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Grădinaru TC, Gilca M, Vlad A, Dragoș D. Relevance of Phytochemical Taste for Anti-Cancer Activity: A Statistical Inquiry. Int J Mol Sci 2023; 24:16227. [PMID: 38003415 PMCID: PMC10671173 DOI: 10.3390/ijms242216227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Targeting inflammation and the pathways linking inflammation with cancer is an innovative therapeutic strategy. Tastants are potential candidates for this approach, since taste receptors display various biological functions, including anti-inflammatory activity (AIA). The present study aims to explore the power different tastes have to predict a phytochemical's anti-cancer properties. It also investigates whether anti-inflammatory phytocompounds also have anti-cancer effects, and whether there are tastes that can better predict a phytochemical's bivalent biological activity. Data from the PlantMolecularTasteDB, containing a total of 1527 phytochemicals, were used. Out of these, only 624 phytocompounds met the inclusion criterion of having 40 hits in a PubMed search, using the name of the phytochemical as the keyword. Among them, 461 phytochemicals were found to possess anti-cancer activity (ACA). The AIA and ACA of phytochemicals were strongly correlated, irrespective of taste/orosensation or chemical class. Bitter taste was positively correlated with ACA, while sweet taste was negatively correlated. Among chemical classes, only flavonoids (which are most frequently bitter) had a positive association with both AIA and ACA, a finding confirming that taste has predictive primacy over chemical class. Therefore, bitter taste receptor agonists and sweet taste receptor antagonists may have a beneficial effect in slowing down the progression of inflammation to cancer.
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Affiliation(s)
- Teodora-Cristiana Grădinaru
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Marilena Gilca
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Adelina Vlad
- Department of Functional Sciences I/Physiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Dorin Dragoș
- Department of Medical Semiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- 1st Internal Medicine Clinic, University Emergency Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 050098 Bucharest, Romania
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Dragoș D, Manea MM, Dobri AM, Stoican IC, Enache II, Ghenu MI, Tuta S. Risk factors for the outcome after thrombolysis in acute ischemic stroke - the prominent role of kidney dysfunction: A retrospective cohort observational study. Medicine (Baltimore) 2023; 102:e35688. [PMID: 37904370 PMCID: PMC10615531 DOI: 10.1097/md.0000000000035688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/27/2023] [Indexed: 11/01/2023] Open
Abstract
A complex interplay of factors reflecting the general biological, cardiovascular, neurological, renal, and metabolic status of patients influences the outcome of thrombolysis in stroke patients. This is a retrospective cohort observational study aimed to determine the importance of kidney dysfunction among these factors. Data (demographic, lifestyle, physical examination, laboratory, imaging, including metabolic and cardiovascular risk factors and comorbidities, neurological scores, and outcomes) of all stroke patients who underwent thrombolysis have been registered since January 1, 2016, in an online database. A total of 296 patients registered until December 31, 2020, were included in the study. The National Institutes of Health Stroke Scale, modified Rankin scale, Barthel index, percentage of hemorrhagic transformation, and in hospital death were used to evaluate the neurological status and outcomes of the patients. Regression analysis, Mann-Whitney test, Fisher exact test, logistic regression, and multivariate analysis were used for statistical analysis. Kidney dysfunction, as reflected by the estimated glomerular filtration rate, was associated with in hospital death and all but one of the neurological scores. Other risk factors most frequently associated with neurological scores were age, international normalized ratio, and cognitive decline. Multivariate analysis revealed estimated glomerular filtration rate (as determined by chronic kidney disease-EPI equation) as a determinant for all but one of these scores, and as the most important determinant for most of them, except for those reflecting the pre-intervention neurological status of the patient. Kidney dysfunction seems to be the most important determinant of the outcome of thrombolysed stroke patients, a result obtained by no other study.
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Affiliation(s)
- Dorin Dragoș
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 1st Internal Medicine Department, Emergency University Hospital, Bucharest, Romania
| | - Maria Mirabela Manea
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania
| | - Ana-Maria Dobri
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania
| | - Iulia-Cosmina Stoican
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania
| | - Iulia-Ioana Enache
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania
| | - Maria Iuliana Ghenu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 1st Internal Medicine Department, Emergency University Hospital, Bucharest, Romania
| | - Sorin Tuta
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania
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Dragoș D, Timofte D, Georgescu MT, Manea MM, Vacaroiu IA, Ionescu D, Balcangiu-Stroescu AE. Cardiovascular Calcifications Are Correlated with Inflammation in Hemodialysis Patients. Medicina (Kaunas) 2023; 59:1801. [PMID: 37893519 PMCID: PMC10608311 DOI: 10.3390/medicina59101801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: The main cause of morbidity and mortality in hemodialysis patients is cardiovascular disease, which is quite common. The main objective of our study was to investigate the relationship between oxidative stress, inflammation, and vascular and valvular calcifications in hemodialysis patients. Materials and Methods: This observational study had 54 hemodialysis patients, with an average age of 60.46 ± 13.18 years. Cardiovascular ultrasound was used to detect and/or measure aortic and mitral valve calcifications, carotid and femoral atheroma plaques, and common carotid intima-media thickness. The aortic calcification score was determined using a lateral abdomen plain radiograph. The inflammatory, oxidative, metabolic, and dietary statuses, as well as demographic characteristics, were identified. Results: There were significant correlations between the levels of IL-6 and carotid plaque number (p = 0.003), fibrinogen level and aortic valve calcifications (p = 0.05), intima-media thickness (p = 0.0007), carotid plaque number (p = 0.035), femoral plaque number (p = 0.00014), and aortic calcifications score (p = 0.0079). Aortic annulus calcifications (p = 0.03) and intima-media thickness (p = 0.038) were adversely linked with TNF-α. Nutrition parameters were negatively correlated with atherosclerosis markers: number of carotid plaques with albumin (p = 0.013), body mass index (p = 0.039), and triglycerides (p = 0.021); number of femoral plaques with phosphorus (0.013), aortic calcifications score with albumin (p = 0.051), intima-media thickness with LDL-cholesterol (p = 0.042). Age and the quantity of carotid plaques, femoral plaques, and aortic calcifications were linked with each other (p = 0.0022, 0.00011, and 0.036, respectively). Aortic annulus calcifications (p = 0.011), aortic valve calcifications (p = 0.023), and mitral valve calcifications (p = 0.018) were all associated with an increased risk of death. Conclusions: Imaging measures of atherosclerosis are adversely connected with dietary status and positively correlated with markers of inflammation and risk of mortality.
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Affiliation(s)
- Dorin Dragoș
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu nr 37, Sect 2, 020021 Bucharest, Romania (I.A.V.)
- 1st Internal Medicine Clinic, University Emergency Hospital Bucharest, Splaiul Independentei nr 169, Sect 5, 050098 Bucharest, Romania
| | - Delia Timofte
- Department of Dialysis, University Emergency Hospital Bucharest, Splaiul Independentei nr 168, Sect 5, 050098 Bucharest, Romania
| | - Mihai-Teodor Georgescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu nr 37, Sect 2, 020021 Bucharest, Romania (I.A.V.)
- Department of Radiotherapy, Prof. Dr. Al. Trestioreanu Institute of Oncology Bucharest, Șos. Fundeni nr 252, Sect 2, 022328 Bucharest, Romania
| | - Maria-Mirabela Manea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu nr 37, Sect 2, 020021 Bucharest, Romania (I.A.V.)
- National Institute of Neurology and Cerebrovascular Diseases, Șos. Berceni nr 10–12, Sect 4, 041915 Bucharest, Romania
| | - Ileana Adela Vacaroiu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu nr 37, Sect 2, 020021 Bucharest, Romania (I.A.V.)
- Nephrology and Dialysis Clinic, “Sf. Ioan” Emergency Clinical Hospital, Șos. Vitan-Barzești nr 12, 042122 Bucharest, Romania
| | - Dorin Ionescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu nr 37, Sect 2, 020021 Bucharest, Romania (I.A.V.)
- Nephrology Clinic, University Emergency Hospital, Splaiul Independentei nr 169, Sect 5, 050098 Bucharest, Romania
| | - Andra-Elena Balcangiu-Stroescu
- Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu nr 37, Sect 2, 020021 Bucharest, Romania
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Bălan DG, Calangiu F, Tănase G, Tulin R, Isac S, Georgescu DE, Dragoș D, Cobilinschi C, Chiperi LV, Ionescu D, Balcangiu-Stroescu AE, Călinoiu AL, Rusu A, Văcăroiu IA. Etiology of Chronic Kidney Disease and Comorbidities in Chronic Hemodialysis Patients. RJMM 2023. [DOI: 10.55453/rjmm.2023.126.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
"Introduction: As general population tends to have increasing life expectancy, the risk associated with developing chronic kidney disease (CKD) with multiple incapacitating concequences, also increases. Method: For the present study, we registered the data from the observation files of 37 patients diagnosed with CKD undergoing treatment by chronic hemodialysis and noted the CKD associated diagnoses included in the notion of comorbidities. We monitored their statistical incidence both in the whole group and separately, in women and men using TTEST and CORREL. Results: The median age of the subjects was 55.86 (± 12.00) years. The study population mean weight was 74.90 (± 14.44) kg, with a mean weight of 69.33 kg for female subjects, and 77.92 kg for males, respectively. Diabetes was identified in 35.13% of patients, whilst heart failure was present in 16.21% of patients. Conclusions: Following the analysis of the information about the patients with CKD in the dialysis program, which we included in the study group, we observed the existence of variations that occur with age, significant correlations between age and weight and between albuminemia and weight. The most common comorbidity is high blood pressure followed by anemia. "
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Bălan DG, Calangiu F, Tănase G, Tulin R, Isac S, Georgescu DE, Dragoș D, Cobilinschi C, Chiperi LV, Ionescu D, Balcangiu-Stroescu AE, Călinoiu AL, Rusu A, Văcăroiu IA. Etiology of Chronic Kidney Disease and Comorbidities in Chronic Hemodialysis Patients. RJMM 2023; 126:153-159. [DOI: http:/doi.org.10.55453/rjmm.2023.126.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
"Introduction: As general population tends to have increasing life expectancy, the risk associated with developing chronic kidney disease (CKD) with multiple incapacitating concequences, also increases. Method: For the present study, we registered the data from the observation files of 37 patients diagnosed with CKD undergoing treatment by chronic hemodialysis and noted the CKD associated diagnoses included in the notion of comorbidities. We monitored their statistical incidence both in the whole group and separately, in women and men using TTEST and CORREL. Results: The median age of the subjects was 55.86 (± 12.00) years. The study population mean weight was 74.90 (± 14.44) kg, with a mean weight of 69.33 kg for female subjects, and 77.92 kg for males, respectively. Diabetes was identified in 35.13% of patients, whilst heart failure was present in 16.21% of patients. Conclusions: Following the analysis of the information about the patients with CKD in the dialysis program, which we included in the study group, we observed the existence of variations that occur with age, significant correlations between age and weight and between albuminemia and weight. The most common comorbidity is high blood pressure followed by anemia. "
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Dragoș D, Petran M, Gradinaru TC, Gilca M. Phytochemicals and Inflammation: Is Bitter Better? Plants (Basel) 2022; 11:plants11212991. [PMID: 36365444 PMCID: PMC9654259 DOI: 10.3390/plants11212991] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 05/13/2023]
Abstract
The taste of a herb influences its use in traditional medicine. A molecular basis for the taste-based patterns ruling the distribution of herbal (ethno) pharmacological activities may not be excluded. This study investigated the potential correlations between the anti-inflammatory activity (AIA) and the phytocompound taste and/or its chemical class. The study relies on information gathered by an extensive literature (articles, books, databases) search and made public as PlantMolecularTasteDB. Out of a total of 1527 phytotastants with reliably documented taste and structure available in PlantMolecularTasteDB, 592 (for each of which at least 40 hits were found on PubMed searches) were included in the statistical analysis. A list of 1836 putative molecular targets of these phytotastants was afterwards generated with SwissTargetPrediction tool. These targets were systematically evaluated for their potential role in inflammation using an international databases search. The correlations between phytochemical taste and AIA, between chemical class and AIA, and between the taste and the number of inflammation related targets were statistically analyzed. Phytochemical taste may be a better predictor of AIA than the chemical class. Bitter phytocompounds have a higher probability of exerting AIA when compared with otherwise phytotastants. Moreover, bitter phytotastants act upon more inflammation related targets than non-bitter tasting compounds.
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Affiliation(s)
- Dorin Dragoș
- Department of Medical Semiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- 1st Internal Medicine Clinic, University Emergency Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 050098 Bucharest, Romania
- Correspondence:
| | - Madalina Petran
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Teodora-Cristiana Gradinaru
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Marilena Gilca
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Manea MM, Dragoș D, Tuță S. Is Acute Ischemic Stroke Really Associated with Left Ventricular Systolic Dysfunction? A Case-Control Study. Neurol India 2022; 70:596-599. [PMID: 35532625 DOI: 10.4103/0028-3886.344651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
CONTEXT Heart failure and acute ischemic stroke (AIS) are frequently associated, due to similar risk factors and intertwined pathophysiologic mechanisms, and both result in a high mortality rate. AIMS Our objective was to demonstrate that left ventricular systolic dysfunction (LVSD) is associated with AIS. SETTINGS AND DESIGN Prospective matched, case-control study on 110 patients with AIS. METHODS AND MATERIAL The patients in the control group (CG) without history of AIS and the same inclusion criteria were matched for age, sex, and atrial fibrillation (AF) prevalence. STATISTICAL ANALYSIS USED Fisher's exact test was used for statistical analysis. RESULTS LVSD of any degree was not statistically more or less frequent in AIS patients than in the CG. The same was true if only the patients with AF were considered (the prevalence of LVSD was not significantly different in patients with AIS and AF than in controls with AF). However, among the patients without AF the proportion of patients with normal systolic function was significantly higher in the controls than in the AIS group (P = 0.036). There was no significant difference regarding LVSD either between the patients with cardioembolic AIS and those with noncardioembolic AIS or between the AIS patients with AF and AIS patients without AF. CONCLUSIONS Our study concluded that the prevalence of LVSD was the same in AIS patients and controls matched for age, sex, and AF prevalence, although the prevalence of LVSD was indeed higher in AIS patients without AF than in controls without AF.
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Affiliation(s)
- Mirabela M Manea
- Department of Neurology, Carol Davila University of Medicine and Pharmacy; Department of Neurology, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania
| | - Dorin Dragoș
- Department of Semiology, Carol Davila University of Medicine and Pharmacy; Departments of Internal Medicine, and Nephrology, Emergency University Hospital, Bucharest, Romania
| | - Sorin Tuță
- Department of Neurology, Carol Davila University of Medicine and Pharmacy; Department of Neurology, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania
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Manea MM, Dragoș D, Enache I, Sirbu AG, Tuta S. Multiple cranial nerve palsies following COVID-19 vaccination-Case report. Acta Neurol Scand 2022; 145:257-259. [PMID: 34725821 PMCID: PMC8653229 DOI: 10.1111/ane.13548] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 12/17/2022]
Abstract
Background The novel COVID‐19 vaccines have side effects that require efficient and close monitoring. Aims of the Study To examine whether the Pfizer‐BioNTech vaccine is associated with multiple cranial neuropathy. Methods We report the case of a 29‐year‐old male patient with no notable history who presented with left oculomotor, abducens, trigeminal and facial palsies 6 days after receiving the first dose of the Pfizer‐BioNTech COVID‐19 vaccine. Results Gadolinium‐enhanced MRI of the brain revealed enhancement in the left facial, trigeminal and oculomotor nerves, which persisted upon repeated examination. The cerebrospinal fluid analysis showed no sign of inflammation, both initially and after 1 month from the start of the patient's symptoms. Other causes were excluded by laboratory tests. The patient received high doses of corticosteroids, with improvement of symptoms. Conclusions In our case, the most probable etiology of the patient's multiple cranial neuropathy is the Pfizer‐BioNTech vaccine, which highlights the need for prolonged surveillance of COVID‐19 vaccine neurological complications.
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Affiliation(s)
- Maria Mirabela Manea
- Carol Davila University of Medicine and Pharmacy Bucharest Romania
- Neurology Department National Institute of Neurology and Neurovascular Diseases Bucharest Romania
| | - Dorin Dragoș
- Carol Davila University of Medicine and Pharmacy Bucharest Romania
- Internal Medicine Department Emergency University Hospital Bucharest Romania
| | - Iulia Enache
- Neurology Department National Institute of Neurology and Neurovascular Diseases Bucharest Romania
| | - Adrian George Sirbu
- Neurology Department National Institute of Neurology and Neurovascular Diseases Bucharest Romania
- MEDINST Centre Bucharest Romania
| | - Sorin Tuta
- Carol Davila University of Medicine and Pharmacy Bucharest Romania
- Neurology Department National Institute of Neurology and Neurovascular Diseases Bucharest Romania
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Timofte D, Dragoș D, Balcangiu-Stroescu AE, Tănăsescu MD, Gabriela Bălan D, Răducu L, Tulin A, Stiru O, Ionescu D. Abdominal aortic calcification in predialysis patients: Contribution of traditional and uremia-related risk factors. Exp Ther Med 2020; 20:97-102. [PMID: 32509000 PMCID: PMC7271689 DOI: 10.3892/etm.2020.8607] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/03/2020] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease is the main cause of morbidity and mortality in end-stage renal disease (ESRD) patients. Recent population based epidemiological studies demonstrated a correlation between reduced renal function and risk for all causes and cardiovascular mortality, 50% of patients dying before the commencement of renal replacement therapy. Vascular calcifications (VC) and arterial stiffness are major contributors to cardiovascular disease and are independent predictors of cardiovascular mortality in ESRD patients. Scarce information is available on the risk factors and prognosis of predialysis patients with VC. The aim of this study was to evaluate the contribution of traditional and uremia related risk factors to abdominal aortic calcification in predialysis patients. A single center, retrospective study was performed on 305 adult patients monitored at the Bucharest University Emergency Hospital for at least 6 months. Our study reports an increased incidence of VC in predialysis chronic kidney disease (CKD) patients, higher in those with advanced age, history of cardiovascular disease, osteoporosis, and declining renal function.
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Affiliation(s)
- Delia Timofte
- Department of Dialysis, Emergency University Hospital, 050098 Bucharest, Romania
| | - Dorin Dragoș
- Department of Medical Semiology, Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Nephrology, Emergency University Hospital, 050098 Bucharest, Romania
| | - Andra-Elena Balcangiu-Stroescu
- Department of Dialysis, Emergency University Hospital, 050098 Bucharest, Romania.,Discipline of Physiology, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Maria-Daniela Tănăsescu
- Department of Medical Semiology, Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Nephrology, Emergency University Hospital, 050098 Bucharest, Romania
| | - Daniela Gabriela Bălan
- Discipline of Physiology, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Laura Răducu
- Department of Plastic and Reconstructive Microsurgery, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Plastic and Reconstructive Surgery, 'Prof. Dr. Agrippa Ionescu' Clinical Emergency Hospital, 011356 Bucharest, Romania
| | - Adrian Tulin
- Department of Anatomy, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of General Surgery, 'Prof. Dr. Agrippa Ionescu' Clinical Emergency Hospital, 011356 Bucharest, Romania
| | - Ovidiu Stiru
- Department of Cardiovascular Surgery, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Cardiovascular Surgery, 'Prof. Dr. C.C. Iliescu' Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania
| | - Dorin Ionescu
- Department of Medical Semiology, Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Nephrology, Emergency University Hospital, 050098 Bucharest, Romania
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10
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Dragoș D, Manea MM, Timofte D, Ionescu D. Mechanisms of Herbal Nephroprotection in diabetes mellitus. J Diabetes Res 2020; 2020:5710513. [PMID: 32695828 PMCID: PMC7362309 DOI: 10.1155/2020/5710513] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/24/2020] [Accepted: 06/06/2020] [Indexed: 12/13/2022] Open
Abstract
Diabetic nephropathy (DN) is a leading cause of kidney morbidity. Despite the multilayered complexity of the mechanisms involved in the pathogenesis of DN, the conventional treatment is limited to just a few drug classes fraught with the risk of adverse events, including the progression of renal dysfunction. Phytoceuticals offer a promising alternative as they act on the many-sidedness of DN pathophysiology, multitargeting its intricacies. This paper offers a review of the mechanisms underlying the protective action of these phytoagents, including boosting the antioxidant capabilities, suppression of inflammation, averting the proliferative and sclerosing/fibrosing events. The pathogenesis of DN is viewed as a continuum going from the original offense, high glucose, through the noxious products it generates (advanced glycation end-products, products of oxidative and nitrosative stress) and the signaling chains consequently brought into action, to the harmful mediators of inflammation, sclerosis, and proliferation that eventually lead to DN, despite the countervailing attempts of the protective mechanisms. Special attention was given to the various pathways involved, pointing out the ability of the phytoagents to hinder the deleterious ones (especially those leading to, driven by, or associated with TGF-β activation, SREBP, Smad, MAPK, PKC, NF-κB, NLRP3 inflammasome, and caspase), to promote the protective ones (PPAR-α, PPAR-γ, EP4/Gs/AC/cAMP, Nrf2, AMPK, and SIRT1), and to favorably modulate those with potentially dual effect (PI3K/Akt). Many phytomedicines have emerged as potentially useful out of in vitro and in vivo studies, but the scarcity of human trials seriously undermines their usage in the current clinical practice-an issue that stringently needs to be addressed.
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Affiliation(s)
- Dorin Dragoș
- Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, str. Dionisie Lupu nr. 37, sect 1, Bucharest 020021, Romania
- Nephrology Clinic of University Emergency Hospital, Splaiul Independentei nr. 169, sect. 5, Bucharest 050098, Romania
| | - Maria Mirabela Manea
- Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, str. Dionisie Lupu nr. 37, sect 1, Bucharest 020021, Romania
- National Institute of Neurology and Cerebrovascular Diseases, Şos. Berceni, Nr. 10-12, Sector 4, Bucharest 041914, Romania
| | - Delia Timofte
- Dialysis Department of University Emergency Hospital, Splaiul Independentei nr. 169, sect. 5, Bucharest 050098, Romania
| | - Dorin Ionescu
- Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, str. Dionisie Lupu nr. 37, sect 1, Bucharest 020021, Romania
- Nephrology Clinic of University Emergency Hospital, Splaiul Independentei nr. 169, sect. 5, Bucharest 050098, Romania
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