Statins in patients with established heart failure: Time for reflection DOI Open Access

Bertram Pitt,

Robert S. Rosenson

Journal of Cardiovascular Pharmacology, Journal Year: 2023, Volume and Issue: 82(5), P. 345 - 346

Published: Sept. 1, 2023

The development and clinical application of statins has been one the most significant advances in health care over past quarter a century. Statins have shown to prevent heart failure (HF), reduce risk myocardial infarction stroke, as well mortality patients with without coronary artery disease, independent serum cholesterol.1 Their role established HF is, however, controversial. Although their use is supported by observational studies meta-analyses,2,3 not results pivotal large-scale prospective randomized trials reduced ejection fraction (HFrEF), GISSI-HF (Gruppo Italiano per la Sperimentazione della Streptochinasi nell'Infarto Miocardico—Heart Failure), Controlled Rosuvastatin Multinational Trial (CORONA).4,5 There suggestion from CORONA trial other that mild evidenced relatively low level NT-pro BNP may benefit.6 Current guidelines do therefore recommend statin indications such hypercholesterolemia, diabetes, or atherosclerotic cardiovascular disease.7 data suggest can be continued who are already on treatment.7 Given large number proven benefit they an increasing HF, both those HFrEF preserved currently being treated statin. Thus, it important understand whether these will at increased explanation why clear beneficial effect hypercholesterolemia and/or disease although clearly proven, remains uncertain. In this issue journal, Ahmad et al8 compared physical performance 172 diagnosed chronic (50 122 statin) 59 control patients. They measured handgrip strength, gait speed, short battery plasma biomarkers including sarcopenia marker C-terminal agrin fragment −22 (CAF22), intestinal barrier integrity zonulin, C-reactive protein (CRP) correlated markers performance. Not surprisingly, found had reduction HF. Of interest was finding irrespective etiology, elevation CAF22 zonulin there strong inverse correlation between also CAF22, CRP were each other. However, increase receiving worse than adversely affect neuromuscular junction permeability resultant systemic inflammation. some but all previous animals.9,10Thus, reason consider implications findings apply them clinically yet. Increasing evidence suggests (gut–heart gut–brain axis).11,12 An suggested diagnostic dysfunction, associated lipoprotein polysaccharide, trimethylamine-N-oxide decrease short-chain fatty acids butyrate.11,12 polysaccharide acid adverse effects inflammation; renal fibrosis; platelet activation thrombosis; major depression; cognitive dysfunction Alzheimer's disease.11,12 study implications, should pointed out observational, small (n = 172), even smaller 50), sodium glucose transport inhibitor mineralocorticoid receptor antagonist, which alter microbiome part recommended "4-pillar" therapy need for further adequately powered, placebo-controlled confirm findings. It considerable variation ethnicity, gender, age, diet. Animal statin.11,12 preclinical studies,9,10 outcomes HF1 benefits outweigh risks. especially advanced inflammation statin,11,12 possible risks benefits. confirmed prospective, and, if confirmed, evaluating means lowering cholesterol bypass gut PCSK9 inhibitors13 determine similar mechanisms inducing skeletal muscle mitochondrial dysfunction. effective tolerated numbers inexpensive. Before advocating change we only implied biomarker findings, thrombosis, several signaling pathways. Future research required differences lipophilic versus hydrophilic outcomes, rather before practice.

Language: Английский

Development of Gut Microbiota in the First 1000 Days after Birth and Potential Interventions DOI Open Access
Alexandru Cosmin Pantazi, Adriana Luminița Bălașa, Cristina Maria Mihai

et al.

Nutrients, Journal Year: 2023, Volume and Issue: 15(16), P. 3647 - 3647

Published: Aug. 20, 2023

The first 1000 days after birth represent a critical window for gut microbiome development, which is essential immune system maturation and overall health. undergoes major changes during this period due to shifts in diet environment. Disruptions the microbiota early life can have lasting health effects, including increased risks of inflammatory disorders, autoimmune diseases, neurological obesity. Maternal environmental factors pregnancy infancy shape infant microbiota. In article, we will review how maintaining healthy important long-term Furthermore, briefly include fungal colonization its effects on host function, are discussed as part ecosystem. Additionally, describe potential approaches such hydrogels enriched with prebiotics probiotics, transplantation (GMT) pregnancy, age-specific microbial ecosystem therapeutics, CRISPR therapies targeting hold advancing research development. Nevertheless, thorough evaluation their safety, effectiveness, impacts crucial prior application clinical approach. article emphasizes need continued optimize development through targeted early-life interventions.

Language: Английский

Citations

55

Exploring the Microbial Landscape: Gut Dysbiosis and Therapeutic Strategies in Pancreatitis—A Narrative Review DOI Creative Commons
Vasile Valeriu Lupu,

Roxana Bratu,

Laura Mihaela Trandafir

et al.

Biomedicines, Journal Year: 2024, Volume and Issue: 12(3), P. 645 - 645

Published: March 14, 2024

The gut microbiota is emerging as an important contributor to the homeostasis of human body through its involvement in nutrition and metabolism, protection against pathogens, development modulation immune system. It has therefore become research topic recent decades. Although association between intestinal dysbiosis numerous digestive pathologies been thoroughly researched, pancreatic diseases constitutes a novelty specialized literature. In years, growing evidence pointed critical pancreas regulating microbiota, well impact on physiology, which implies existence bidirectional connection known "gut-pancreas axis". theorized that any change at either these levels triggers response other component, hence leading evolution pancreatitis. However, there are not enough data determine whether underlying cause or result pancreatitis; therefore, more needed this area. purpose narrative review highlight role pathogenesis acute chronic pancreatitis, evolution, prospect employing therapeutic intervention for

Language: Английский

Citations

9

Clinical Perspectives of Gut Microbiota in Patients with Chronic Kidney Disease and End-Stage Kidney Disease: Where Do We Stand? DOI Creative Commons
Alexandru Cosmin Pantazi, Mustafa Ali Kassim Kassim, Wassan Nori

et al.

Biomedicines, Journal Year: 2023, Volume and Issue: 11(9), P. 2480 - 2480

Published: Sept. 7, 2023

The gut microbiota (GM) plays a vital role in human health, with increasing evidence linking its imbalance to chronic kidney disease and end-stage disease. Although the exact methods underlying kidney-GM crosstalk are not fully understood, interventions targeting GM were made lay three aspects: diagnostic, predictive, therapeutic interventions. While these show promising results reducing uremic toxins inflammation, challenges remain form of patient-specific variability, potential side effects, safety concerns. Our understanding GMs is still evolving, necessitating further research elucidate causal relationship mechanistic interactions. Personalized focusing on specific signatures could enhance patient outcomes. However, comprehensive clinical trials needed validate approaches’ safety, efficacy, feasibility.

Language: Английский

Citations

20

Exploring a Complex Interplay: Kidney–Gut Axis in Pediatric Chronic Kidney Disease DOI Open Access
Adriana Mocanu,

Roxana Alexandra Bogos,

Tudor Ilie Lazaruc

et al.

Nutrients, Journal Year: 2023, Volume and Issue: 15(16), P. 3609 - 3609

Published: Aug. 17, 2023

The human intestinal microbiota is a highly intricate structure with crucial role in promoting health and preventing disease. It consists of diverse microbial communities that inhabit the gut contribute to essential functions such as food digestion, nutrient synthesis, immune system development. composition function are influenced by variety factors, including diet, host genetics, environmental features. In pediatric patients, particularly dynamic vulnerable disruption from endogenous exogenous factors. Recent research has focused on understanding interaction between kidneys. individuals chronic kidney disease, there often significant disturbance microbiota. This imbalance can be attributed factors like increased levels harmful toxins entering bloodstream, inflammation, oxidative stress. review looks at what known about link child’s gut–kidney axis, how dysbiosis, or an microbiome, affects treatments, both pharmaceutical non-pharmaceutical, available for this condition.

Language: Английский

Citations

19

The Footprint of Microbiome in Pediatric Asthma—A Complex Puzzle for a Balanced Development DOI Open Access

Ancuța Lupu,

Elena Jechel, Cristina Maria Mihai

et al.

Nutrients, Journal Year: 2023, Volume and Issue: 15(14), P. 3278 - 3278

Published: July 24, 2023

Considered to be of greater complexity than the human genome itself, microbiome, structure body made up trillions bacteria, viruses, and fungi, has proven play a crucial role in context development pathological processes body, starting from various infections, autoimmune diseases, atopies, culminating its involvement some forms cancer, diagnosis that is considered most disabling for patient psychological point view. Therefore, being cornerstone understanding optimal treatment multitude ailments, body’s microbiome become an intensively studied subject scientific literature last decade. This review aims bring microbiome–asthma correlation date by classifying asthmatic patterns, emphasizing patterns perinatal period impact pulmonary dysbiosis on symptoms children. Likewise, effects intestinal reflected at level homeostasis internal environment through intestine–lung/vital organs axis, circumstances which it occurs, but also main methods studying bacterial variability used diagnostic purposes research should not omitted. In conclusion, we draw current future therapeutic lines worthy consideration both obtaining maintaining remission, as well delaying primary acute episodes preventing relapses.

Language: Английский

Citations

17

Celiac disease - a pluripathological model in pediatric practice DOI Creative Commons
Vasile Valeriu Lupu, Maria Oana Mărginean, Elena Jechel

et al.

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: April 23, 2024

Being defined as an autoimmune, chronic pathology, frequently encountered in any age group, but especially pediatrics, celiac disease (also called gluten enteropathy), is gaining more and ground terms of diagnosis, also interest research. The data from the literature last decades attest chameleonic way its presentation, there may be both classic onset symptoms atypical symptoms. Given impact played by disease, optimal growth development children, current narrative review aims to highlight presentation methods, intended guide clinician towards inclusion pathology differential diagnosis scheme. To these we add summary general therapeutic lines regarding underlying condition existing comorbidities. In order place related information up date, performed a recent articles published international databases. We bring forward theories approaches manifestations. Among note mainly constitutional, skin or mucous, bone, neuro-psychic, renal, reproductive injuries, disorders biological constants association with multiple autoimmunities. Knowing correlating them key management patients, thus reducing subsequent burden disease.

Language: Английский

Citations

7

Is oxidative stress - antioxidants imbalance the physiopathogenic core in pediatric obesity? DOI Creative Commons

Ancuța Lupu,

Silvia Fotea,

Elena Jechel

et al.

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: Aug. 8, 2024

Despite the early recognition of obesity as an epidemic with global implications, research on its pathogenesis and therapeutic approach is still rise. The literature 21st century records excess weight found in up to 1/3 children. Both determining factors systemic effects are multiple variable. Regarding involvement potentiation cardio-vascular, pulmonary, digestive, metabolic, neuro-psychic or even dermatological diseases, information already broadly outlined. connection between underlying disease associated comorbidities seems be partially attributable oxidative stress. In addition these, light recent COVID-19 pandemic, role played by stress induction, maintenance chronic inflammation among overweight children adolescents becomes a topic interest again. Thus, this review’s purpose update general data obesity, emphasis physiopathological mechanisms that underlie it involve At same time, we briefly present latest principles pathology diagnosis management. Among will mainly emphasize impact endogenous exogenous antioxidants evolutionary course pediatric obesity. order achieve our objectives, refer most studies published specialized literature.

Language: Английский

Citations

7

The role of vitamin D in pediatric systemic lupus erythematosus - a double pawn in the immune and microbial balance DOI Creative Commons
Vasile Valeriu Lupu,

Ancuța Lupu,

Elena Jechel

et al.

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: April 23, 2024

Having increased popularity during the Covid-19 pandemic, vitamin D3 is currently impressing thanks to numerous researches aimed at its interactions with body’s homeostasis. At same time, there a peak in terms of recommendations for supplementation it. Some studies focus on link between autoimmune diseases and nutritional deficiencies, especially D3. Since specialized literature children (patients 0-18 years old) far from equal informational diversity adult-centered branch, this review aims bring up date relationship microbial balance activity pediatric systemic lupus erythematosus (pSLE). The desired practical purpose resides better understanding an adequate, individualized management affected persons reduce morbidity. center summary establish impact hypovitaminosis D development evolution erythematosus. We will address aspects related two entities played by pathophysiological cascade lupus, but also risk toxicity effects when deficiency over supplemented (hypervitaminosis D). debate modulation immune function, potentiation inflammatory processes, increase oxidative stress, perfusion cognitive brain areas, seasonal incidence SLE severity. Finally, we current knowledge, post-pandemic, regarding – pSLE relationship.

Language: Английский

Citations

6

The Disease with a Thousand Faces and the Human Microbiome—A Physiopathogenic Intercorrelation in Pediatric Practice DOI Open Access
Vasile Valeriu Lupu, Lăcrămioara Ionela Butnariu,

Silvia Fotea

et al.

Nutrients, Journal Year: 2023, Volume and Issue: 15(15), P. 3359 - 3359

Published: July 28, 2023

Numerous interrelationships are known in the literature that have final effect of unmasking or influencing various pathologies. Among these, present article aims to discuss connection between systemic lupus erythematosus (SLE) and human microbiome. The main purpose this work is popularize information about impact dysbiosis on pathogenesis evolutionary course pediatric patients with SLE. Added interest knowledge awareness adjunctive therapeutic means has ultimate goal increasing quality life. by which can be achieved briefly divided into prophylactic curative, depending phase condition patient is. We thus reiterate importance clinician acquiring an overview SLE microbiome, doubled in-depth physio-pathogenic interactions two (in part through much-studied gut-target organ axes—brain, heart, lung, skin), target objective being obtaining individualized, multimodal efficient management for each individual patient.

Language: Английский

Citations

15

Konjac Glucomannan: A functional food additive for preventing metabolic syndrome DOI Creative Commons
Xiaoying Jian,

Shiyan Jian,

Baichuan Deng

et al.

Journal of Functional Foods, Journal Year: 2024, Volume and Issue: 115, P. 106108 - 106108

Published: March 5, 2024

Metabolic syndrome (MS), which involves visceral obesity, hyperglycemia, hypertension, and dyslipidemia, has become a global health challenge. Preventive measures include lifestyle changes, dietary treatments, etc. Konjac been widely used as culinary ingredient traditional Chinese medicine in Asian countries for thousands of years. The main component the konjac tuber is glucomannan (KGM), kind hydrocolloid fiber. Many problems diseases are affected by gut microbiota, may provide an alternative preventing disease. In this review, we describe prevention treatment MS using KGM, with focus on its impact relation to regulation microbes. Developing comprehensive understanding role played KGM via microbiota will help us determine underlying mechanisms associated microbiota.

Language: Английский

Citations

5