Medical hypotheses最新文献

Micro-vascular hyperpermeability is often induced by the extensive burns and subsequent sepsis, and the most common clinical complication is acute lung injury (ALI), which is mortal and is the focus of our attention when treating large-area burns. We found that elderly patients have increased lung vascular permeability after extensive burns and the incidence of ALI is heavier than that of young people, which may be related to multiple underlying diseases in the elderly. Interestingly, some female patients who have total ovariectomy in the past also suffered more severe pulmonary vascular endothelial injury and ALI after extensive burns. So simple osteoporosis might have direct relationship with lung microvascular barrier disruption and the development of ALI under sepsis. In the clinic work, we found that Osteoporosis might exacerbate the lung edema after extensive burns. Additionally, by establishing the mice osteoporosis model and performing LPS in vivo to induce the sepsis-associated ALI model, we found that sepsis induced more severe ALI in the osteoporosis mice. Thus, we hypothesized that osteoporosis-mediated osteoclast activation might pre-stimulated pulmonary micro-endothelium and aggravate sepsis-induced endothelial injury and ALI by osteoclast exosomes.

Parkinson’s disease (PD) is one of the most common diseases of the central nervous system. This disease stems from damage to the dopaminergic neurons in the substantia nigra (SN). Patients with PD experience a spectrum of motor and non-motor symptoms. Common motor symptoms comprise bradykinesia, stiffness, and resting tremors. Alongside these primary motor symptoms, patients often deal with non-motor issues such as depression, anxiety, and cognitive impairment. For years, drugs such as L-Dopa and other medications have been used to alleviate the symptoms of this disease. However, prolonged use of these medications may lead to serious health complications such as impulsive and compulsive behaviors, hallucinations or delusions, and dyskinesia. Additionally, deep brain stimulation of the SN and stem cell therapy represent relatively novel and experimental treatment approaches for PD, each with its limitations. As an alternative approach, we propose the implantation of sinoatrial node-like pacemaker cells (SANLPCs) in the SN of the brain in PD patients. SANLPCs are engineered to generate continuous action potentials. Our hypothesis posits that implanting SANLPCs in the SN could result in sustained stimulation of the cells within the SN pars compacta, thereby potentially enhancing dopamine production. We anticipate that this innovative intervention may pave the way for more targeted and effective treatments for individuals afflicted with PD.

Muscle atrophy represents a multifaceted and intricate syndrome characterized by the reduction in both mass and strength of skeletal muscles, leading to muscle dysfunction and weakness. Its potential causes encompass aging, denervation, disuse, and various diseases. One well-known pharmacological agent for glycemic control in diabetes patients is the glucagon-like peptide-1 receptor (GLP-1R) agonist. Our recent research findings have shown that compounds such as exendin-4 (Ex-4) or dulaglutide can effectively mitigate muscle atrophy in dexamethasone (Dex)-induced cellular and animal models as well as chronic kidney disease (CKD) and rodent sarcopenia models. However, it’s noteworthy that these agents may concurrently induce a decrease in body weight following administration, posing challenges when considering them as potential treatments for muscle atrophy in cachectic and sarcopenic conditions. Ghrelin, being the sole circulating orexigenic hormone known to be associated with growth hormone release, offers a potential solution to counterbalance the appetite-inhibiting effect of GLP-1R agonists. Additionally, ghrelin enhanced muscle anabolism and exerted protective effects for muscle atrophy. Therefore, combination of a GLP-1R agonist and a ghrelin analogue emerges as a synergistic therapeutic approach to effectively combat muscle atrophy.

Metformin is a biguanide antidiabetic and a first-line therapy for type-2 diabetes mellitus. It is highly effective, cheap, and easily available since taken in tablet form. Metformin-associated lactic acidosis (MALA) is a serious adverse event with high mortality. It is currently treated with bicarbonate and haemodialysis. The mechanism by which metformin can precipitate lactic acidosis remains subject to debate. Lactic acidosis has also been reported in thiamine (vitamin B1) deficiency. Thiamine deficiency results in a switch from aerobic to anaerobic metabolism with accumulation of lactate. MALA and thiamine-associated lactic acidosis are usually considered separate entities. Both, thiamine and metformin are competitive substrates of the organ cation and thiamine transporters. This way, metformin could cause thiamine deficiency in liver cells. We hypothesize that MALA may be treatable with thiamine. High-dose intravenous thiamine treatment is used routinely for the treatment of Wernicke’s encephalopathy and is regarded as safe. Thiamine has been reported to have improved MALA in four cases, who had been refractory to haemodialysis. Thiamine is widely available, easy to administer, and cheap. Thiamine could already be given while waiting for dialysis. Above all, thiamine could prove life-saving in the treatment of MALA in clinical settings in which dialysis is not available.

Despite significant advances in transplantation medicine, allograft rejection remains a major challenge in clinical practice. The preexistence of alloreactive lymphocytes is a primary cause of allograft rejection. The forthcoming challenges in clinical transplantation will involve the suppression or eradication of allospecific memory T cells. Viral infections and allograft rejection interact in multiple ways that can compromise the survival of transplanted organs. Evidence is currently accumulating on the incorporation of HLA antigens and other host cell plasma membrane molecules into the viral envelope. A consequence of the viral envelope displaying the HLA signature acquired from the plasma membrane of infected cells is that when virions are transmitted to the next host, the newly infected person became exposed to allogeneic molecules stimulating alloimmunity and generating memory to alloantigens. Thus, successive exposure to viral infections throughout life could potentially contribute to the development of alloimmunity and the generation of numerous clones of memory alloreactive lymphocytes. In this paper a novel hypothesis is developed on the potential role and mechanisms of alloresponse induced by human spread of enveloped viruses. As this hypothesis could aid in the knowledge of preexisting alloreactivity, additional research into the intricacies of virion-incorporated host cell proteins is necessary. A deeper understanding of this dynamic interaction will help promote advances in the long-term acceptance of transplants.

In oncological patients, whole body vibration (WBV) can be used to reduce cancer therapy-related morbidities, including in the case of intensive/high-dose chemotherapy. Based on the fact that WBV has the unique effect among physical exercises of intensifying blood circulation in the splanchnic territory, the medical hypothesis can be formulated according to which this type of training performed immediately after or ideally during intravenous chemotherapy would enhance the effectiveness of drug therapy due to the increase in the rate of distribution. This effect, which can benefit especially patients with abdominal tumors, may also allow the reduction of doses, thus reducing the probability of the occurrence of adverse reactions. Testing the hypothesis is possible on experimental animals, but for the organization of the research protocol, it must be taken into account that mechanical vibrations can destroy tumor cells by their own action, by influencing mesenchymal stem cells or by stimulating the secretion of irisin. Research on experimental animals is also necessary to discern whether mechanical vibrations do not affect the treatment of tumors with stem cells or do not decrease anti-tumor immunity.

Atherosclerosis and wound healing are complex pathophysiological processes involving multiple cell types, including endothelial cells and platelets. Endothelial-to-mesenchymal transition (EndMT) involves the transformation of endothelial cells into mesenchymal cells. This transition serves as a critical mechanism in vascular remodeling, essential for both atherosclerosis pathogenesis and wound healing. On the other hand, epithelial-to-mesenchymal transition (EMT), which involves the transformation of epithelial cells into mesenchymal cells, is crucial for wound healing. Platelets are known to release various growth factors and cytokines which are integral to wound healing and tissue repair, although their direct role in the modulation of EndMT and EMT remains unclear. However, a few studies have shown a potential mechanistic link between platelet activity and these cellular transitions. Since EndMT and EMT play a critical role in vascular remodeling and tissue repair, respectively, it is plausible that these processes are modulated by platelets, which are known for their dynamic and context-dependent release of growth factors and cytokines. Therefore, we postulate that platelets significantly impact the progression of atherosclerosis through the modulation of EndMT, and that of wound healing through the regulation of both EndMT and EMT. The influence of platelets on these processes can have both beneficial and detrimental effects. This hypothesis represents a significant advance in our understanding of the complex interplay between platelets, cellular phenotype, and disease pathophysiology. Elucidating the specific mechanisms by which platelets modulate EMT and EndMT could pave the way for innovative therapeutic strategies that harness the body’s innate capacity for repair and regeneration, thereby enhancing clinical outcomes for these conditions.

We hypothesize that the Gray-Level Co-occurrence Matrix (GLCM) and the Run-Length Matrix (RLM) techniques can effectively quantify discrete changes in EEG signals, and that the features extracted from these matrices can be utilized to train a Random Forest (RF) model. Our contribution includes the development of a robust code in sci-kit learn for a hypothetical model that, after adequate training and testing, could be used to detect and remove artifacts as well as differentiate between physiological and pathological EEG signals. Moreover, our approach envisions the RF model as a powerful tool capable of differentiating between normal and abnormal EEG signals. This approach could lead to the development of more potent AI tools that enhance clinical decision-making in neurology and psychiatry.