The role of physiological elements in future therapies of rheumatoid arthritis. III. The role of the electromagnetic field in regulation of redox potential and life cycle of inflammatory cells

Each material consisting of charged particles can be influenced by a magnetic field. Polarized particles play an essential role in almost all physiological processes. Locally generated electromagnetic fields several physiological processes within the human body, for example: stimulation of nerves, muscles, and cardiac electrical activity. This phenomenon is used today in many medical applications. In this article, we discuss ways in which electromagnetic field affects the physiological and pathological processes in cells and tissues. This knowledge will help to better understand the electrophysiological phenomenon in connective tissue diseases and can bring new therapeutic strategies (in the form of “invisible drugs”) for the treatment of rheumatic diseases?     

Failure to sense energy depletion may be a novel therapeutic target in chronic kidney disease

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The importance of inflammation control for the treatment of chronic diabetic wounds

Diabetic chronic wounds cause massive levels of patient suffering and economic problems worldwide. The state of chronic inflammation arises in response to a complex combination of diabetes mellitus-related pathophysiologies. Advanced treatment options are available; however, many wounds still fail to heal, exacerbating morbidity and mortality. This review describes the chronic inflammation pathophysiologies in diabetic ulcers and treatment options that may help address this dysfunction either directly or indirectly. We suggest that treatments to reduce inflammation within these complex wounds may help trigger healing.     

Malnutrition and inflammation are associated with impaired pulmonary function in patients with chronic kidney disease.

BACKGROUND: Inflammation and malnutrition are common findings in patients with chronic kidney disease (CKD). We hypothesized that in inflamed and malnourished patients, respiratory and peripheral muscle dysfunction may have significant consequences on pulmonary function. The aim of this study was to investigate possible associations between pulmonary function and inflammation and malnutrition in patients with CKD. METHODS: We studied 109 patients (63% males; 53+/-12 years) at the initiation of dialysis treatment (GFR 7.5+/-2.5 ml/min). Pulmonary function tests [forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC) and peak expiratory flow (PEF)] were performed and the percentages of predicted values were calculated (%FEV(1), %FVC and %PEF). Systemic inflammation, assessed by high-sensitivity C-reactive protein (hsCRP) and nutritional status assessed by subjective global assessment (SGA), lean body mass (LBM) (estimated with dual energy X-ray absorptiometry) and hand-grip strength (HGS), were evaluated at the same time. RESULTS: Significant negative correlations were found between hsCRP and the percent predicted values for all pulmonary function tests [%FEV(1) (Rho = -0.45), %FVC (Rho = -0.43) and %PEF (Rho = -0.38)], respectively. Malnourished patients defined as SGA >or=2 had lower %FEV(1) (64+/-19 vs 82+/-23%; P<0.001) and %FVC (67+/-18 vs 83+/-21%; P<0.001) than well nourished patients. Significant correlations were observed between HGS and %FVC (Rho = 0.38; P <0.001), %FEV(1) (Rho = 0.37; P<0.001) and %PEF (Rho = 0.22; P<0.05) and between LBM and %PEF (Rho = 0.20; P<0.05). Multivariate Cox analysis showed that cardiovascular disease and low %FVC were associated with poor survival. CONCLUSIONS: Impaired pulmonary function is associated with malnutrition and inflammation, and predicts mortality in CKD patients. This may reflect an impact of malnutrition and inflammation on respiratory muscle performance, leading to pulmonary dysfunction, which could influence the clinical outcome.     

The role of the neutrophil in rheumatoid arthritis

Neutrophils acquire lysosomal granules and assembly systems for producing soluble mediators of inflammation during the process of maturation in the bone marrow. Subsequently, they emigrate from the circulation when they become attracted to joint spaces of rheumatoid arthritis patients by chemoattractants such as the complement split product, C5a, and leukotriene B4. Exposure to immune complexes, rheumatoid factor, and cytokines in the synovial fluid results in neutrophil activation with release of granule contents, toxic oxygen metabolites, and proinflammatory products of the arachidonic acid cascade. This process is analogous to a local Arthus reaction in which activation of the complement system is a central event. Some of the inflammatory materials released by this reaction contribute to the cartilage destruction seen in rheumatoid arthritis. Because others are chemoattractants themselves, they perpetuate intraarticular inflammation and permit the predominance of acute inflammatory cells in lesions maintained by chronic inflammation.     

成骨过程中细胞内能量代谢研究进展

骨质疏松症是一种全身性代谢性骨病,是由于破骨细胞介导的骨吸收和成骨细胞介导的骨形成之间失衡引起的。近年来骨骼细胞内能量代谢重新引起人们的兴趣,因为这些过程有可能成为骨质疏松症治疗的靶点。成骨细胞是骨骼重塑单位的骨形成细胞,对骨骼的生长和稳定至关重要。本文拟探讨骨形成过程中骨髓间充质干细胞和成骨细胞等成骨相关细胞的生物能学,主要包含葡萄糖、脂肪酸、氨基酸在成骨过程中分解代谢并产生能量的特点。     

High percentage of apoptotic spermatozoa in ejaculates from men with chronic genital tract inflammation

Silent chronic inflammation of genital tract (CIGT) is considered as a major contributing factor to male fertility disorders. Within CIGT, inflammatory cytokines such as TNF-alpha might induce spermatozoal apoptosis, which in turn has been shown to have a negative influence on the sperm-oocyte penetration capacity. Thus, the aim of this study was to investigate spermatozoal apoptosis in patients with fertility disorders and signs of CIGT. Apoptosis of spermatozoa was determined by expression of annexin V using flow cytometry. Apoptotic spermatozoa were further discriminated from necrotic spermatozoa by 7-amino-actinomycin (7AAD). Ejaculates of patients showing signs of CIGT (P-CIGT) such as high polymorphonuclear (PMN) elastase were compared to control ejaculates of patients lacking signs of CIGT (CON). Thereby we detected a significant correlation between PMN elastase and TNF-alpha in the seminal plasma and apoptotic spermatozoa. Furthermore, we demonstrated a significantly higher percentage of apoptotic spermatozoa in the ejaculate of P-CIGT compared to CON. Interestingly, a significantly higher percentage of apoptotic spermatozoa was detected in the swim-up fraction demonstrating motility of apoptotic spermatozoa. This is in line with the missing correlation of apoptotic spermatozoa and motility. In conclusion, patients with signs of CIGT display high numbers of apoptotic spermatozoa with progressive motility, which might have an impact on reproductive techniques such as intrauterine insemination or in-vitro fertilisation.     

骨质疏松进程中破骨细胞能量代谢重编程研究进展

骨质疏松症是一种成骨细胞和破骨细胞之间失衡造成的代谢性骨病。破骨细胞通过吸收葡萄糖、脂肪酸、氨基酸等产生的能量,并分化激活代谢程序。代谢重编程产生能量以支持单核前体细胞向多核破骨细胞的表型改变,并促进骨吸收,这是终末分化成熟破骨细胞主要的功能,所有代谢途径紧密联系。因此研究不同能量、不同环境下,破骨细胞代谢重编程具有重要的意义。     

The role of the anaesthetist in chronic pain management

The role of the anaesthetist in the continuing care of patients suffering from chronic pain has been discussed. Many of the techniques, both invasive and non-invasive, which are currently available for the treatment of chronic pain have been reviewed.     

Management of the patient with rheumatoid arthritis. The role of the hand therapist

The treatment of patients with rheumatoid arthritis requires a team approach, with the patient as the key player. These patients have a chronic disease that necessitates monitoring by physicians, nurses, social workers, therapists, and vocational counselors. The hand therapist provides individual exercise and activities programs, hand splinting, and instruction in joint protection and energy conservation techniques. When a patient requires surgery, the hand therapist works in conjunction with the surgeon in both the preoperative phase of patient evaluation and education, and in the postoperative management. The team working together helps the patient receive maximum benefits from treatment and to live more comfortably with his disease.     

Endotoxins in the prostatic secretions of chronic prostatitis patients

AIM: To evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients. METHODS: The EPS of 45 patients with CP and 15 normal volunteers were obtained for microscopic examination, bacterial culture and endotoxin determination. The level of endotoxins was determined by the Limulus-amebocyte-lysate test with chromogenic substrate. RESULTS: Patients with CP had higher mean levels of endotoxins in EPS than normal volunteers [52.06 +/- 32.83 EU/L vs. 4.77 +/- 4.14 EU/L (P <0.05)]. The levels of endotoxins in CP type II, type IIIa and type IIIb were 68.62 +/- 34.78 EU/L, 45.30 +/- 23.33 EU/L and 15.83 +/- 5.31 EU/L, respectively [type II vs. type IIIa (P >0.05), type IIIb vs. normal controls (P <0.05), type II/type IIIa vs. normal controls P >0.05)]. CONCLUSION: CP patients have elevated levels of endotoxins in the EPS, which suggests that inflammation is a feature of this disease. EPS endotoxin determination is not only helpful in diagnostic confirmation, but also in evaluating the response to treatment in CP patients.     

曲美他嗪对慢性肾衰竭大鼠心肌能量代谢及超微结构的影响

目的 观察曲美他嗪(TZM)对慢性肾衰竭大鼠心肌能量代谢及病理结构的影响。 方法 40只雄性SD大鼠行5/6肾切除术,将成模大鼠随机分为手术对照组、曲美他嗪小剂量（3 mg/kg）组、中剂量（6 mg/kg）组和大剂量（9 mg/kg）组,并设假手术组（雄性SD大鼠10只）。各治疗组大鼠每日灌胃给药,假手术组和手术对照组则予生理盐水,持续17周。实验结束时,测量各组大鼠左心室/体质量、全心/体质量比值;监测平均动脉压及心率;观察心脏超声检查和病理形态学改变,并测定尿素氮（BUN）、血肌酐（Scr）、三磷酸腺苷（ATP）、二磷酸腺苷（ADP）、超氧化物歧化酶（SOD）、丙二醛（MDA）、白细胞介素6（IL-6）、肿瘤坏死因子(TNF)α。 结果 （1）曲美他嗪中剂量组、大剂量组左室收缩末内径、左室舒张末期前壁厚度、左室收缩末期前壁厚度、左室舒张末期后壁厚度均显著低于手术对照组（均P < 0.05）。（2）曲美他嗪中剂量组、大剂量组左心室/体质量、全心/体质量均显著低于手术对照组（P < 0.05）。（3）光镜可见手术对照组心肌细胞排列紊乱、肥大,部分心肌纤维化;电镜可见手术对照组心肌组织大片心肌纤维溶解,线粒体增多、肿胀、空泡化,膜断裂。各治疗组心肌病理形态学改变均比手术对照组轻,且随曲美他嗪剂量增大有好转趋势。（4）各组大鼠心率差异无统计学意义,5/6肾切除各组收缩压、舒张压及平均动脉压均显著高于假手术组（P <0.01）,而5/6肾切除各组间收缩压、舒张压及平均动脉压差异均无统计学意义（P > 0.05）。（5）曲美他嗪3个剂量组ATP、ADP均显著高于手术对照组（均P < 0.05）,且大剂量组、中剂量组ATP、ADP均显著高于小剂量组（均P < 0.05）。（6）曲美他嗪大剂量组、中剂量组剂量IL-6、TNF-α、MDA均显著低于手术对照组（均P < 0.05）,而SOD均显著高于手术对照组（均P < 0.05）。 结论 曲美他嗪可以改善慢性肾衰竭大鼠心肌能量代谢、微炎性反应和氧化应激状态,从而防治慢性肾衰竭大鼠心肌细胞纤维化及左心室肥厚。     

破骨细胞能量代谢的研究进展

破骨细胞在骨代谢中发挥重要的噬骨功能,其分化成熟和功能发挥对骨代谢具有重要意义.破骨细胞分化和发挥功能阶段都需要能量代谢的参与,能量代谢的异常会导致破骨细胞分化功能的异常,从而导致骨代谢的异常.本文拟从能量代谢的角度综述破骨细胞分化和发挥功能的不同阶段,其主要的能量来源和调控机制.