RESUMEN
The purpose of the review of scientific medical literature was to evaluate the data of the epidemiology of osteoarthritis (OA) and cardiovascular diseases (CVD) with the analysis of risk factors, pathophysiological and pathobiochemical mechanisms of the relationship between OA and the risk of developing CVD in the presence of chronic pain, modern strategies for screening and management of this cohort of patients, the mechanism of action and pharmacological effects of chondroitin sulfate (CS). Conclusions were drawn about the need for additional clinical and observational studies of the efficacy and safety of the parenteral form of CS (Chondroguard) in patients with chronic pain in OA and CVD, improvement of clinical recommendations for the treatment of chronic pain in patients with OA and cardiovascular risk, with special attention to interventions that eliminate mobility restrictions in patients and the inclusion of basic and adjuvant therapy with DMOADs to achieve the goals of multipurpose monotherapy in patients with contraindications to standard therapy drugs.
Asunto(s)
Enfermedades Cardiovasculares , Dolor Crónico , Osteoartritis , Humanos , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/epidemiología , Dolor Crónico/etiología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Osteoartritis/complicaciones , Osteoartritis/tratamiento farmacológico , Osteoartritis/epidemiología , Sulfatos de Condroitina , Terapia CombinadaRESUMEN
This Expert Council focuses on the meta-analysis of studies on the risk of atrial fibrillation (AF) in patients taking omega-3 polyunsaturated fatty acids (PUFA) and of data on the omega-3 PUFA treatment in patients with cardiovascular and kidney diseases.The major statements of the Expert Council: the meta-analysis of AF risk in patients taking omega-3 PUFA showed an increased risk of this arrhythmia. However, it should be taken into account that the risk of complications was low, and there was no significant increase in the risk of AF when omega-3 PUFA was used at a dose of ≤1âg and a standard dose of the only omega-3 PUFA drug registered in the Russian Federation, considering all AF episodes in the ASCEND study.At the present time, according to Russian and international clinical guidelines, the use of omega-3 PUFA can be considered in the following cases: ⢠for patients with chronic heart failure (CHF) with reduced left ventricular ejection fraction as a supplement to the basic therapy (2B class of recommendations according to the 2020 Russian Society of Cardiology guidelines (RSC) and the 2022 AHAâ/âACCâ/âHFSA guidelines); ⢠for patients with hypertriglyceridemia (>1.5 mmol/l) as a part of combination therapy (IIb class of recommendations and B level of evidence according to the 2021 European guidelines on cardiovascular disease prevention, etc.); ⢠for adult patients with stage 3-4 chronic kidney disease (CKD), long-chain omega-3 PUFA 2 g/day is recommended for reducing the level of triglycerides (2C class of recommendations). Data on the use of omega-3 PUFA for other indications are heterogenous, which can be partially explained by using different form and doses of the drugs.
Asunto(s)
Fibrilación Atrial , Sistema Cardiovascular , Ácidos Grasos Omega-3 , Insuficiencia Renal Crónica , Adulto , Humanos , Volumen Sistólico , Función Ventricular Izquierda , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Federación de Rusia/epidemiologíaRESUMEN
A reduced supply of micronutrient vitamin D leads to a more severe course of coronavirus infection (COVID-19). Vitamin D deficiency is combined with a decrease in innate antiviral immunity and excess of inflammation. Vitamin D supplementation stimulates the synthesis of antibacterial peptides and is important for weakening the cytokine storm, reducing excessive acute and chronic inflammation, and also for compensating for chronic comorbid pathologies. Active forms of vitamin D (alfacalcidol, etc.) are of particular importance for compensating for vitamin D deficiency in elderly patients, endocrine-immune dysfunction, sarcopenia, chronic renal failure (in which the metabolism of vitamin D in the kidneys is disturbed).
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COVID-19 , Deficiencia de Vitamina D , Humanos , Anciano , Vitamina D/metabolismo , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico , Inflamación/tratamiento farmacológico , Vitaminas/farmacología , Vitaminas/uso terapéutico , Micronutrientes , Sistema Inmunológico/metabolismo , Antivirales , AntibacterianosRESUMEN
OBJECTIVE: Optimization of the choice of neuroprotective treatment regimens in patients with chronic cerebral ischemia that takes into account the synergy of drug interactions gives the doctor an opportunity for personalized approach that increases the effectiveness of treatment. MATERIAL AND METHODS: Differential chemoreactomic analysis of the synergism of ethyl methyl hydroxypyridine succinate (EMHPS) and a number of monocomponent neuroprotective agents (piracetam, vinpocetine, citicoline, choline alfoscerate); proteomic analysis of polypeptide neuroprotectors (cerebrolysin, etc.); an expert analysis of multicomponent neuroprotector Cytoflavin. RESULTS: Piracetam, citicoline (Neupilept) and choline alfoscerate (Cereton) effectively enhance the pharmacological properties of EMHPS and vice versa. Expert assessments of the synergism between the properties of EMHPS, polypeptide neuroprotectors (cerebrolysin) and other multicomponent drugs (cytoflavin), which are also used in adjuvant therapy with EMHPS, are presented. CONCLUSION: In real clinical practice, of particular interest is the objectification of the appointment of combined therapy regimens. This study indicates that EMHPS can provide a favorable background for maximizing the effectiveness of therapy when used with other drugs.
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Isquemia Encefálica , Fármacos Neuroprotectores , Citidina Difosfato Colina , Interacciones Farmacológicas , Humanos , ProteómicaRESUMEN
Background Effects of drugs and biologically active supplements based on omega-3 polyunsaturated fatty acids (ω3 PUFA) considerably depend on the standardized content of eicosatetraenoic acid (EPA), docosahexaenoic acid (DHA), and other fatty acids in the extracts.Material and methods In this study, we comprehensively examined the composition of 10 ω3 PUFA samples with chromatographic measurement of more than 40 metabolites of fatty acids and other compounds. The data on extract composition were analyzed with current methods of intelligent data analysis (metric condensation method; multidimensional scaling; principal component analysis with axis identification; topology-metrical approach to recognition).Results Quantitative markers were obtained, which allowed separating the standardized ω3 PUFA-based samples (Omacor, Solgar omega-3 700, Femibion Natalker-2, Omega-3 concentrate, Omegamama) from less standardized ones (Fish oil-Teva, Omegatrin, Omeganol, etc.) based on results of a chromatographic analysis of fatty acid composition in the studied samples (EPA+DHA marker, ω6+ω11 marker, and standardization coefficient showing conformity of measured ω3 PUFA levels with the content stated by the manufacturer).Conclusions Among the studied samples, the pharmaceutical product Omacor showed the best values of standardization indexes.
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Ácidos Grasos Omega-3/análisis , Suplementos Dietéticos , Ácidos Docosahexaenoicos , Ácidos GrasosRESUMEN
Zinc and vitamin C supplementation of the body is important for CNS functioning. Zinc ions are involved in the neurotransmission (signal transmission from acetylcholine, catecholamine, serotonin, prostaglandin receptors) and in ubiquitin-related protein degradation. Zinc deficits are associated with Alzheimer's disease and depression. Zinc supplementation (10-30 mg daily) improves neurologic recovery rate in patients with stroke and brain injury, has a positive impact on memory and reduces hyperactivity in children. Vitamin C, a zinc synergist, maintains antioxidant resources of the brain, synaptic activity and detoxification. Vitamin C in dose 130-500 mg daily should be used to prevent dementia and neurodegenerative pathology.
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Antioxidantes/farmacología , Ácido Ascórbico/farmacología , Atención/efectos de los fármacos , Memoria/efectos de los fármacos , Enfermedades del Sistema Nervioso/prevención & control , Vitaminas/administración & dosificación , Zinc/farmacología , Enfermedad de Alzheimer/prevención & control , Antioxidantes/administración & dosificación , Ácido Ascórbico/administración & dosificación , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Niño , Suplementos Dietéticos , Sinergismo Farmacológico , Humanos , Enfermedades del Sistema Nervioso/epidemiología , Proteolisis , Riesgo , Ubiquitinación , Vitaminas/farmacología , Zinc/administración & dosificación , Zinc/deficienciaRESUMEN
The diet of population consisting of natural products is quite adequate and even excessive of energy consumption, but is not able to meet fully the need of organism in a number of micronutrients. Due to lack of sun exposure and long presence indoors endogenous synthesis of vitamin D in the skin by ultraviolet radiation does not provide the body's need for this vitamin. Intake of vitaminmineral supplements (VMS) is appropriate because combined deficiency of vitamins and minerals takes place in population. Prophylactic doses (equal to physiological needs) provide a diet completeness and reduce the risk of vitamin deficiency and its consequences. The high incidence of combined deficiency of vitamins among population and the existence of vitamin interactions are the basis for the application of the multivitamins. The simultaneous intake of vitamins is more physiological, their combination is more effective than a separate or isolated destination of each of them. Efficacy of the VMS has been shown in the treatment and prevention of some diseases. The main requirements for the VMS are full list of vitamins and minerals, the lack of which is detected most frequently, in doses covering the needs of organism. For the health of the pregnant woman and her unborn child preference should be given for complexes, containing DHA and/or probiotics along with vitamins. The principles of the selection of the composition and vitamin doses in the VMS for using patients suffering from various pathologies should be based on data on the patient's sufficiency with vitamins, the understanding of the role of vitamin deficiency in the pathogenesis of the disease, as well as on the composition of the diet and its modifications.
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Avitaminosis/dietoterapia , Suplementos Dietéticos , Ingestión de Alimentos , Minerales/uso terapéutico , Fenómenos Fisiologicos de la Nutrición Prenatal , Vitaminas/uso terapéutico , Adulto , Avitaminosis/sangre , Femenino , Humanos , Masculino , EmbarazoAsunto(s)
Ácidos Grasos Omega-3/uso terapéutico , Enfermedades del Sistema Nervioso/tratamiento farmacológico , Adulto , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Niño , Oftalmopatías/tratamiento farmacológico , Ácidos Grasos Omega-3/administración & dosificación , Femenino , Humanos , Masculino , Accidente Cerebrovascular/tratamiento farmacológicoRESUMEN
Safe pharmacotherapy and prevention of arrhythmia is an urgent problem of modern cardiology. Essential micronutrients such as omega-3 polyunsaturated fatty acids (-3 PUF-) significantly contribute to the metabolic processes in cardiomyocytes and cardiac conduction system. This article presents a systematic analysis of anti-arrhythmic effects of omega-3 PUFA and of standardized ethyl esters of omega-3 PUFA. The currently available data indicate two fundamentally different molecular mechanisms of anti-arrhythmic effects: "slow" and "fast" types. Formulation of fundamental prospects of bioinformatic studies of molecular effects of anti-arrhythmic action of omega-3 PUF-s is presented.
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Arritmias Cardíacas , Ácidos Grasos Omega-3 , Sistema de Conducción Cardíaco/efectos de los fármacos , Miocitos Cardíacos/efectos de los fármacos , Ácido Araquidónico/metabolismo , Arritmias Cardíacas/tratamiento farmacológico , Arritmias Cardíacas/metabolismo , Biotransformación , Fármacos Cardiovasculares/metabolismo , Fármacos Cardiovasculares/farmacología , Ensayos Clínicos como Asunto , Citocromos/metabolismo , Ácidos Docosahexaenoicos/metabolismo , Ácidos Docosahexaenoicos/farmacología , Combinación de Medicamentos , Ácido Eicosapentaenoico/metabolismo , Ácido Eicosapentaenoico/farmacología , Ácidos Grasos Omega-3/metabolismo , Ácidos Grasos Omega-3/farmacología , Sistema de Conducción Cardíaco/metabolismo , Humanos , Canales Iónicos/metabolismo , Micronutrientes/metabolismo , Micronutrientes/farmacología , Miocitos Cardíacos/metabolismo , Receptores Eicosanoides/metabolismo , Receptores de Prostaglandina/metabolismoRESUMEN
Undifferentiated connective tissue dysplasia (UCTD) is one of most common diseases of the connective tissue. High frequency of UCTD in population along with the fact that it can provoke a number of other diseases make UCTD an important object of the modern biomedical research in the areas of cardiology, neurology, rheumatology and pulmonology. Modern diagnostics and determination of the predisposition to UCTD allow elaboration of personalized therapy. In particular, Mg-containing supplements and medications can be effectively used in the therapy of UCTD. In one of our previous works we have analyzed possible molecular mechanisms of UCTD etiology as well as therapeutic action of magnesium. The use of data on nucleotide polymorphisms as complementation of standard medical diagnostics is one of perspective trends of the post-genomic medical research. The present work suggest a number of nucleotide polymorphisms that can be used in genetic association analyses of the UCTD as of well as therapeutic efficiency of magnesium treatment. Selection and analysis of the polymorphisms was done on the base of molecular mechanisms we had proposed earlier, comprehensive analysis of published data and also with the use of an integral approach to analysis of the functional effects of the nucleotide polymorphisms and corresponding amino acid substitutions.
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Enfermedades del Tejido Conjuntivo/genética , Enfermedades del Tejido Conjuntivo/patología , Expresión Génica/genética , Polimorfismo de Nucleótido Simple/genética , Alelos , Enfermedades del Tejido Conjuntivo/prevención & control , Genoma , Antígenos HLA-B/genética , Humanos , Óxido de Magnesio/uso terapéutico , Metaloproteinasa 2 de la Matriz/genética , Fenotipo , Receptores Sensibles al Calcio/genética , Canales Catiónicos TRPM/genéticaAsunto(s)
Adyuvantes Inmunológicos/farmacología , Adyuvantes Inmunológicos/uso terapéutico , Isquemia Encefálica/tratamiento farmacológico , Isquemia Encefálica/fisiopatología , Encéfalo/irrigación sanguínea , Encéfalo/efectos de los fármacos , Bloqueadores de los Canales de Calcio/farmacología , Bloqueadores de los Canales de Calcio/uso terapéutico , Cinarizina/farmacología , Cinarizina/uso terapéutico , Interferón beta/farmacología , Interferón beta/uso terapéutico , Propiocepción/efectos de los fármacos , Vestíbulo del Laberinto/efectos de los fármacos , Animales , Enfermedad Crónica , Modelos Animales de Enfermedad , Hemodinámica/efectos de los fármacos , Interferon beta-1b , RatasAsunto(s)
Aminoácidos/farmacología , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Fármacos Neuroprotectores/farmacología , Nootrópicos/farmacología , Oligoelementos/metabolismo , Aminoácidos/administración & dosificación , Animales , Interpretación Estadística de Datos , Homeostasis/efectos de los fármacos , Técnicas In Vitro , Manganeso/análisis , Manganeso/metabolismo , Espectrometría de Masas , Fármacos Neuroprotectores/administración & dosificación , Ratas , Selenio/análisis , Selenio/metabolismo , Factores de Tiempo , Oligoelementos/análisis , Zinc/análisis , Zinc/metabolismoRESUMEN
The tests on rats with common carotid artery occlusion showed that bilobil increases the cerebral blood flow and decreases brain edema, thus decreasing the loss of experimental animals. The drug also increases the blood circulation and improves the excretory function of kidneys. Under clinical conditions, bilobil increases the cerebral blood flow, normalizes the metal ligand homeostasis, and improves the antioxidant status in children with early forms of cerebrovascular disease (neurocirculate distonia) and attention deficit hyperactivity syndrome.