RESUMO
Resumen La enfermedad por COVID-19 fue detectada a finales de 2019 en Wuhan, China. Debido a su rápida propagación fue declarada emergencia sanitaria de forma inicial y luego de identificar casos fuera de China con transmisión autóctona y caracterizado por una mortalidad considerablemente alta en países como Italia y España, fue declarada pandemia por la Organización Mundial de la Salud. Se ha evidenciado que los pacientes mayores y con antecedentes de enfermedades crónicas incluido el cáncer desarrollan una enfermedad severa, presentando mayor riesgo de mortalidad por SARS-CoV2/ COVID-19. Lo anterior es por supuesto especialmente importante en el manejo de pacientes con Mieloma Múltiple (MM), generando en el personal Médico nuevos desafíos, oportunidades de mejora y aprendizajes, que aporten al análisis riesgo-beneficio del tratamiento inmunodepresor en este tipo de patologías. El consenso tiene como objetivo brindar orientación sobre el manejo de pacientes con MM en estos momentos donde el profesional de la salud requiere información para llevar a cabo terapias eficientes en el cuidado del paciente.
Abstract COVID-19 disease was detected in late 2019 in Wuhan, China. Due to its rapid spread, it was initially declared a health emergency, but after cases with indigenous transmission were identified outside China, characterized by considerably high mortality in countries such as Italy and Spain, it was declared a pandemic by the World Health Organization. It has been shown that elderly patients with a history of chronic diseases, including cancer, develop a severe disease, presenting a higher risk of mortality from SARS-CoV2 / COVID-19. This becomes especially important in the management of patients with Multiple Myeloma (MM), generating new challenges, opportunities for improvement and learning opportunities in the health professionals, which will contribute to the risk-benefit analysis of immunosuppressive treatment for this type of pathology. The consensus aims to provide guidance for the management of patients with MM in these times when the health professional requires information to deliver efficient therapies in patient care.
Assuntos
Humanos , Consenso , COVID-19 , Mieloma Múltiplo , TerapêuticaRESUMO
Anthocyanins are pigments with antihyperglycemic properties, and they are potential candidates for developing functional foods for the therapy or prevention of Diabetes mellitus type 2 (DM2). The mechanism of these beneficial effects of anthocyanins are, however, hard to explain, given their very low bioavailability due to poor intestinal absorption. We propose that free fatty acid receptor 1 (FFA1, also named GPR40), is involved in an inhibitory effect of the anthocyanidin delphinidin over intestinal glucose absorption. We show the direct effects of delphinidin on the intestine using jejunum samples from RF/J mice, and the human intestinal cell lines HT-29, Caco-2, and NCM460. By the use of specific pharmacological antagonists, we determined that delphinidin inhibits glucose absorption in both mouse jejunum and a human enterocytic cell line in a FFA1-dependent manner. Delphinidin also affects the function of sodium-glucose cotransporter 1 (SGLT1). Intracellular signaling after FFA1 activation involved cAMP increase and cytosolic Ca2+ oscillations originated from intracellular Ca2+ stores and were followed by store-operated Ca2+ entry. Taken together, our results suggest a new GPR-40 mediated local mechanism of action for delphinidin over intestinal cells that may in part explain its antidiabetic effect. These findings are promising for the search for new prevention and pharmacological treatment strategies for DM2 management.
