There is a continued debate and exchange of knowledge with respect to serum 25- hydroxyvitamin D (25(OH)D) cut-off levels. Based on our current knowledge it is time to reconsider our recommendations of the optimal level of serum 25(OH)D in the clinical setting and not only focus on low levels but also recommend an upper serum limit of around 125 nmol/L (40–50 ng/mL) among healthy and diseased.
{"title":"Time for New Recommendation of Upper Limit of Serum Vitamin D in Humans","authors":"P. Schwarz","doi":"10.31038/edmj.2019353","DOIUrl":"https://doi.org/10.31038/edmj.2019353","url":null,"abstract":"There is a continued debate and exchange of knowledge with respect to serum 25- hydroxyvitamin D (25(OH)D) cut-off levels. Based on our current knowledge it is time to reconsider our recommendations of the optimal level of serum 25(OH)D in the clinical setting and not only focus on low levels but also recommend an upper serum limit of around 125 nmol/L (40–50 ng/mL) among healthy and diseased.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48664360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims To test whether neurite-inhibitory plasma autoantibodies in chronic schizophrenia activate Gq/11- and Gi- coupled signaling pathways downstream of 5-hydroxytryptamine 2A receptor activation; and for modulation of serotonergic signaling by the metabotropic 2/3 receptor agonist LY379268. Methods Plasma from five older adults with chronic schizophrenia and eight age-matched patients having another neuropsychiatric, immune or metabolic disorder was subjected to Protein-A affinity chromatography to obtain IgG autoantibodies. Mean neurite retraction (5 minutes) or cell survival (24 hours) was determined in mouse N2A neuroblastoma cells incubated with autoantibodies in the presence or absence of specific antagonists of the Gq/11/PLC/IP3R signaling pathway, Gi-coupled, beta-arrestin2-directed pathways, or LY379268. Results Chronic schizophrenia plasma autoantibodies- mediated dose- and time-dependent acute N2A neurite retraction was completely prevented by M100907, a selective 5-hydroxytryptamine 2A receptor antagonist. LY379268 promoted autoantibody-induced neurite retraction causing a shift-to-the-left in the dose-response curve. Antagonists of the RhoA/Rho kinase and Gq/11/PLC/IP3R signaling pathways blocked autoantibody-mediated neurite retraction. Chronic schizophrenia plasma autoantibodies mediated increased N2A cell survival which was blocked by LY379268, pertussis toxin, and antagonists of PI3-kinase- mediated survival signaling. Conclusion Schizophrenia plasma autoantibodies activate the 5-hydroxytryptamine 2A receptor positively coupled to Gq/11/PLC/IP3R pathway and RhoA/Rho kinase signaling activation in promoting acute N2A cell neurite retraction. Autoantibodies in a subset of patients experiencing hallucinations promoted increased N2A cell survival mediated (in part) via a pertussis-toxin sensitive, Gi-coupled, PI3-kinase-dependent mechanism. Positive modulation of 5-HT2AR-mediated neurite retraction by LY379268 suggests the autoantibodies may target (in part) the 5-HT2AR/mGlu2R heteromer.
{"title":"Schizophrenia Plasma Autoantibodies Promote 'Biased Agonism' at the 5-Hydroxytryptamine 2A Receptor: Neurotoxicity is Positively Modulated by Metabotropic Glutamate 2/3 Receptor Agonism.","authors":"M. Zimering, S. Nadkarni","doi":"10.31038/edmj.2019344","DOIUrl":"https://doi.org/10.31038/edmj.2019344","url":null,"abstract":"Aims\u0000To test whether neurite-inhibitory plasma autoantibodies in chronic schizophrenia activate Gq/11- and Gi- coupled signaling pathways downstream of 5-hydroxytryptamine 2A receptor activation; and for modulation of serotonergic signaling by the metabotropic 2/3 receptor agonist LY379268.\u0000\u0000\u0000Methods\u0000Plasma from five older adults with chronic schizophrenia and eight age-matched patients having another neuropsychiatric, immune or metabolic disorder was subjected to Protein-A affinity chromatography to obtain IgG autoantibodies. Mean neurite retraction (5 minutes) or cell survival (24 hours) was determined in mouse N2A neuroblastoma cells incubated with autoantibodies in the presence or absence of specific antagonists of the Gq/11/PLC/IP3R signaling pathway, Gi-coupled, beta-arrestin2-directed pathways, or LY379268.\u0000\u0000\u0000Results\u0000Chronic schizophrenia plasma autoantibodies- mediated dose- and time-dependent acute N2A neurite retraction was completely prevented by M100907, a selective 5-hydroxytryptamine 2A receptor antagonist. LY379268 promoted autoantibody-induced neurite retraction causing a shift-to-the-left in the dose-response curve. Antagonists of the RhoA/Rho kinase and Gq/11/PLC/IP3R signaling pathways blocked autoantibody-mediated neurite retraction. Chronic schizophrenia plasma autoantibodies mediated increased N2A cell survival which was blocked by LY379268, pertussis toxin, and antagonists of PI3-kinase- mediated survival signaling.\u0000\u0000\u0000Conclusion\u0000Schizophrenia plasma autoantibodies activate the 5-hydroxytryptamine 2A receptor positively coupled to Gq/11/PLC/IP3R pathway and RhoA/Rho kinase signaling activation in promoting acute N2A cell neurite retraction. Autoantibodies in a subset of patients experiencing hallucinations promoted increased N2A cell survival mediated (in part) via a pertussis-toxin sensitive, Gi-coupled, PI3-kinase-dependent mechanism. Positive modulation of 5-HT2AR-mediated neurite retraction by LY379268 suggests the autoantibodies may target (in part) the 5-HT2AR/mGlu2R heteromer.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46340296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes is associated with a substantially increased risk of certain neurovascular and neurodegenerative complications, e.g. stroke, dementia, Parkinson’s disease, major depressive disorder [1], through complex and poorly-defined mechanisms. We previously reported the occurrence of activating 5-HT2A receptor IgG autoantibodies in plasma or serum from older adult diabetes suffering with major depressive disorder [2], Parkinson’s disease or dementia [3]. Acute neurite retraction and accelerated mouse neuroblastoma N2a cell death induced by the autoantibodies in cell culture was partially or completely prevented by co-incubation (of IgG autoantibodies) with selective antagonists of the 5-HT2A receptor [2,3].
{"title":"Autoantibodies in Type-2 Diabetes having Neurovascular Complications Bind to the Second Extracellular Loop of the 5-Hydroxytryptamine 2A Receptor.","authors":"M. Zimering","doi":"10.31038/edmj.2019345","DOIUrl":"https://doi.org/10.31038/edmj.2019345","url":null,"abstract":"Diabetes is associated with a substantially increased risk of certain neurovascular and neurodegenerative complications, e.g. stroke, dementia, Parkinson’s disease, major depressive disorder [1], through complex and poorly-defined mechanisms. We previously reported the occurrence of activating 5-HT2A receptor IgG autoantibodies in plasma or serum from older adult diabetes suffering with major depressive disorder [2], Parkinson’s disease or dementia [3]. Acute neurite retraction and accelerated mouse neuroblastoma N2a cell death induced by the autoantibodies in cell culture was partially or completely prevented by co-incubation (of IgG autoantibodies) with selective antagonists of the 5-HT2A receptor [2,3].","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"3 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44758686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Autoantibodies in Type-2 Diabetes having Neurovascular Complications Bind to the Second Extracellular Loop of the 5-Hydroxytryptamine 2A Receptor.","authors":"Mark B Zimering","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764514/pdf/nihms-1050585.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9591966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Pedersen, L. Havé, H. Andersen, N. Ejskjaer, C. Z. Swan
Aim : To investigate whether reduced muscle strength in the lower extremities in diabetic patients is associated to the development of Diabetic Foot Ulcer (DFU). Methods : We conducted a retrospective cohort study on 95 diabetic patients who participated in studies on Diabetic Polyneuropathy (DPN) and motor function 12–16 years earlier. Isokinetic muscle strength at the ankle and knee, Neurological Impairment Scores (NIS), vibration perception thresholds (VPT), and demographic data were obtained from the initial studies. Patient files were systematically reviewed, and information on DFU occurrence and Macrovascular Disease (MVD) acquired. Results : Twenty-six patients developed DFU. A temporal relationship was found for development of DFU among patients with reduced strength at both the ankle and knee (all P<0.05). Univariate analyses showed a relationship between DFU and reduced strength for ankle dorsal flexion (P<0.001), ankle plantar flexion (P<0.005), knee extension (P<0.001), and knee flexion (P<0.005). DFU was related to NIS (P<0.001) and MVD (P<0.05) in both univariate and multivariate regression analyses. After adjustment for MVD, all strength measures were related to DFU. When adjusting for NIS, a trend was only found for ankle dorsal flexion (P=0.08). Conclusions : In DPN, muscle weakness at the ankle and knee contributes to development of foot ulcers.
{"title":"Risk of Foot Ulcer Development in Diabetic Patients – Relation to Isokinetic Muscle Strength, Sensory Function, and Clinical Findings","authors":"A. Pedersen, L. Havé, H. Andersen, N. Ejskjaer, C. Z. Swan","doi":"10.31038/edmj.2019333","DOIUrl":"https://doi.org/10.31038/edmj.2019333","url":null,"abstract":"Aim : To investigate whether reduced muscle strength in the lower extremities in diabetic patients is associated to the development of Diabetic Foot Ulcer (DFU). Methods : We conducted a retrospective cohort study on 95 diabetic patients who participated in studies on Diabetic Polyneuropathy (DPN) and motor function 12–16 years earlier. Isokinetic muscle strength at the ankle and knee, Neurological Impairment Scores (NIS), vibration perception thresholds (VPT), and demographic data were obtained from the initial studies. Patient files were systematically reviewed, and information on DFU occurrence and Macrovascular Disease (MVD) acquired. Results : Twenty-six patients developed DFU. A temporal relationship was found for development of DFU among patients with reduced strength at both the ankle and knee (all P<0.05). Univariate analyses showed a relationship between DFU and reduced strength for ankle dorsal flexion (P<0.001), ankle plantar flexion (P<0.005), knee extension (P<0.001), and knee flexion (P<0.005). DFU was related to NIS (P<0.001) and MVD (P<0.05) in both univariate and multivariate regression analyses. After adjustment for MVD, all strength measures were related to DFU. When adjusting for NIS, a trend was only found for ankle dorsal flexion (P=0.08). Conclusions : In DPN, muscle weakness at the ankle and knee contributes to development of foot ulcers.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41890742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Soutelo, Y. Samaniego, MC Fornari, C. ReyesToso, Ponzo OJ Ph
Objective: to evaluate the presence and type of cardiovascular damage in normogonadic and hypogonadic male rats with a induced condition of mild hyperuricemia and exposed to a high-fructose diet. Methods: Fifty six (56) male adult Wistar rats were used in the present work. Animals were divided into two groups; normogonadic (NGN) and hypogonadic (HGN), and each group was divided into four subgroups according to their treatment: control with only water (C), Fructose (F), Oxonic acid (OA) and Fructose plus Oxonic acid (FOA). Cardiovascular changes were evaluated by measuring systolic blood pressure , myocyte volume, fibrosis and intima media of aorta. Results: The FOA group significantly increased blood pressure, myocyte volume (p<0.0001), the percentage of fibrosis was significant in the group receiving OA (p<0.001). When comparing NGN vs HGN, hypogonadic animals showed a less favorable lipid profile. Conclusion: Hypogonadic, hyperuricemic conditions and a high-fructose diet favor blood pressure increase , along with changes in the cardiac hypertrophy, fibrosis and thickness increase of the intima media.
{"title":"Cardiovascular Changes in Normo and Hypogonadal Rats Treated with a High-Fructose Diet and Induced Hyperuricemia Condition","authors":"J. Soutelo, Y. Samaniego, MC Fornari, C. ReyesToso, Ponzo OJ Ph","doi":"10.31038/edmj.2019332","DOIUrl":"https://doi.org/10.31038/edmj.2019332","url":null,"abstract":"Objective: to evaluate the presence and type of cardiovascular damage in normogonadic and hypogonadic male rats with a induced condition of mild hyperuricemia and exposed to a high-fructose diet. Methods: Fifty six (56) male adult Wistar rats were used in the present work. Animals were divided into two groups; normogonadic (NGN) and hypogonadic (HGN), and each group was divided into four subgroups according to their treatment: control with only water (C), Fructose (F), Oxonic acid (OA) and Fructose plus Oxonic acid (FOA). Cardiovascular changes were evaluated by measuring systolic blood pressure , myocyte volume, fibrosis and intima media of aorta. Results: The FOA group significantly increased blood pressure, myocyte volume (p<0.0001), the percentage of fibrosis was significant in the group receiving OA (p<0.001). When comparing NGN vs HGN, hypogonadic animals showed a less favorable lipid profile. Conclusion: Hypogonadic, hyperuricemic conditions and a high-fructose diet favor blood pressure increase , along with changes in the cardiac hypertrophy, fibrosis and thickness increase of the intima media.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42735062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The State health services of Mauritius are provided free to all 1.27 million inhabitants of the island. Despite so, successive surveys by the Ministry of Health and Quality of Life have shown that diabetes remains a major public health threat to Mauritians. With 24% of the adult population affected by (type 2 diabetes) T2D, our island is ranked amongst those countries with highest diabetes-related mortality, which emphasizes the need for educating the population proper self-management of the disease. It is also evident that poor treatment adherence looms large. Patients with T2D under conventional treatment often require multiple medications to achieve glycaemic control. This induces a significant pill burden when coupled with co-morbid conditions associated to diabetes and deters adherence to treatment. Public health institutions in Mauritius support the usage of loose pills for diabetes treatment as opposed to private institutions who promote the adoption of Fixed Dose Combination (FDC) therapy as a means to improve treatment efficacy. A scaled-study was conducted to explore the efficiency and patients’ perspectives on FDC in the management of T2D. 65 patients from the Diabetes and Vascular Health Centre were grouped according to their treatment regimen: FDC from start; switched to FDC from loose pills; reverted to loose pills after trying FDC and loose pills treatment. Patients were interviewed and their clinical parameters recorded. Results showed that 67.7 % of patients were taking more than 7 pills a day to achieve glycaemic control, with only 30.8 % being made aware of possible FDC options by their healthcare practitioner. 96.3% patients who were on loose pills expressed their willingness to shift to FDC if made available in public institutions. Overall glycaemic control was better managed among the FDC group. Our findings concluded that the loose pill regime was indeed problematic for diabetics to achieve optimal glycaemic control. FDC could be pivotal in improving their health outcomes, barriers such as communication of treatment availabilities, financial constraints, shared decision-making and self-management training also need to be addressed.
{"title":"The Need for Fixed Dose Combination (FDC) for the Management of Type 2 Diabetes in Mauritius","authors":"Mohammad Yaasir Ozeer, Jhoti Somanah Bhugowandeen","doi":"10.31038/edmj.2019331","DOIUrl":"https://doi.org/10.31038/edmj.2019331","url":null,"abstract":"The State health services of Mauritius are provided free to all 1.27 million inhabitants of the island. Despite so, successive surveys by the Ministry of Health and Quality of Life have shown that diabetes remains a major public health threat to Mauritians. With 24% of the adult population affected by (type 2 diabetes) T2D, our island is ranked amongst those countries with highest diabetes-related mortality, which emphasizes the need for educating the population proper self-management of the disease. It is also evident that poor treatment adherence looms large. Patients with T2D under conventional treatment often require multiple medications to achieve glycaemic control. This induces a significant pill burden when coupled with co-morbid conditions associated to diabetes and deters adherence to treatment. Public health institutions in Mauritius support the usage of loose pills for diabetes treatment as opposed to private institutions who promote the adoption of Fixed Dose Combination (FDC) therapy as a means to improve treatment efficacy. A scaled-study was conducted to explore the efficiency and patients’ perspectives on FDC in the management of T2D. 65 patients from the Diabetes and Vascular Health Centre were grouped according to their treatment regimen: FDC from start; switched to FDC from loose pills; reverted to loose pills after trying FDC and loose pills treatment. Patients were interviewed and their clinical parameters recorded. Results showed that 67.7 % of patients were taking more than 7 pills a day to achieve glycaemic control, with only 30.8 % being made aware of possible FDC options by their healthcare practitioner. 96.3% patients who were on loose pills expressed their willingness to shift to FDC if made available in public institutions. Overall glycaemic control was better managed among the FDC group. Our findings concluded that the loose pill regime was indeed problematic for diabetics to achieve optimal glycaemic control. FDC could be pivotal in improving their health outcomes, barriers such as communication of treatment availabilities, financial constraints, shared decision-making and self-management training also need to be addressed.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42636031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rune Tønnesen, Kristian Buch, P. Hovind, L. T. Jensen, P. Schwarz
Objective Our study aimed to investigate the effect of vitamin D supplementation on blood pressure in vitamin D insufficient young volunteers compared to an age matched control group with sufficient levels of vitamin D. Secondarily we aimed to evaluate the effect of vitamin D supplementation on the RAAS and sympathetic nervous system. Design Single centre, Randomised controlled Trial. of Range 2.4) mmHg (p = 0.009), diastolic BP (daytime) decreased -4.5 (2.1) mmHg (p = 0.03), norepinephrine decreased -0.80 (0.21) nmol/L, (p = 0.0002). There was no effect of vitamin D supplementation on night time systolic or diastolic BP, and no effect on angiotensinogen, renin, angiotensin (I+II), aldosterone or epinephrine. We observed that 180 days of vitamin D supplementation in normal youngsters with insufficient vitamin D significantly lowered systolic and diastolic BP during daytime. Vitamin D supplementation also significantly lowered circulating norepinephrine. Nothing happened in the control group with normal vitamin D. Hence, it is tempting to conclude that vitamin D acts on BP through SNS as no changes were observed in the RAAS.
{"title":"Blood Pressure in Healthy Youngsters is modified by Vitamin-D Supplementation","authors":"Rune Tønnesen, Kristian Buch, P. Hovind, L. T. Jensen, P. Schwarz","doi":"10.31038/edmj.2019325","DOIUrl":"https://doi.org/10.31038/edmj.2019325","url":null,"abstract":"Objective Our study aimed to investigate the effect of vitamin D supplementation on blood pressure in vitamin D insufficient young volunteers compared to an age matched control group with sufficient levels of vitamin D. Secondarily we aimed to evaluate the effect of vitamin D supplementation on the RAAS and sympathetic nervous system. Design Single centre, Randomised controlled Trial. of Range 2.4) mmHg (p = 0.009), diastolic BP (daytime) decreased -4.5 (2.1) mmHg (p = 0.03), norepinephrine decreased -0.80 (0.21) nmol/L, (p = 0.0002). There was no effect of vitamin D supplementation on night time systolic or diastolic BP, and no effect on angiotensinogen, renin, angiotensin (I+II), aldosterone or epinephrine. We observed that 180 days of vitamin D supplementation in normal youngsters with insufficient vitamin D significantly lowered systolic and diastolic BP during daytime. Vitamin D supplementation also significantly lowered circulating norepinephrine. Nothing happened in the control group with normal vitamin D. Hence, it is tempting to conclude that vitamin D acts on BP through SNS as no changes were observed in the RAAS.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41422836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Reg`Activ Cholesterol Positive Effects in Asymptomatic Volunteers with Borderline Values of Cardio-Metabolic Risk Factors are Sustainable in Long-Term Run","authors":"","doi":"10.31038/edmj.2019324","DOIUrl":"https://doi.org/10.31038/edmj.2019324","url":null,"abstract":"","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41371088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
De Lucio, Capretti Camilla, Scarcella Simone, Damiano
OBJECTIVE: Several studies have investigated the role of cranberry extract and D-mannose in the prevention of recurrent urinary tract infections (UTIs). The aim of this preliminary study was to test whether the use of a new dietary supplement (UROIAL TM sachets) containing cranberry extracts (S&R PACs), D-mannose, hyaluronic Acid and Glucosamine Chondroitin may reduce the incidence of episodes of cystitis and improve urinary symptoms. METHODS: In this prospective comparative study, 40 women with an acute diagnosis of cystitis received a single sachet of Fosfomycin Tromethamine (3gr). The subjects were then randomly assigned to two groups: Group A: 20 women were given UROIAL TM , 2 sachet per day during the first 7 days, then 1 sachet per day for two weeks; Group B: 20 women did not receive any treatment to serve as a control group. RESULTS: The results of the present study showed a complete remission of urinary symptoms in 37 women, a slight decrease in urinary symptoms was observed in 2 subjects, whereas 1 woman who stopped the treatment was considered a drop-out. Patients in Group A had a lower incidence of episodes of recurrent cystitis during treatment and follow-up; urine samples had significantly lower median bacterial load compared to baseline as well as a symptomatic relief was reported in treated subjects despite the control group. DISCUSSION: Several studies have investigated and demonstrated the role of cranberry extracts in the prevention of recurrent urinary tract infections (UTIs), on different selected subpopulations and even at increased risk of UTI. Even the use of D-mannose, a natural sugar has proven to have clinical benefit, although clinical data is limited. A randomized placebo-controlled non-blinded clinical trial has shown that a daily dose of 2 g d-mannose was superior to placebo in preventing UTI. Mannose receptors are found on uroepithelial cells lining the urinary tract they constitute the protective mucopolysaccharide layer of the bladder. The mechanism of action involves binding of the mannose receptors to E. coli pili, thus preventing both adhesion to and invasion of urothelial cells. The interaction between mannose molecules and E. coli bacteria can then be washed away with urine voiding. CONCLUSIONS: Our data indicate that the addition of GAGs (hyaluronic acid and chondroitin sulfate) to cranberry/D-Mannose containing products could represent a valid novel therapeutic approach for the treatment and/or prophylaxis of cystitis.
{"title":"Effects of a New Combination of Cranberry Extracts, D-Mannose and GAGs for the Management of Uncomplicated Urinary Tract Infection","authors":"De Lucio, Capretti Camilla, Scarcella Simone, Damiano","doi":"10.31038/edmj.2019315","DOIUrl":"https://doi.org/10.31038/edmj.2019315","url":null,"abstract":"OBJECTIVE: Several studies have investigated the role of cranberry extract and D-mannose in the prevention of recurrent urinary tract infections (UTIs). The aim of this preliminary study was to test whether the use of a new dietary supplement (UROIAL TM sachets) containing cranberry extracts (S&R PACs), D-mannose, hyaluronic Acid and Glucosamine Chondroitin may reduce the incidence of episodes of cystitis and improve urinary symptoms. METHODS: In this prospective comparative study, 40 women with an acute diagnosis of cystitis received a single sachet of Fosfomycin Tromethamine (3gr). The subjects were then randomly assigned to two groups: Group A: 20 women were given UROIAL TM , 2 sachet per day during the first 7 days, then 1 sachet per day for two weeks; Group B: 20 women did not receive any treatment to serve as a control group. RESULTS: The results of the present study showed a complete remission of urinary symptoms in 37 women, a slight decrease in urinary symptoms was observed in 2 subjects, whereas 1 woman who stopped the treatment was considered a drop-out. Patients in Group A had a lower incidence of episodes of recurrent cystitis during treatment and follow-up; urine samples had significantly lower median bacterial load compared to baseline as well as a symptomatic relief was reported in treated subjects despite the control group. DISCUSSION: Several studies have investigated and demonstrated the role of cranberry extracts in the prevention of recurrent urinary tract infections (UTIs), on different selected subpopulations and even at increased risk of UTI. Even the use of D-mannose, a natural sugar has proven to have clinical benefit, although clinical data is limited. A randomized placebo-controlled non-blinded clinical trial has shown that a daily dose of 2 g d-mannose was superior to placebo in preventing UTI. Mannose receptors are found on uroepithelial cells lining the urinary tract they constitute the protective mucopolysaccharide layer of the bladder. The mechanism of action involves binding of the mannose receptors to E. coli pili, thus preventing both adhesion to and invasion of urothelial cells. The interaction between mannose molecules and E. coli bacteria can then be washed away with urine voiding. CONCLUSIONS: Our data indicate that the addition of GAGs (hyaluronic acid and chondroitin sulfate) to cranberry/D-Mannose containing products could represent a valid novel therapeutic approach for the treatment and/or prophylaxis of cystitis.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49365338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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