Endometriosis: Cellular and Molecular Mechanisms Leading to Fibrosis.

Endometriosis is a chronic inflammatory condition affecting women of reproductive age. A relevant feature of endometriosis is the presence of fibrotic tissue inside and around the lesions, thus contributing to the classic endometriosis-related symptoms, pain, and infertility. The molecular mechanisms responsible for the development of fibrosis in endometriosis are not yet defined. The present review aimed to examine the biological mechanisms and signalling pathways involved in fibrogenesis of endometriotic lesions, highlighting the difference between deep infiltrating and ovarian endometriosis. The main cell types involved in the development of fibrosis are platelets, myofibroblasts, macrophages, and sensory nerve fibers. Members of the transforming growth factor (TGF) -ß family, as well as the receptor Notch, or the bioactive sphingolipid sphingosine 1-phosphate (S1P), play a role in the development of tissue fibrosis, resulting in their metabolism and/or their signalling pathways altered in endometriotic lesions. It is relevant the knowledge of the molecular mechanisms that guide and support fibrosis in endometriosis, to identify new drug targets and provide new therapeutic approaches to patients.

Overweight and Obese Adult Patients Show Larger Benefits from Concurrent Training Compared with Pharmacological Metformin Treatment on Insulin Resistance and Fat Oxidation.

Metformin, a drug widely used to treat insulin resistance, and training that combines aerobic and strength exercise modalities (i.e., concurrent training) may improve insulin sensitivity. However, there is a paucity of clinical trials investigating the effects of concurrent training, particularly on insulin resistance and fat oxidation in overweight and obese patients. Furthermore, only a few studies have compared the effects of concurrent training with metformin treatment. Therefore, the aim of this study was to examine the effects of a 12-week concurrent training program versus pharmaceutical treatment with metformin on maximum fat oxidation, glucose metabolism, and insulin resistance in overweight or obese adult patients. Male and female patients with insulin resistance were allocated by convenience to a concurrent training group (n = 7 (2 males); age = 32.9 ± 8.3 years; body mass index = 30 ± 4.0 kg·m-2) or a metformin group (n = 7 (2 males); age = 34.4 ± 14.0 years; body mass index = 34.4 ± 6.0 kg·m-2). Before and after the interventions, all participants were assessed for total body mass, body mass index, fat mass, fat-free mass, maximum oxygen consumption, maximal fat oxidization during exercise, fasting glucose, and insulin resistance through the homeostatic model assessment (HOMA-IR). Due to non-normal distribution of the variable maximal fat oxidation, the Mann-Whitney U test was applied and revealed better maximal fat oxidization (Δ = 308%) in the exercise compared with the metformin group (Δ = -30.3%; p = 0.035). All other outcome variables were normally distributed, and significant group-by-time interactions were found for HOMA-IR (p < 0.001, Δ = -84.5%), fasting insulin (p < 0.001, Δ = -84.6%), and increased maximum oxygen consumption (p = 0.046, Δ = 12.3%) in favor of the exercise group. Similar changes were found in both groups for the remaining dependent variables. Concurrent training seems to be more effective compared with pharmaceutical metformin treatment to improve insulin resistance and fat oxidation in overweight and obese adult patients with insulin resistance. The rather small sample size calls for more research in this area.

Effects of High-Intensity Interval Training With Specific Techniques on Jumping Ability and Change of Direction Speed in Karate Athletes: An Inter-individual Analysis.

This study investigated the effect of 4weeks of high-intensity interval training (HIIT) with specific techniques and analyzed inter-individual variability [classified in responders (Rs) and non-responders (NRs)] on jumping ability and change of direction speed (CODS) in youth karate athletes. Athletes of both genders (n=10) were randomly assigned into experimental group (EG; n=5) and the control group (CG; n=5). The EG trained 2-3days per week applying HIIT (three rounds [15 sets of 4s all-out specific efforts with 8s of dynamical pauses] with 3min of recovery between rounds) during their usual training during 4weeks. Assessments included squat jump (SJ) and countermovement jump (CMJ) and CODS by T-test. No significant interaction effect group by time was found. Although, in percentage and effect size (ES) terms increases were reported in both groups for SJ (EG: 15.2%, ES=0.91 vs. CG: 12.4%, ES=0.02) and only in EG for the T-test (-1.7%; ES=-0.35). In turn, a trend toward a higher proportion of Rs was observed in the EG (40% Rs) vs. CG (20% Rs) for SJ and CODS, respectively. In conclusion, the addition to regular training of a HIIT with specific techniques and based on the temporal combat structure after 4weeks was not a sufficient stimulus to increase jumping ability and CODS in karate athletes.

Inter-Individual Variability of a High-Intensity Interval Training With Specific Techniques vs. Repeated Sprints Program in Sport-Related Fitness of Taekwondo Athletes.

This study investigated the effect of 4 weeks of high-intensity interval training (HIIT) with specific techniques (TS-G) vs. repeated sprints (RS-G) and analyzed the inter-individual variability [classified into responders (Rs) and non-responders (NRs)] on sport-related fitness in taekwondo (TKD) athletes. Athletes of both genders (n = 12) were randomly assigned into TS-G and RS-G groups. Both groups trained 3 days/week for 4 weeks [two blocks of three rounds of 2 min of activity (4-s of all-out efforts with 28-s dynamical pauses) with 1 min of recovery in between and 5 min between blocks] during their regular training. The related sport fitness assessments included squat jump (SJ), countermovement jump (CMJ), multiple frequency speed of kick test (FSKTMULT), specifically total kicks and Kick Decrement Index (KDI), and 20-m shuttle run (20MSR). Relevant results indicate a significant effect of the time factor in both groups for SJ performance and a significant decrease for KDI in RS-G. In addition, an improvement in performance according to the effect size analysis in the TS-G in total kicks, KDI, and 20MSR. Complementarily, a higher proportion of athlete Rs was reported in TS-G vs. RS-G for SJ (50% vs. 30.3%, respectively), CMJ, and total kicks (16.6% vs. 0%). In conclusion, the addition to the regular training of a HIIT with specific-techniques and repeated-sprints associated with intervals and similar structure of the combat during 4 weeks of training can improve the concentric characteristics of lower limb performance, although they were not the sufficient stimuli in the other components of TKD-related fitness.

Effects of 4 Weeks of a Technique-Specific Protocol with High-Intensity Intervals on General and Specific Physical Fitness in Taekwondo Athletes: An Inter-Individual Analysis.

The aim of this research was to compare the effects of a technique-specific high-intensity interval training (HIIT) protocol vs. traditional taekwondo training on physical fitness and body composition in taekwondo athletes, as well as to analyse the inter-individual response. Utilising a parallel controlled design, sixteen male and female athletes (five females and 11 males) were randomly divided into an experimental group (EG) that participated in the technique-specific HIIT and a control group (CG) that participated in traditional taekwondo training. Both groups trained three days/week for four weeks. Squat jump (SJ), countermovement jump (CMJ), 5-metre sprint (5M), 20-metre shuttle run (20MSR), taekwondo specific agility test (TSAT), multiple frequency speed of kick test (FSKTMULT), total kicks, and kick decrement index (KDI), as well as body composition were evaluated. Results indicate that there are no significant differences (p > 0.05) in the factors group and time factor and group by time interaction (p > 0.05). Although percentage and effect size increases were documented for post-intervention fitness components in TSAT, total kicks, KDI, and 20MSR, responders and non-responders were also documented. In conclusion, a HIIT protocol based on taekwondo-specific technical movements does not report significant differences in fitness and body composition compared to traditional taekwondo training, nor inter-individual differences between athletes.

Prevenir mejor que curar / Prevention is better than cure

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Effect of Pectin on the Expression of Proteins Associated with Mitochondrial Biogenesis and Cell Senescence in HT29-Human Colorectal Adenocarcinoma Cells.

Mitochondria dynamic is regulated by different proteins, maintaining a balance between fission and fusion. An imbalance towards mitochondrial fission has been associated with tumor cell proliferation. The aim of this study was to analyze whether pectin modifies the viability of human colon cancer cells and the expression of proteins involved in mitochondrial fusion and fission. The human colon carcinoma cell line HT29 cells was growth in 10% fetal bovine serum in the absence and presence of pectin. Pectin reduced HT29 cell viability in a concentration-dependent manner, reaching a plateau at 150~300 µmol/L pectin. The presence of 200 µmol/L pectin reduced the expression of dynamin-related protein-1 and increased expression of the mitochondrial fusion-associated proteins mitofusin-1 and 2. Expression of cyclin B1, a protein involved in G2/M transition, was found decreased in pectin-incubated HT29 cells. Moreover, expression of p53 protein, the amount of p53 in the nucleous and ß-galactosidase activity, which are all biomarkers for cellular senescence, were significantly higher in pectin-incubated HT29 cells than in HT29 cells incubated without pectin. Expression of the protein B-cell lymphoma 2 (Bcl-2) homologous antagonist/killer was increased in response to incubation with pectin. However, incubation with pectin did not affect expression of Bcl-2-associated X protein or Bcl-2, or the caspase-3 activity. Overall, we concluded that pectin reduces the viability of human HT29 colon cancer cells, which is accompanied with a shift in the expression of proteins associated with mitochondrial dynamics towards mitochondrial fusion. Moreover, incubation with pectin favors cellular senescence over apoptosis in HT29 cells.

Recomendaciones para la prescripción de ejercicio físico en pacientes con espondiloartritis / Recommendations for the prescription of physical exercise for patients with spondyloarthritis

Objetivos: Desarrollar recomendaciones sobre la actividad física y el ejercicio para pacientes con espondiloartritis (EspA) basadas en la opinión de expertos. Métodos: Dos grupos de expertos, uno de fisioterapeutas, rehabilitadores y profesionales de la actividad física y deporte y otro de reumatólogos con interés en EspA, se reunieron para discutir los resultados de grupos focales con pacientes sobre barreras al ejercicio y de una encuesta a reumatólogos sobre ejercicio en EspA. A continuación se redactaron unas recomendaciones preliminares que fueron sometidas a la opinión de los expertos de ambos grupos mediante metodología Delphi a dos rondas. Resultados: Se emitieron 21 recomendaciones que cubren el ejercicio físico, la adaptación al paciente, el modo de dar los mensajes, el manejo del dolor, el tipo de ejercicios indicado y el seguimiento. El grado de acuerdo varía ligeramente entre los grupos de expertos pero en general fue alto. Los ítems discordantes o con poco acuerdo fueron eliminados del consenso. Conclusiones: Se han emitido recomendaciones sobre cuándo y cómo prescribir ejercicio físico y monitorizarlo en pacientes con EspA basadas en la opinión de expertos en espondilitis y en la prescripción de ejercicio. Deberemos confirmar si estas recomendaciones son útiles para la práctica clínica y tienen efecto en los pacientes con EspA atendidos por reumatólogos

Objective: To develop expert-based recommendations on physical activity and exercise for patients with spondyloarthritis (SpA). Methods: Two discussion groups, one of physical therapists, rehabilitation physicians, and professionals of physical activity and sports, and another of rheumatologists interested in SpA, were held to discuss the results of a survey of rheumatologists on exercise and two focus groups with patients on barriers to exercise. Preliminary recommendations were drafted. These were submitted to the opinion of the experts in both groups according to a two round Delphi methodology. Results: Twenty one recommendations covering general aspects of exercise, adaptation to patient, how to deliver messages, pain management, and type of exercise and monitoring were issued. The level of agreement varied slightly between expert groups but it was high overall. Items with poor agreement were removed from the consensus. Conclusions: We present recommendations on when and how to prescribe and monitor exercise in patients with SpA based on the opinion of experts in exercise and in SpA. We must now test whether these recommendations are useful for clinical practice and have an effect on patients with SpA seen by rheumatologists

Recommendations for the prescription of physical exercise for patients with spondyloarthritis. / Recomendaciones para la prescripción de ejercicio físico en pacientes con espondiloartritis.

OBJECTIVE: To develop expert-based recommendations on physical activity and exercise for patients with spondyloarthritis (SpA). METHODS: Two discussion groups, one of physical therapists, rehabilitation physicians, and professionals of physical activity and sports, and another of rheumatologists interested in SpA, were held to discuss the results of a survey of rheumatologists on exercise and two focus groups with patients on barriers to exercise. Preliminary recommendations were drafted. These were submitted to the opinion of the experts in both groups according to a two round Delphi methodology. RESULTS: Twenty one recommendations covering general aspects of exercise, adaptation to patient, how to deliver messages, pain management, and type of exercise and monitoring were issued. The level of agreement varied slightly between expert groups but it was high overall. Items with poor agreement were removed from the consensus. CONCLUSIONS: We present recommendations on when and how to prescribe and monitor exercise in patients with SpA based on the opinion of experts in exercise and in SpA. We must now test whether these recommendations are useful for clinical practice and have an effect on patients with SpA seen by rheumatologists.

Eficacia de la periodización del entrenamiento sobre la potencia máxima / Efficacy of periodized programson power training

El objetivo de este artículo es comparar la eficacia de los programas periodizados respecto a los no periodizados durante 5 semanas de entrenamiento en participantes físicamente activos con la intención de mejorar la potencia máxima de ejecución en el ejercicio de press de banca. 22 sujetos participaron en la investigación divididos en dos grupos, grupo 1(n=9, 2 mujeres y 7 hombres, edad 21.6 ± 1.1 años) cuyo tratamiento era un programa de entrenamiento no periodizado y grupo 2 (n=13, 3 mujeres y 10 hombres, edad 21.8 ± 1.4 años) con un tratamiento de programa de entrenamiento periodizado. El modelo no periodizado realizó 5 series de 6 repeticiones 2 veces/sem. durante 5 semanas, reevaluando la máxima potencia a las 2,5 semanas. El modelo periodizado se realizaron en la 1ª semana: 5 series de6 repeticiones; 2ª semana: 4x5; 3ª sem: 5x7; 4ª sem.: 5x8; 5ª sem.: 4x6, reevaluando la potencia a la mitad del estudio. El volumen y la intensidad total fueron igualados. Los resultados muestran como la potencia en la medición intermedia aumentó significativamente (p<0.05) un 13,26% respecto a la medición pretest en el modelo periodizado, mientras que en el no periodizado el incremento porcentual significativo fue de un 19,83%. En la medición final respecto a la intermedia la potencia disminuyó significativamente (p<0.05) un 10,21% en el modelo no periodizado. Concluimos que no existen diferencias significativas en las ganancias de potencia máxima entre ambos grupos, estimando asimismo que los resultados en sujetos no entrenados muestran limitaciones en la aplicabilidad de éstos a deportistas altamente entrenados (AU)

Periodization is one of the most important concepts in training. The purpose of this study was to compare periodized programs (PG) and non periodized programs (NPG) for gains maximal power in bench press. 22 subjects (sport sciences students) were randomly assigned to non periodized program (n=9; 2females and 7males; age 21.6 ± 1.1 years) or periodized program (n=13, 3 females; 10 males)age 21.8 ± 1.4 years). The non periodized program performed 5set of6 repetitions 2 days per week during 5 weeks changing the maximal power every 2,5 weeks. The periodized program performed (1st week: 5sets x 6 rept.;2nd week: 4x5;3th week: 5x7; 4 week:5x8; 5 week:4x6) changing the maximal power every 2,5 weeks. Volume and intensity were equated for each training program. After the end of the training programs, a testing session was performed to obtain the maximal power in bench press exercise. PG and NPG increased(p<.05) the maximal power after 2.5 training weeks (15.3% and 24.7%, respectively), without significant differences between groups. However, in the 2.5 next weeks, the maximal power increased 2.9% in PG, although this increase was not significant, while a decrease (10.2%; p<.05) in the maximal power happened in the NPG. PG and NPG increased(p <.05) the maximal power after 5 training weeks (18.6% and 11.9%, respectively), without significant differences between groups. In conclusion, so much a periodized training program like one non periodized training program producedim provements in the maximal power in bench press exercise in these participants, without significant differences between groups. Anyway, the results obtained in this type of subjects showed limitations in the applicability to highly trained sportsmen (AU)