LH supplementation of ovarian stimulation protocols influences follicular fluid steroid composition contributing to the improvement of ovarian response in poor responder women.

In this prospective study, we evaluated the steroid levels in 111 follicular fluids (FF) collected from 13 women stimulated with FSH monotherapy and 205 FF collected from 28 women stimulated with FSH + LH because of a previous history of hypo-responsiveness to FSH. Steroid levels were measured by HPLC/MS-MS and related to ovarian stimulation protocol, oocyte maturity, fertilization and quality of blastocysts, after individually tracking the fate of all retrieved oocytes. 17-Hydroxy-Progesterone, Androstenedione, Estradiol and Estrone were significantly higher in the FSH + LH protocol. Progesterone, 17-Hydroxy-Progesterone and Estradiol were more expressed in FF yielding a mature oocyte (p < 0.01) in the FSH + LH protocol. FF Progesterone concentration was correlated with the rate of normal fertilization in the FSH protocol. None of the FF steroids measured were associated with blastocyst quality and achievement of pregnancy. Our results indicate that LH supplementation in hypo-responsive women modifies ovarian steroid production, mimicking physiological production better and likely contributing to an improved ovarian response. Employing a correct methodological procedure to evaluate the relationship between FF steroid hormones and assisted reproduction outcomes, our study reveals that some steroids in single follicles may be helpful in predicting oocyte maturity and fertilization.

Dual effects of a homeopathic mineral complex on carrageenan-induced oedema in rats.

Carrageenan oedema, a classical experimental model commonly used to test activity of anti-inflammatory drugs, was used to evaluate the therapeutic activity of a low-potency mineral complex (MC). The MC was administered in the right plantar surface of albino rats 60 min before, simultaneously and 30 min after injection of carrageenan, an irritant which causes a local, transitory increase of fluid volume. The administration of the MC 60 min before the injection of carrageenan primed the animal to enhanced inflammatory response to the irritant. The administration of MC contemporarily to carrageenan did not modify the kinetic and the extent of the oedema, while the administration of the MC 30 min after the induction of the oedema significantly reduced the early phase of the inflammatory reaction. This indicated that the therapeutic action of this MC is not due to conventional anti-inflammatory effect but to activation of endogenous regulatory mechanisms, a phenomenon which may be regarded as a simple application of the 'similia rule'.

[Homeopathy in the perspective of scientific research]. / L'omeopatia nella prospettiva della ricerca scientifica.

A significant portion of the traditional concepts of homeopathy (similia principle, experimentation on healthy humans, the cure of whole person, the use of minimum doses or high dilution/potency of medicines) are amenable to investigations conducted according to criteria accepted by biomedical science. Even though many randomized and controlled clinical studies seem to demonstrate the efficacy of some homeopathic medicines and their superiority to placebo, other trials have given negative results. A definite clear answer is not yet possible due to the scarce quality of some published reports, to lack of reproduction by independent investigators and to the uncertainty regarding the methodologies to be used for testing the claims of homeopathy. As regards the possible physiopathological, biophysical and pharmacological explanations for the action of homeopathic remedies, there are models which tend to set the similia principle as a general expression of the action-reaction principle, within the context of dynamic systems theory. The clarification of the more controversial aspects regarding dilution/potency of medicines remains tied to several promising developments in physics of condensed matter, in chaos theory and in biophysics.

Effect of Traumeel S, a homeopathic formulation, on blood-induced inflammation in rats.

OBJECTIVE: To evaluate the activity of Traumeel S (TRS), a homeopathic formulation containing Arnica montana and other plant extracts and minerals on an animal model of traumatic inflammation. DESIGN: TRS and individual components thereof were administered locally to rats 1 h before hind-paw injection with 0.1 ml of homologous blood and the development of oedema was measured over five hours. In each experiment, a control group was treated with saline. MAIN OUTCOME MEASURES: Paw volume of each rat was measured before oedema and 1, 3, and 5 h after oedema induction. Serum levels of IL-6 were determined at hour 5. RESULTS: The decrease of paw oedema, associated with the process of healing, was more rapid in rats treated with TRS (P < 0.05 after 3 h and P < 0.01 after 5 h). Similar effects were also induced by separate injection of most, but not all, TRS ingredients. The efficacy of complete mixture of TRS was higher than the combination of a selection of active components. TRS also reduced oedema development when administered after the oedema induction. The therapeutic effect of TRS was associated with a significant decrease of systemic interleukin-6 production. CONCLUSION: TRS seems to act by speeding up the healing process instead of blocking the development of oedema from the beginning. Moreover, its effect cannot be considered as the 'sum' of its active components and probably a synergistic interaction occurs to determine the final effect.

A scientific reappraisal of the 'principle of similarity'.

In the history of therapeutics, the 'principle of similarity'--the treatment of 'same by same' or of 'like by like'--may be traced back to a number of medical traditions, including the systems of Hippocrates, Paracelsus and Hahnemann. Although in recent years we have witnessed a renaissance of interest in traditional medicines and 'holistic' medical practices, the reliability of the principle of similarity has still to be demonstrated on experimental grounds, and very few studies have been conducted to understand the underlying mechanism(s). Acceptance of this phenomenon requires supporting evidence of possible mechanisms and high-quality studies exploring its effectiveness in clinical medicine. The aim of this work is to provide a rational approach to the analysis of the various aspects of this historical yet also modern medical principle, in order to construct a plausible framework of ideas capable of facilitating further basic and clinical research into this field.

Effects on intestinal microflora, gastrointestinal tolerability and antiinflammatory efficacy of diclofenac and nitrofenac in adjuvant arthritic rats.

Since it is known that nitric oxide plays an important protective role in maintaining the tissue integrity and is cytotoxic for invasive micro-organisms, diclofenac and a new original diclofenac-derivate, nitrofenac (containing the nitric oxide group), was administered at doses of 0.3 and 3 mg kg-1 per os to adjuvant arthritic rats. At the 14th, 21st and 28th days after arthritis induction, the antiinflammatory efficacy and the effects on intestinal microflora of the two drugs were evaluated; moreover, at the end of the study period, the gastrointestinal tract was examined macroscopically for any presence of lesions. Daily oral administration of diclofenac and nitrofenac at 3 mg kg-1 markedly and significantly inhibited arthritis development until the end of the study period. Some significant changes were observed in anaerobic and Gram-negative bacterial flora, particularly the total disappearance, in all treated rats, of Escherichia coli 1, also 7 days after the last drug administration. Finally, no ulcers or severe damage were observed macroscopically with either drug, even if some alterations in the mucosa and haemorrhagic effusions were more evident in rats treated with diclofenac at 3 mg kg-1. In conclusion, in this chronic model a similar therapeutic efficacy of diclofenac and nitrofenac is shown in arthritic rats. The better gastrointestinal tolerability observed in nitrofenac-treated rats could be attributed to the release of nitric oxide.

Desferrioxamine potentiated SOD antiinflammatory activity in rat adjuvant arthritis: role of iron and bacterial toxins.

In this paper we studied the modulating inflammatory activity of iron in the adjuvant arthritis, taking indomethacin as a standard antiinflammatory drug and a superoxide dismutase derivative (MPEG-SOD) as a scavenger of free radicals. Moreover, we evaluated the changes in potential intestinal pathogens requiring iron for growth, in order to study the role of bacteria in the altered gastrointestinal functions observed during arthritis. We observed a 50% arthritis inhibition on the 14th day with MPEG-SOD plus desferrioxamine, a significant decrease in serum iron in arthritic rats compared to controls, and a significant Cl. perfringens increase on the 28th day in the presence of MPEG-SOD. Our data demonstrate that hypoferremia, in arthritis, is a protective mechanism overall in the early phase and could protect the intestinal tract by inhibiting the development of potential pathogens.

Anti-inflammatory activity of monomethoxypolyethylene glycol superoxide dismutase on adjuvant arthritis in rats.

In previous studies we observed an enhanced anti-inflammatory activity of MPEG-SOD derivatives in acute inflammation in rat. To assess the activity in chronic inflammation we tested the compound with longer half-life (MPEG-SOD 18) in complete adjuvant arthritis in rat. According to the prophylactic schedule of treatment (i.m. administration at alternative days of 10 mg/kg from day 3 to day 21), the MPEG-SOD derivative reduced arthritic lesions in a significant way (P less than 0.01 at 14th, 21st, 28th day). Indomethacin, administered i.m. daily at the dose of 1.5 mg/kg according to the same schedule, significantly inhibited adjuvant arthritis each time it was considered (% of inhibition are 66.5% at 14th day, 58.3% at 21st day and 50.8% at 28th day). Native SOD and inactivated enzyme, administered from day 3 to day 21 did not show any anti-inflammatory properties. According to the therapeutic schedule of treatment (from day 14 to day 28), neither MPEG-SOD nor native SOD showed antiarthritic activity.