Ateroskleróza je hlavnou prí činou kardiovaskulá rnych ochorení a významne prispieva k celosvetovej úmrtnosti. Stá le rastúci počet dôkazov naznačuje, že črevný mikrobióm môže zohrá vať kľúčovú úlohu v patogenéze tohto ochorenia. Črevný mikrobióm pozostá va z biliónov mikroorganizmov, ktoré nielen podporujú trá venie a metabolizmus, ale tiež ovplyvňujú imunitnú odpoveď hostiteľa. Zmeny v zložení črevného mikrobiómu boli spojené s rôznymi chronickými ochoreniami, vrá tane obezity, cukrovky a aterosklerózy. Tento člá nok poskytuje stručný prehľad zloženia črevného mikrobiómu u pacientov s koroná rnou chorobu srdca a sumarizuje možné zá kladné mechanizmy vplyvu na rozvoj aterosklerózy. Zloženie črevného mikrobiómu u pacientov s aterosklerózou sa líš i od zdravých jedincov. Identifiká cia a pochopenie týchto rozdielov poskytuje nové možnosti pre diagnostiku a liečbu aterosklerózy.
Atherosclerosis is a major cause of cardiovascular diseases and significantly contributes to global mortality. An increasing body of evidence suggests that the gut microbiome may play a key role in the pathogenesis of this disease. The gut microbiome consists of trillions of microorganisms that not only support digestion and metabolism but also influence the host's immune response. Alterations in the composition of the gut microbiome have been associated with various chronic diseases, including obesity, diabetes, and atherosclerosis. This article provides a brief overview of the gut microbiome composition in patients with coronary artery disease and summarizes the potential underlying mechanisms influencing the development of atherosclerosis. The composition of the gut microbiome in patients with atherosclerosis differs from that in healthy individuals. Identifying and understanding these differences offers new opportunities for the diagnosis and treatment of atherosclerosis.
- MeSH
- Arteriosclerosis * etiology prevention & control MeSH
- Humans MeSH
- Gastrointestinal Microbiome * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Arteriosclerosis * etiology prevention & control MeSH
- Hypertension * etiology drug therapy MeSH
- Angiotensin-Converting Enzyme Inhibitors pharmacology therapeutic use MeSH
- Congresses as Topic MeSH
- Humans MeSH
- Oral Health MeSH
- Heart Disease Risk Factors MeSH
- Gastrointestinal Microbiome MeSH
- Inflammation drug therapy complications MeSH
- Check Tag
- Humans MeSH
- Publication type
- News MeSH
Schimke immuno-osseous dysplasia is a rare multisystemic disorder caused by biallelic loss of function of the SMARCAL1 gene that plays a pivotal role in replication fork stabilization and thus DNA repair. Individuals affected from this disease suffer from disproportionate growth failure, steroid resistant nephrotic syndrome leading to renal failure and primary immunodeficiency mediated by T cell lymphopenia. With infectious complications being the leading cause of death in this disease, researching the nature of the immunodeficiency is crucial, particularly as the state is exacerbated by loss of antibodies due to nephrotic syndrome or immunosuppressive treatment. Building on previous findings that identified the loss of IL-7 receptor expression as a possible cause of the immunodeficiency and increased sensitivity to radiation-induced damage, we have employed spectral cytometry and multiplex RNA-sequencing to assess the phenotype and function of T cells ex-vivo and to study changes induced by in-vitro UV irradiation and reaction of cells to the presence of IL-7. Our findings highlight the mature phenotype of T cells with proinflammatory Th1 skew and signs of exhaustion and lack of response to IL-7. UV light irradiation caused a severe increase in the apoptosis of T cells, however the expression of the genes related to immune response and regulation remained surprisingly similar to healthy cells. Due to the disease's rarity, more studies will be necessary for complete understanding of this unique immunodeficiency.
- MeSH
- Apoptosis genetics MeSH
- Arteriosclerosis genetics etiology immunology MeSH
- Child MeSH
- DNA Helicases genetics MeSH
- Humans MeSH
- Bone Diseases, Metabolic etiology genetics MeSH
- Nephrotic Syndrome etiology genetics MeSH
- DNA Repair * genetics MeSH
- Osteochondrodysplasias * genetics immunology MeSH
- Pulmonary Embolism genetics etiology MeSH
- Growth Disorders genetics etiology MeSH
- Primary Immunodeficiency Diseases * genetics diagnosis immunology MeSH
- Immunologic Deficiency Syndromes genetics immunology MeSH
- T-Lymphocytes immunology MeSH
- Ultraviolet Rays adverse effects MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Arteriosclerosis etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Lipoprotein(a) * analysis adverse effects MeSH
- Heart Disease Risk Factors MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Newspaper Article MeSH
- MeSH
- Arteriosclerosis etiology complications MeSH
- Stroke etiology complications MeSH
- Hypertension etiology complications MeSH
- Myocardial Ischemia etiology complications MeSH
- Cardiovascular Diseases etiology prevention & control MeSH
- Nursing Diagnosis MeSH
- Nurse's Role MeSH
- Aged MeSH
- Heart Failure etiology complications MeSH
- Check Tag
- Aged MeSH
- MeSH
- Arteriosclerosis * etiology physiopathology MeSH
- Atherosclerosis * etiology physiopathology MeSH
- Cholesterol MeSH
- Epidemiologic Studies MeSH
- Body Mass Index MeSH
- Cardiovascular Diseases etiology mortality MeSH
- Clinical Trials as Topic statistics & numerical data MeSH
- Blood Glucose MeSH
- Blood Pressure MeSH
- Humans MeSH
- Risk Factors * MeSH
- Statistics as Topic MeSH
- Inflammation drug therapy physiopathology MeSH
- Life Style MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
Diabetická dyslipidemie patří mezi sekundární dyslipoproteinemie, protože abnormality metabolizmu lipidů jsou součástí komplexní poruchy látkové výměny u diabetu. Diabetická dyslipidemie významně přispívá ke zvýšení rizika rozvoje aterosklerózy a kardiovaskulární mortality u osob s diabetem. Výsledky studií a provedené metaanalýzy poskytly přesnější data o účinnosti a bezpečnosti jednotlivých skupin léčiv v rámci prevence kardiovaskulárních příhod u nemocných s diabetem. Příznivé výsledky léčby statiny u populace nemocných s DM (proporcionální snížení celkové mortality o 9 % a rizika kardiovaskulárních příhod o 21 % při poklesu LDL cholesterolu o 1 mmol/l nezávisle na dalších parametrech) upevnily jejich výsadní postavení v doporučeních odborných společností. Naopak kombinační léčba se stala předmětem intenzivních diskuzí, zejména poté co výsledky studií s niacinem/laropiprantem neprokázaly očekávaný přínos. Podobně i analýzy účinnosti fibrátů svědčí pro snížení kardiovaskulárních příhod jen u osob s určitým metabolickým profilem (hladina TG > 2,3mmol/l a zároveň HDL cholesterol < 0,9 mmol/l) a nikoli u osob s diabetem obecně. Taktika léčby diabetické dyslipidemie se tak opírá o léčbu statiny a v případě, že maximálně tolerované dávky statinů nevedou k dosažení cílových hodnot či významnému poklesu LDL cholesterolu (> 30% pokles hodnoty před léčbou), lze použít kombinační terapii s ezetimibem, fenofibrátem či sekvestranty žlučových kyselin. Není ovšem doloženo, že uvedené kombinace snižují kardiovaskulární riziko více než samotné statiny. Snížení tzv. reziduálního kardiovaskulárního rizika po účinné léčbě statiny tak zůstává cílem pro vývoj nových hypolipidemik. Zda uspějí např. zástupci ze skupiny inhibitorů cholesteryl ester transfer proteinu, bude známo v roce 2017.
Diabetic dyslipidaemia is among secondary dyslipoproteinaemias due to the fact that lipid metabolism abnormalities are a part of the complex metabolic disorder in diabetes. Diabetic dyslipidaemia significantly contributes to an increased risk of developing atherosclerosis and cardiovascular mortality in people with diabetes. The results of studies and the meta-analyses performed have provided more accurate data on the efficacy and safety of individual drug groups in terms of preventing cardiovascular events in patients with diabetes. The favourable results of treatment with statins in the population of patients with DM (a proportional reduction in all-cause mortality by 9% and of the risk of cardiovascular events by 21 % while reducing LDL cholesterol by 1 mmol/l independently on other parameters) have strengthened their dominant position in the guidelines of professional societies. There has been a continuing debate over the form of combination therapy and the role of other pharmaceuticals, particularly fibrates and nicotinic acid. These drugs combined with statins failed to have the expected cardiovascular protective effect in the studies. The results of analyses suggest that fibrates may only be beneficial in those with a certain metabolic profile (a triglyceride level > 2.3 mmol/l as well as HDL < 0.9 mmol/l) and not in persons with diabetes in general. In order to improve the strategy of treatment for diabetic dyslipidaemia, it will be necessary to know the results of ongoing studies of niacin, ezetimibe and/or novel cholesteryl ester transfer protein inhibitors that would define the efficacy of these agents in reducing residual cardiovascular risk following an effective treatment with statins.
- MeSH
- Arteriosclerosis etiology drug therapy complications metabolism prevention & control MeSH
- Azetidines administration & dosage pharmacology therapeutic use MeSH
- Fibric Acids administration & dosage pharmacology therapeutic use MeSH
- Diabetes Mellitus drug therapy metabolism MeSH
- Dyslipidemias drug therapy MeSH
- Drug Therapy methods MeSH
- Drug Combinations MeSH
- Cardiovascular Diseases etiology drug therapy complications mortality prevention & control MeSH
- Comorbidity MeSH
- Humans MeSH
- Niacin administration & dosage pharmacology therapeutic use MeSH
- Fatty Acids, Omega-3 administration & dosage pharmacology therapeutic use MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage pharmacology adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Albuminuria diagnosis etiology physiopathology MeSH
- Antihypertensive Agents administration & dosage adverse effects therapeutic use MeSH
- Arteriosclerosis diagnosis etiology physiopathology MeSH
- Biomedical Research methods trends MeSH
- Renal Insufficiency, Chronic * diagnosis epidemiology prevention & control MeSH
- Fibrosis MeSH
- Glomerular Filtration Rate MeSH
- Hypertension physiopathology prevention & control therapy MeSH
- Peritoneal Dialysis, Continuous Ambulatory methods utilization MeSH
- Creatinine isolation & purification blood MeSH
- Quality of Life MeSH
- Humans MeSH
- Renal Replacement Therapy * methods trends utilization MeSH
- Nephrosclerosis epidemiology complications physiopathology MeSH
- Proteinuria diagnosis etiology MeSH
- Aging physiology metabolism pathology MeSH
- Statistics as Topic MeSH
- Age Factors * MeSH
- Check Tag
- Humans MeSH
Kardiovaskulární onemocnění jsou nejčastější příčinou morbidity a mortality diabetiků. V přítomnosti diabetu dochází k akceleraci aterosklerózy všech tepen – v tomto případě hovoříme o diabetické makroangiopatii, ale i ke změnám v oblasti mikrocirkulace – nazývané též diabetická mikroangiopatie. Tato je charakterizovaná ztluštěním bazální membrány kapilár, arteriol a venul. Změny ve velkých tepnách jsou zodpovědné za častější výskyt ischemické choroby srdeční, cévních mozkových příhod a ischemické choroby dolních končetin u osob s diabetem ve srovnání s osobami bez diabetu. Mikroangiopatie je zodpovědná za rozvoj specifických orgánových komplikací diabetu – tj. diabetickou retinopatii, nefropatii a částečně přispívá i k rozvoji neuropatie. Specifickým problémem diabetu je tzv. syndrom diabetické nohy způsobený kombinací ischemie a neuropatie, s častou spoluúčastí infekce. Tyto problémy vyžadují dlouhodobou léčbu a jsou velkou zátěží nejen pro samotné nemocné a jejich rodinu, ale představují velký problém i pro zdravotnická zařízení, která se věnují péči o tyto nemocné.
Vascular disease is the leading cause of morbidity and mortality in people with diabetes. The diabetic process leads to both accelerated form of atherosclerosis affecting arteries of all sizes (large vessel disease or macroangiopathy) and to a specific microangiopathy characterised by basement membrane thickening inm capillaries, arterioles and venules. Large vessel disease accounts for the excess of coronary artery, cerebrovascular and peripheral vascular disease, whereas microangiopathy contributes mainly to diabetes retinopathy and nephropathy and partly also to neuropathy. Diabetic foot problems are due to a combination of ischaemia and neuropathy, often complicated by infection. As foot ulcers usually take many weeks or months to heal, they are a major burden for the diabetic, their family and the health care team from physical, psychological and financial perspectives. macroangiopathy, diabetic foot syndrome.
- Keywords
- ischemická choroba dolních končetin, diabetická mikroangiopatie a makroangiopatie, kritická končetinová ischemie, syndrom diabetické nohy,
- MeSH
- Arteriosclerosis diagnosis etiology therapy MeSH
- Atherosclerosis diagnosis etiology therapy MeSH
- Diabetes Mellitus, Type 1 complications MeSH
- Diabetes Mellitus, Type 2 complications MeSH
- Diabetes Mellitus metabolism prevention & control therapy MeSH
- Diabetic Foot diagnosis etiology therapy MeSH
- Diabetic Angiopathies diagnosis etiology therapy MeSH
- Diabetic Neuropathies complications MeSH
- Hyperglycemia complications MeSH
- Humans MeSH
- Peripheral Arterial Disease diagnosis etiology therapy MeSH
- Oxidative Stress MeSH
- Preventive Medicine methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
