占循环尿草酸盐的 50-70%。对于有肾结石家族史的人来说,可以适量食用草酸盐含量高的食物,但前提是饮食中必须摄入足够的钙,以减少对所摄入食物中草酸盐的吸收。
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引用次数: 0
Failed Induction of the TH1 System in TH2 Dominant Patients: The Cancer-Permissive Immune Macroenvironment. TH2显性患者的TH1系统诱导失败:诱发癌症的免疫大环境
Q3 Medicine Pub Date : 2024-05-01
Samuel F Yanuck

Tumor microenvironment infiltration by cells of the T helper cell type 1 (TH1) system, including TH1 cells, M1 macrophages, natural killer cells, and CD8+ T cells, is associated with better cancer prognosis. In contrast, tumor microenvironment infiltration by cells of the TH2 system, including TH2 cells, M2 macrophages, and innate lymphoid cells type 2, as well as immune suppressive myeloid-derived suppressor cells and regulatory T cells, is associated with poorer cancer prognosis. Beyond the tumor itself and a myriad of other modifying factors, such as genetic and epigenetic influences on tumorigenesis, the overall immune state of the patient, termed the macroenvironment, has also been shown to significantly influence cancer outcomes. Alterations in the tricarboxylic acid (TCA) cycle (TCA cycle breaks) involving loss of function of succinate dehydrogenase, isocitrate dehydrogenase, and fumarate hydratase have been shown to be associated with an intracellular metabolic shift away from oxidative phosphorylation and into glycolysis in cells that are transforming into cancer cells. The same loss of function of succinate dehydrogenase and isocitrate dehydrogenase has also been identified as inducing a shift in macrophages toward glycolysis that is associated with M1 macrophage polarization. M1 macrophages make interleukin 12, which stimulates TH1 cells and natural killer cells to produce interferon gamma (IFN-γ), which in turn stimulates M1 macrophage activity, forming an activation loop. IFN-γ also drives activation of CD8+ T cells. Thus, M1 macrophage activation initiates and sustains activation of the TH1 system of cells. In this fashion, TCA cycle breaks at succinate dehydrogenase and isocitrate dehydrogenase that promote cellular transformation into cancer cells are also associated with upregulation of the TH1 system that provides anti-cancer immune surveillance. The TH1 and TH2 systems are known to inhibit each other's activation. It is this author's hypothesis that, in patients whose macroenvironment is sufficiently TH2-dominant, the metabolic shift toward glycolysis induced by TCA cycle breaks that gives rise to mutagenic changes in tissue parenchymal cells is not counterbalanced by adequate activation of M1 macrophages, thus giving rise to cancer cell development. For instance, the atopic TH2-high asthma phenotype, a TH2 dominance-based comorbidity, is associated with a more than doubled incidence of colon, breast, lung, and prostate cancer, compared with non-asthmatics. Failure of TCA cycle breaks to induce M1 polarization of tissue-resident macrophages yields a tissue environment in which the tissue-resident macrophages fail to routinely perform M1-associated functions such as phagocytizing newly developing cancer cells. Failure of M1 phenotypic expression in both tissue-resident ma

T辅助细胞1型(TH1)系统细胞(包括TH1细胞、M1巨噬细胞、自然杀伤细胞和CD8+T细胞)的肿瘤微环境浸润与较好的癌症预后有关。相反,TH2 系统细胞(包括 TH2 细胞、M2 巨噬细胞和先天性 2 型淋巴细胞)以及免疫抑制性髓源性抑制细胞和调节性 T 细胞的肿瘤微环境浸润则与较差的癌症预后有关。除了肿瘤本身和无数其他改变因素(如遗传和表观遗传对肿瘤发生的影响)外,患者的整体免疫状态(称为大环境)也被证明对癌症预后有显著影响。琥珀酸脱氢酶、异柠檬酸脱氢酶和富马酸氢化酶功能丧失导致的三羧酸(TCA)循环(TCA 循环断裂)改变已被证明与细胞内代谢从氧化磷酸化转向糖酵解有关,而糖酵解正在向癌细胞转化。同样,琥珀酸脱氢酶和异柠檬酸脱氢酶功能的丧失也被确定为诱导巨噬细胞转向糖酵解,这与 M1 型巨噬细胞的极化有关。M1 巨噬细胞产生白细胞介素 12,白细胞介素 12 刺激 TH1 细胞和自然杀伤细胞产生γ 干扰素(IFN-γ),γ 干扰素又刺激 M1 巨噬细胞的活性,形成一个活化环。IFN-γ 还能促进 CD8+ T 细胞的活化。因此,M1 巨噬细胞的活化启动并维持了 TH1 细胞系统的活化。这样,促进细胞转化为癌细胞的琥珀酸脱氢酶和异柠檬酸脱氢酶的 TCA 循环断裂也与提供抗癌免疫监视的 TH1 系统的上调有关。众所周知,TH1 和 TH2 系统会相互抑制对方的激活。笔者的假设是,在大环境中 TH2 系统占主导地位的患者中,TCA 循环断裂引起的新陈代谢向糖酵解的转变导致组织实质细胞发生突变性变化,而 M1 巨噬细胞的充分激活无法抵消这种转变,从而导致癌细胞的发展。例如,与非哮喘患者相比,特应性TH2-高哮喘表型(一种基于TH2优势的合并症)与结肠癌、乳腺癌、肺癌和前列腺癌的发病率加倍相关。如果 TCA 循环断裂不能诱导组织驻留巨噬细胞的 M1 极化,就会产生一种组织环境,在这种环境中,组织驻留巨噬细胞不能例行执行与 M1 相关的功能,如吞噬新出现的癌细胞。组织驻留巨噬细胞和被招募到肿瘤微环境中的单核细胞衍生巨噬细胞中的 M1 表型表达失败会导致 M1 巨噬细胞失去直接抗肿瘤作用,TH1 系统的激活也普遍失败,包括 CD8+ T 细胞激活失败,从而导致肿瘤微环境癌症易发,现有癌症患者的预后较差。本文提出了一个概念框架,将现有研究中的既有要素联系起来,并指出了患者特征描述过程的实用性,旨在通过识别和针对每位患者肿瘤微环境和大环境中导致不良预后的要素,实现个性化治疗。
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引用次数: 0
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Integrative medicine
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