1
|
Gallo G, Picciariello A, Tufano A, Camporese G. Clinical evidence and rationale of mesoglycan to treat chronic venous disease and hemorrhoidal disease: a narrative review. Updates Surg 2024; 76:423-434. [PMID: 38356039 PMCID: PMC10995001 DOI: 10.1007/s13304-024-01776-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
Chronic venous disease (CVD) and hemorrhoidal disease (HD) are among the most common vascular diseases in the world, with CVD affecting 22-41% of the population in Europe and HD having a point prevalence of 11-39%. The burden is substantial in terms of the effect of symptoms on patients' health-related quality of life (HRQoL) and direct/indirect medical costs. Treatment begins with lifestyle changes, compression in CVD and topical therapies in HD, and escalates as needed through oral therapies first and eventually to surgery for severe disease. CVD and HD share etiological features and pathological changes affecting the structure and function of the tissue extracellular matrix. Mesoglycan, a natural glycosaminoglycan (GAG) preparation composed primarily of heparan sulfate and dermatan sulfate, has been demonstrated to positively impact the underlying causes of CVD and HD, regenerating the glycocalyx and restoring endothelial function, in addition to having antithrombotic, profibrinolytic, anti-inflammatory, antiedema and wound-healing effects. In clinical trials, oral mesoglycan reduced the severity of CVD signs and symptoms, improved HRQoL, and accelerated ulcer healing. In patients with HD, mesoglycan significantly reduced the severity of signs and symptoms and the risk of rectal bleeding. In patients undergoing excisional hemorrhoidectomy, adding mesoglycan to standard postoperative care reduced pain, improved HRQoL, reduced incidence of thrombosis, and facilitated an earlier return to normal activities/work, compared with standard postoperative care alone. The clinical effects of mesoglycan in patients with CVD or HD are consistent with the agent's known mechanisms of action.
Collapse
Affiliation(s)
- Gaetano Gallo
- Department of Surgery, Sapienza University of Rome, Rome, Italy.
| | | | - Antonella Tufano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Giuseppe Camporese
- Department of Internal Medicine, Padua University Hospital, Padua, Italy
| |
Collapse
|
2
|
Kurhaluk N. The Effectiveness of L-arginine in Clinical Conditions Associated with Hypoxia. Int J Mol Sci 2023; 24:ijms24098205. [PMID: 37175912 PMCID: PMC10179183 DOI: 10.3390/ijms24098205] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The review summarises the data of the last 50 years on the effectiveness of the amino acid L-arginine in therapeutic practice in conditions accompanied by different-origin hypoxia. The aim of this review was to analyse the literature and our research data on the role of nitric oxide in the modulation of individual physiological reactivity to hypoxia. The review considers the possibility of eliminating methodological conflicts in the case of L-arginine, which can be solved by taking into account individual physiological reactivity (or the hypoxia resistance factor). Considerable attention is paid to genetic and epigenetic mechanisms of adaptation to hypoxia and conditions of adaptation in different models. The article presents data on the clinical effectiveness of L-arginine in cardiovascular system diseases (hypertension, atherosclerosis, coronary heart disease, etc.) and stress disorders associated with these diseases. The review presents a generalised analysis of techniques, data on L-arginine use by athletes, and the ambiguous role of NO in the physiology and pathology of hypoxic states shown via nitric oxide synthesis. Data on the protective effects of adaptation in the formation of individual high reactivity in sportsmen are demonstrated. The review demonstrates a favourable effect of supplementation with L-arginine and its application depending on mitochondrial oxidative phosphorylation processes and biochemical indices in groups of individuals with low and high capacity of adaptation to hypoxia. In individuals with high initial anti-hypoxic reserves, these favourable effects are achieved by the blockade of NO-dependent biosynthesis pathways. Therefore, the methodological tasks of physiological experiments and the therapeutic consequences of treatment should include a component depending on the basic level of physiological reactivity.
Collapse
Affiliation(s)
- Natalia Kurhaluk
- Department of Biology, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk, Arciszewski St. 22 B, 76-200 Słupsk, Poland
| |
Collapse
|
3
|
Costa D, Andreucci M, Ielapi N, Serraino GF, Mastroroberto P, Bracale UM, Serra R. Molecular Determinants of Chronic Venous Disease: A Comprehensive Review. Int J Mol Sci 2023; 24:ijms24031928. [PMID: 36768250 PMCID: PMC9916309 DOI: 10.3390/ijms24031928] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Chronic Venous Disease (CVD) refers to several pathological and hemodynamic alterations of the veins of lower limbs causing a wide range of symptoms and signs with a high prevalence in the general population and with disabling consequences in the most severe forms. The etiology and pathophysiology of CVD is complex and multifactorial, involving genetic, proteomic, and cellular mechanisms that result in changes to the venous structure and functions. Expressions of several genes associated with angiogenesis, vascular development, and the regulation of veins are responsible for the susceptibility to CVD. Current evidence shows that several extracellular matrix alterations (ECM) could be identified and in some cases pharmacologically targeted. This review shows the most up to date information on molecular determinants of CVD in order to provide a complete overview of the current knowledge on this topic. In particular, the article explores the genetic influence, the hormonal influence, ECM imbalance, and histopathology of CVD and the role of endothelial dysfunction in CVD.
Collapse
Affiliation(s)
- Davide Costa
- Department of Law, Economics and Sociology, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Michele Andreucci
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Nicola Ielapi
- Department of Public Health and Infectious Disease, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Giuseppe Filiberto Serraino
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Pasquale Mastroroberto
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | | | - Raffaele Serra
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Correspondence:
| |
Collapse
|
4
|
Doghri Y, Dubreil L, Lalanne V, Hélissen O, Fleurisson R, Thorin C, Desfontis JC, Mallem MY. Soluble guanylate cyclase chronic stimulation effects on cardiovascular reactivity in cafeteria diet-induced rat model of metabolic syndrome. Eur J Pharmacol 2021; 899:173978. [PMID: 33691164 DOI: 10.1016/j.ejphar.2021.173978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 11/19/2022]
Abstract
Metabolic syndrome is linked to an increased risk of cardiovascular complications by a mechanism involving mainly decreased nitric oxide (NO) bioavailability and impaired NO-soluble guanylate cyclase (sGC)- cyclic guanosine monophosphate (cGMP) signalling (NO-sGC-cGMP). To further develop this scientific point, this study aimed to investigate the effects of long-term treatment with BAY 41-2272 (a sGC stimulator) on cardiovascular reactivity of spontaneously hypertensive rats (SHR) as a model of metabolic syndrome. SHR were randomly divided into 3 groups: control group, cafeteria diet (CD)-fed group and CD-fed group treated daily with BAY 41-2272 (5 mg/kg) by gastric gavage for 12 weeks. In vivo measurements of body weight, abdominal circumference, blood pressure and glucose tolerance test were performed. At the end of the feeding period, ex vivo cumulative concentration-response curves were performed on isolated perfused heart (isoproterenol (0.1 nM - 1 μM)) and thoracic aorta (phenylephrine (1 nM-10 μM), acetylcholine (1 nM-10 μM), and sodium nitroprusside (SNP) (0.1 nM-0.1 μM)). We showed that chronic CD feeding induced abdominal obesity, hypertriglyceridemia, glucose intolerance and exacerbated arterial hypertension in SHR. Compared to control group, CD-fed group showed a decrease in β-adrenoceptor-induced cardiac inotropy, in coronary perfusion pressure and in aortic contraction to phenylephrine. While relaxing effects of acetylcholine and SNP were unchanged. BAY 41-2272 long-term treatment markedly prevented arterial hypertension development and glucose intolerance, enhanced the α1-adrenoceptor-induced vasoconstriction, and restored cardiac inotropy and coronary vasodilation. These findings suggest that BAY 41-2272 may be a potential novel drug for preventing metabolic and cardiovascular complications of metabolic syndrome.
Collapse
MESH Headings
- Animals
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/physiopathology
- Cardiovascular Diseases/enzymology
- Cardiovascular Diseases/etiology
- Cardiovascular Diseases/physiopathology
- Cardiovascular Diseases/prevention & control
- Coronary Circulation/drug effects
- Cyclic GMP/metabolism
- Disease Models, Animal
- Enzyme Activation
- Enzyme Activators/pharmacology
- Glucose Intolerance/enzymology
- Glucose Intolerance/etiology
- Glucose Intolerance/physiopathology
- Glucose Intolerance/prevention & control
- Hypertension/enzymology
- Hypertension/etiology
- Hypertension/physiopathology
- Hypertension/prevention & control
- Hypertriglyceridemia/enzymology
- Hypertriglyceridemia/etiology
- Hypertriglyceridemia/physiopathology
- Hypertriglyceridemia/prevention & control
- Isolated Heart Preparation
- Male
- Metabolic Syndrome/enzymology
- Metabolic Syndrome/etiology
- Metabolic Syndrome/physiopathology
- Metabolic Syndrome/prevention & control
- Nitric Oxide Synthase Type II/metabolism
- Obesity, Abdominal/enzymology
- Obesity, Abdominal/etiology
- Obesity, Abdominal/physiopathology
- Obesity, Abdominal/prevention & control
- Pyrazoles/pharmacology
- Pyridines/pharmacology
- Rats, Inbred SHR
- Soluble Guanylyl Cyclase/metabolism
- Vasoconstriction/drug effects
- Vasodilation/drug effects
- Ventricular Function, Left/drug effects
- Ventricular Pressure/drug effects
- Rats
Collapse
Affiliation(s)
- Yosra Doghri
- UPSP NP3 (2017.B146), Nutrition, Pathophysiology and Pharmacology, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France
| | - Laurence Dubreil
- UMR PAnTher 703 INRA/Oniris Animal Pathophysiology and Bio Therapy for Muscle and Nervous System Diseases, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France
| | - Valérie Lalanne
- UPSP NP3 (2017.B146), Nutrition, Pathophysiology and Pharmacology, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France
| | - Ophélie Hélissen
- UPSP NP3 (2017.B146), Nutrition, Pathophysiology and Pharmacology, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France
| | - Romain Fleurisson
- UMR PAnTher 703 INRA/Oniris Animal Pathophysiology and Bio Therapy for Muscle and Nervous System Diseases, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France
| | - Chantal Thorin
- UPSP NP3 (2017.B146), Nutrition, Pathophysiology and Pharmacology, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France
| | - Jean-Claude Desfontis
- UPSP NP3 (2017.B146), Nutrition, Pathophysiology and Pharmacology, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France
| | - M Yassine Mallem
- UPSP NP3 (2017.B146), Nutrition, Pathophysiology and Pharmacology, Oniris, Nantes-Atlantic College of Veterinary Medicine Food Sciences and Engineering, 44307, Nantes Cedex 03, France.
| |
Collapse
|
5
|
Noce A, Di Lauro M, Di Daniele F, Pietroboni Zaitseva A, Marrone G, Borboni P, Di Daniele N. Natural Bioactive Compounds Useful in Clinical Management of Metabolic Syndrome. Nutrients 2021; 13:630. [PMID: 33669163 PMCID: PMC7919668 DOI: 10.3390/nu13020630] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 12/11/2022] Open
Abstract
Metabolic syndrome (MetS) is a clinical manifestation characterized by a plethora of comorbidities, including hyperglycemia, abdominal obesity, arterial hypertension, and dyslipidemia. All MetS comorbidities participate to induce a low-grade inflammation state and oxidative stress, typical of this syndrome. MetS is related to an increased risk of cardiovascular diseases and early death, with an important impact on health-care costs. For its clinic management a poly-pharmaceutical therapy is often required, but this can cause side effects and reduce the patient's compliance. For this reason, finding a valid and alternative therapeutic strategy, natural and free of side effects, could represent a useful tool in the fight the MetS. In this context, the use of functional foods, and the assumption of natural bioactive compounds (NBCs), could exert beneficial effects on body weight, blood pressure and glucose metabolism control, on endothelial damage, on the improvement of lipid profile, on the inflammatory state, and on oxidative stress. This review focuses on the possible beneficial role of NBCs in the prevention and in the clinical management of MetS and its comorbidities.
Collapse
Affiliation(s)
- Annalisa Noce
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.L.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Manuela Di Lauro
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.L.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Francesca Di Daniele
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.L.); (F.D.D.); (A.P.Z.); (N.D.D.)
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Anna Pietroboni Zaitseva
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.L.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Giulia Marrone
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.L.); (F.D.D.); (A.P.Z.); (N.D.D.)
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Patrizia Borboni
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy;
| | - Nicola Di Daniele
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.L.); (F.D.D.); (A.P.Z.); (N.D.D.)
| |
Collapse
|
6
|
Liu W, Wu Y, Hu Y, Qin S, Guo X, Wang M, Wu L, Liu T. Effects of Cyclocarya paliurus Aqueous and Ethanol Extracts on Glucolipid Metabolism and the Underlying Mechanisms: A Meta-Analysis and Systematic Review. Front Nutr 2020; 7:605605. [PMID: 33335910 PMCID: PMC7736088 DOI: 10.3389/fnut.2020.605605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022] Open
Abstract
Background and Aims:Cyclocarya paliurus (CP) has been used as an herbal tea to treat diabetes mellitus and obesity for hundreds of years. Previous research suggests that CP specifically restores glucolipid metabolic homeostasis, and the two most studied preparations are aqueous and ethanol extracts. In order to verify the effect of CP on glucolipid metabolism in animal models with metabolic syndrome, a meta-analysis was performed, and the active components and underlying mechanisms were systematically reviewed. Methods: Four databases: PubMed, Web of Science, Embase, and Cochrane Library were searched to identify potential literature. Data of blood glucose (BG) level, area under curve (AUC) of oral glucose tolerance test (OGTT), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels were extracted as indicators of the assessment of CP's effects. Follow-up analyses including subgroup analysis, meta-regressions, and publication bias were also conducted. Results: A total of 96 papers were identified from the databases and 11 papers including 31 data reports were involved in the meta-analysis. CP had a positive effect in down-regulating BG, AUC of OGTT, TC, TG, and LDL, and up-regulating HDL (P < 0.001, 95% confidence interval of standard mean difference did not incorporate the null value 0). Conclusion: CP showed definite activity of regulating glucolipid metabolism in animal models, and it exerted its function through multiple mechanisms including but not limited to: (1) improving insulin resistance; (2) protecting pancreatic β cells; (3) decreasing inflammatory infiltration; and (4) anti-oxidative stress.
Collapse
Affiliation(s)
- Wei Liu
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, China.,Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - You Wu
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, China.,Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuli Hu
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, China.,Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Shuai Qin
- First School of Clinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xiaoyuan Guo
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Minghui Wang
- Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Lili Wu
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, China
| | - Tonghua Liu
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|