Progranulin in Musculoskeletal Inflammatory and Degenerative Disorders, Focus on Rheumatoid Arthritis, Lupus and Intervertebral Disc Disease: A Systematic Review.

Progranulin (PGRN) is a glycoprotein formed by 593 amino acids encoded by the GRN gene. It has an important role in immunity and inflammatory response, as well as in tissue recovery. Its role in musculoskeletal inflammatory diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and intervertebral disc degeneration disease (IVDD), is, nowadays, an important target to investigate. The objective of this review is to systematically sum up all the recent findings concerning PGRN as a target in the development and resolution of the inflammatory diseases. PubMed was examined with the terms combinations (Progranulin) AND (Lupus Erythematosus, Systemic), (Progranulin) AND (Arthritis, Rheumatoid), and (Progranulin) AND (Intervertebral Disc Degeneration). PubMed was examined with the terms combinations (Atsttrin) AND (Lupus Erythematosus, Systemic), (Atsttrin) AND (Arthritis, Rheumatoid), and (Atsttrin) AND (Intervertebral Disc Degeneration). Moreover, research through Web of Science was performed searching the same items. The inclusion criteria were: studies whose main topic were progranulin, or atsttrin, with emphasis on the three selected diseases. On the other hand, the exclusion criteria were studies that only focused on diseases not related to RA, lupus or IVDD, in addition to the previous published literature reviews. Since few results were obtained, we did not filter by year. The records assessed for eligibility were 23, including all the studies with the information in state of art of progranulin and its capability to be a potential target or treatment for each one of the selected diseases. As these results are descriptive and not clinical trials, we did not perform risk of bias methods. Within these results, many studies have shown an anti-inflammatory activity of PGRN in RA. PGRN levels in serum and synovial fluids in RA patients were reported higher than controls. On the other hand, serum levels were directly correlated with SLE disease activity index, suggesting an important role of PGRN as a player in the progression of inflammatory diseases and a therapeutical approach for the recovery. This review has some limitations due to the small number of studies in this regard; therefore, we highlight the importance and the necessity of further investigation. No external funding was implicated in this systematical review.

Optic neuritis as sign presentation of acute disseminated encephalomyelitis following Mycoplasma pneumoniae infection

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Evaluation of the safety and effectiveness of oral propranolol in patients with von Hippel-Lindau disease and retinal hemangioblastomas: phase III clinical trial.

BACKGROUND: von Hippel-Lindau disease (VHL) is a multisystem cancer syndrome caused by mutations in the VHL gene. Retinal hemangioblastoma is one of the most common tumours, and when it appears near the optic nerve, its treatment is challenging and risky. To date, no treatment has proven effective in changing the course of the disease. This study was designed to evaluate the safety and effectiveness of propranolol in controlling these tumours. METHODS: Seven patients were included. All patients took a daily dose of 120 mg of propranolol for 1 year. Clinical variables were assessed at baseline, and at 1, 3, 6, 9 and 12 months. The primary endpoint of the study was the number and size of retinal hemangioblastomas. On every visit, retinal outcomes and blood biomarkers (such as vascular endothelial growth factor (VEGF) and miR210) were analysed. RESULTS: Number and size of retinal hemangioblastomas remained stable in all patients. All of them had initially increased levels of VEGF and miR210. There was a gradual reabsorption of retinal exudation in two patients, correlating with a progressive decrease of both biomarkers. The only adverse effect reported was hypotension in one patient. CONCLUSIONS: Propranolol could be used to treat retinal hemangioblastomas in VHL patients, although more studies are needed to determine the ideal dose and long-term effect. VEGF and miR210 should be explored as biomarkers of disease activity. As far as we know, these are the first biomarkers proposed to monitor the VHL disease activity. TRIAL REGISTRATION NUMBER: 2014-003671-30.

Potencial terapéutico del extracto de Ginkgo biloba (EGb) en pacientes con esquizofrenia / Potencial terapêutico do extrato de Ginkgo biloba (EGb) em pacientes com esquizofrenia / Therapeutic potential of Ginkgo biloba extract (EGb) in patients with schizophrenia

La esquizofrenia representa uno de los trastornos psiquiátricos más graves. Se trata de un trastorno mental psicótico caracterizado por alteraciones del pensamiento, del estado de ánimo y del comportamiento. Casi todos los antipsicóticos tienen efectos secundarios neurológicos o físicos, lo que frecuentemente conlleva el incumplimiento del tratamiento. Desde esta perspectiva es fácil justificar la conveniencia y relevancia social de buscar productos que ofrezcan una mejoría en la sintomatología de la enfermedad y reduzcan los efectos adversos y las interacciones en los pacientes. El extracto seco purificado de la hoja de Ginkgo biloba es capaz de mejorar los síntomas de la esquizofrenia crónica como un coadyuvante a la terapia con antipsicóticos, paliando los efectos adversos provocados por el uso prolongado de éstos (AU)

A esquizofrenia representa um dos transtornos psiquiátricos mais graves. É um transtorno mental psicótico caracterizado por alterações no pensamento, humor e comportamento. Quase todos os antipsicóticos têm efeitos secundários neurológicos ou físicos, o que muitas vezes leva ao abandono do tratamento. Nesta perspectiva, é fácil justificar a conveniência e a relevância social da procura de produtos que ofereçam uma melhoria na sintomatologia da doença e reduzam os efeitos adversos e as interações nos doentes. O extrato seco purificado da folha de Ginkgo biloba é capaz de melhorar os sintomas da esquizofrenia crónica como complemento da terapia antipsicótica, aliviando os efeitos adversos causados pela sua utilização prolongada (AU)

Schizophrenia is one of the most serious psychiatric disorders. It is a psychotic mental disorder characterized by alterations in thinking, mood and behavior. Almost all antipsychotic drugs have neurological or physical side effects, which often leads to noncompliance. From this perspective, it is justified the convenience and social relevance of searching products that offer an improvement in the symptomatology of the disease and reduce adverse effects and interactions in patients. The purified dry extract of Ginkgo biloba leaf is able to improve the symptoms of chronic schizophrenia when it is used as an adjuvant to antipsychotic therapy, alleviating the adverse effects caused by its prolonged use (AU)