Philosophy,Medicine and Healthcare: Insights from the Italian Experience

To contribute to our understanding of the relationship between philosophical ideas and medical and healthcare models. A diachronic analysis is put in place in order to evaluate, from an innovative perspective, the influence over the centuries on medical and healthcare models of two philosophical concepts, particularly relevant for health: how Man perceives his identity and how he relates to Nature. Five epochs are identified—the Archaic Age, Classical Antiquity, the Middle Ages, the Modern Age, the ‘Postmodern’ Era—which can be seen, à la Foucault, as ‘fragments between philosophical fractures’. From a historical background perspective, up to the early 1900s progress in medical and healthcare models has moved on a par with the evolution of philosophical debate. Following the Second World War, the Health Service started a series of reforms, provoked by anti-positivistic philosophical transformations. The three main reforms carried out however failed and the medical establishment remained anchored to a mechanical, reductionist approach, perfectly in line with the bureaucratic stance of the administrators. In this context, future scenarios are delineated and an anthropo-ecological model is proposed to re-align philosophy, medicine and health care.     

Daily Leucine Intake Is Positively Associated with Lower Limb Skeletal Muscle Mass and Strength in the Elderly

Higher daily protein intake, with an emphasis on leucine content, is thought to mitigate age-related anabolic resistance, potentially counteracting age-related morphological and functional declines. The present study investigated potential associations between total daily leucine intake and dependent variables, including quadriceps muscle cross-sectional area (CSA) and maximum dynamic muscle strength (1-RM) in a cohort of healthy free-living older individuals of both sexes (n = 67; 34/33 men/women). Participants performed three 24 h dietary recalls and underwent a magnetic resonance imaging exam followed by 1-RM tests. Our results demonstrate moderate associations between total daily leucine and both quadriceps CSA (r = 0.42; p = 0.004) and 1-RM (r = 0.45; p = 0.001). Furthermore, our exploratory biphasic linear regression analyses, adjusted for sex, age, and protein intake relative to body weight, revealed a plateau for daily leucine intake and muscle mass and muscle strength (~7.6–8.0 g·day⁻¹) in older adults. In conclusion, we demonstrated that total daily leucine intake is associated with muscle mass and strength in healthy older individuals and this association remains after controlling for multiple factors, including overall protein intake. Furthermore, our breakpoint analysis revealed non-linearities and a potential threshold for habitual leucine intake, which may help guide future research on the effects of chronic leucine intake in age-related muscle loss.     

The Nutraceutical N-Palmitoylethanolamide (PEA) Reveals Widespread Molecular Effects Unmasking New Therapeutic Targets in Murine Varicocele

Varicocele is an age-related disease with no current medical treatments positively impacting infertility. Toll-like receptor 4 (TLR4) expression is present in normal testis with an involvement in the immunological reactions. The role of peroxisome proliferator-activated receptor-α (PPAR-α), a nuclear receptor, in fertility is still unclear. N-Palmitoylethanolamide (PEA), an emerging nutraceutical compound present in plants and animal foods, is an endogenous PPAR-α agonist with well-demonstrated anti-inflammatory and analgesics characteristics. In this model of mice varicocele, PPAR-α and TLR4 receptors’ roles were investigated through the administration of ultra-micronized PEA (PEA-um). Male wild-type (WT), PPAR-α knockout (KO), and TLR4 KO mice were used. A group underwent sham operation and administration of vehicle or PEA-um (10 mg/kg i.p.) for 21 days. Another group (WT, PPAR-α KO, and TLR4 KO) underwent surgical varicocele and was treated with vehicle or PEA-um (10 mg/kg i.p.) for 21 days. At the end of treatments, all animals were euthanized. Both operated and contralateral testes were processed for histological and morphometric assessment, for PPAR-α, TLR4, occludin, and claudin-11 immunohistochemistry and for PPAR-α, TLR4, transforming growth factor-beta3 (TGF-β3), phospho-extracellular signal-Regulated-Kinase (p-ERK) 1/2, and nucleotide-binding oligomerization domain-like receptor (NLR) family pyrin domain-containing 3 (NLRP3) Western blot analysis. Collectively, our data showed that administration of PEA-um revealed a key role of PPAR-α and TLR4 in varicocele pathophysiology, unmasking new nutraceutical therapeutic targets for future varicocele research and supporting surgical management of male infertility.     

Avicholic Acid: A Lead Compound from Birds on the Route to Potent TGR5 Modulators

相似文献   

Effects of GW274150, a novel and selective inhibitor of iNOS activity, in acute lung inflammation

1. The aim of this study was to investigate the effect of GW274150, a novel, potent and selective inhibitor of inducible nitric oxide synthase (iNOS) activity in a model of lung injury induced by carrageenan administration in the rats. 2. Injection of carrageenan into the pleural cavity of rats elicited an acute inflammatory response characterized by: fluid accumulation in the pleural cavity which contained a large number of polymorphonuclear cells (PMNs) as well as an infiltration of PMNs in lung tissues and subsequent lipid peroxidation, and increased production of nitrite/nitrate (NO(x)), tumour necrosis factor alpha (TNF-alpha) and interleukin-1beta (IL-1beta). 3. All parameters of inflammation were attenuated in a dose-dependent manner by GW274150 (2.5, 5 and 10 mg x kg(-1) injected i.p. 5 min before carrageenan). 4. Carrageenan induced an upregulation of the intracellular adhesion molecules-1 (ICAM-1), as well as nitrotyrosine and poly (ADP-ribose) (PAR) as determined by immunohistochemical analysis of lung tissues. 5. The degree of staining for the ICAM-1, nitrotyrosine and PAR was reduced by GW274150. These results clearly confirm that NO from iNOS plays a role in the development of the inflammatory response by altering key components of the inflammatory cascade. 6. GW274150 may offer a novel therapeutic approach for the management of various inflammatory diseases where NO and related radicals have been postulated to play a role.     

EEG power spectra and auditory P300 during free smoking and enforced smoking abstinence

We investigated resting EEG and auditory P300 during free smoking and 36 h of enforced smoking abstinence in 12 healthy volunteers. Resting EEG was recorded on 19 scalp leads and auditory P300 was obtained by an oddball paradigm task. Spectral analysis of EEG (absolute and relative power, mean frequency), latency and amplitude of auditory P300 were considered for statistical analysis. EEG changes were not significant during free smoking but were significant during smoking abstinence. Theta absolute power increased by +57% (P<.001), whereas alpha and delta absolute power increased by +26% (P<.01) and +19% (P<.01), respectively; theta absolute power change was delayed and prolonged. Alpha mean frequency reduced by -0.31 Hz (P<.001), whereas delta, theta and beta1 mean frequency increased by +0.13 Hz (P<.05), +0.09 Hz (P<.05) and +0.23 Hz (P<.01), respectively. Auditory P300 amplitude and latency were unaffected by smoking abstinence. Resting EEG, but not auditory P300, was sufficiently sensitive to detect changes during enforced smoking abstinence, and EEG bands had different temporal changes.     

Folic acid and vitamin E supplementation effects on homocysteinemia, endothelial function and plasma antioxidant capacity in young myocardial-infarction patients.

We examined the effects of folate (either alone or co-supplemented with Vitamin E) on endothelial function in hyperhomocysteinimic patients and correlated results with serum antioxidant capacity. A randomized trial was carried out in 30 young patients with recent acute myocardial infarction (AMI) and high plasma homocysteine concentrations. Intervention consisted of high doses of folate, either alone (group A) or in combination with Vitamin E (group B), for three months. Main outcome measures were endothelial function, serum antioxidant capacity, and homocysteinemia. Folic acid treatment reduced plasma homocysteine concentrations in both groups by 41% and, as compared with baseline values, was associated with a significant (P<0.001) improvement of endothelial function (from 0.322 (0.03) to 0.450 (0.02)mm in group A and from 0.338 (0.03) to 0.584 (0.04)mm in group B). However, there was no difference in endothelial function improvement between folic acid and folic acid plus Vitamin E group. Plasma antioxidant capacity significantly (P<0.001) increased in both groups. In conclusion, beneficial effects of folic acid on vasomotion appear to be independent of antioxidant action but, rather, seem to be strongly associated with reduction of homocysteinemia. Confirming previous reports, the effects of Vitamin E are still equivocal.     

The impact of infection on the incidence of autoimmune disease

Falling infection rates in the developed world are being matched by a rapidly rising incidence of allergic and autoimmune diseases. This review explores the hypothesis that there is a causal link between these phenomena and that infections can prevent the onset of autoimmune disease. The hypothesis is discussed with particular reference to Type I diabetes in the NOD mouse and the ability of the helminth infection Schistosoma mansoni to prevent its onset. The article addresses the possible mechanisms that underly this protection. The effects of protective pathogen-derived agents on key cells of the innate immune system such as dendritic cells are distinct and include the production of anti-inflammatory cytokines such as IL-10. The most likely mechanisms by which these innate changes prevent the subsequent adaptive autoimmune destruction are: (1) the production of systemically high levels of cytokines that oppose the production of cytokines that drive the autoimmune process - possibly via the action of natural killer T (NKT) cells (2) the induction of regulatory T cells that inhibit the action of autoreactive cells and (3) the production of pathogen-specific T cells that are not autoreactive and compete with autoreactive cells for survival signals such as cytokines and T cell receptor ligation.     

The N-terminal of icatibant and bradykinin interact with the same Asp residues in the human B2 receptor

The pharmacology of peptide and non-peptide bradykinin B2 receptor ligands was evaluated in the inositol phosphate (IP) production assay in CHO cells expressing the human bradykinin B2 receptor. The effect of single and double alanine mutation of D266 and D284 residues at the human bradykinin B2 receptor was evaluated on the agonist profile of bradykinin (H-Arg-Pro-Pro-Gly-Phe-Ser-Pro-Phe-Arg-OH) and the synthetic agonist FR190997 (8-[2,6-dichloro-3-[N-methylcarbamoyl)cinnamidoacetyl]-N-methylamino]benzyloxy]-2-methyl-4-(2-pyridylmethoxy)quinoline). Bradykinin potency (EC50 0.5 nM at the wild-type receptor) was reduced by 16-fold at D266A and D284A mutants and by 2300-fold at the D266A/D284A double mutant. None of the mutants affected the potency or the efficacy of FR190997. Peptide antagonists, Icatibant (H-DArg-Arg-Pro-Hyp-Gly-Thi-Ser-Dtic-Oic-Arg-OH) and MEN11270 (H-DArg-Arg-Pro-Hyp-Gly-Thi-c(Dab-DTic-Oic-Arg)c(7gamma-10alpha)) (100 nM) similarly antagonized the concentration-response curve to bradykinin or FR190997 (pA2 values 8.5 and 8.4 versus bradykinin and 8.2 and 8.4 versus FR190997) at the wild-type receptor. Non-peptide antagonists FR173657 ((E)-3-(6-acetamido-3-pyridyl)-N-[N-[2,4-dichloro-3-[(2-methyl-8-quinolinyl) oxymethyl]phenyl]-N-methylaminocarbonyl methyl]acrylamide) and LF16-0687 (1-[[2,4-dichloro-3-[(2,4-dimethylquinolin-8-yl)oxy] methyl]-phenyl]sulfonyl]-N-[3-[[4-(aminoiminomethyl)-phenyl]carbonylamino]propyl]-(S)-pyrrolidine carboxamide) (100 nM) showed an equivalent potency values in blocking the IP production induced by bradykinin or FR190997 (pA2 values 8.7 and 8.8 versus bradykinin and 8.8 and 8.6 versus FR190997). Whilst the antagonist potency of FR173657 and LF16-0687 was not affected by D266A/D284A double mutation (IP production induced by the synthetic agonist), that of Icatibant and MEN11270 was reduced by 50- and 200-fold. The antagonist potency of [Ala1]-Icatibant and [Ala2]-Icatibant (pA2 values at wild-type 7.7 and 6.4) was significantly less reduced (20-fold and 13-fold, respectively) by the D266A/D284A double mutation. Our results highlight a crucial role for two aspartic residues, D266 and D284, located at the top of transmembrane segments 6 and 7, in the high-affinity interaction of peptide antagonists with the human bradykinin B2 receptor. An interaction of these receptor residues with the N-terminal basic residues of Icatibant is hypothesized.