Role of Liver X Receptor, Insulin and Peroxisome Proliferator Activated Receptor α on in Vivo Desaturase Modulation of Unsaturated Fatty Acid Biosynthesis

We examined the in vivo contribution of insulin, T090137 (T09), agonist of liver X receptor (LXR), fenofibrate, agonist of peroxisome proliferator activated receptor (PPAR-α) and sterol regulatory element binding protein-1c (SREBP-1c) on the unsaturated fatty acid synthesis controlled by Δ6 and Δ5 desaturases, compared with the effects on stearoylcoenzyme A desaturase-1. When possible they were checked at three levels: messenger RNA (mRNA), desaturase protein and enzymatic activity. In control rats, only fenofibrate increased the insulinemia that was maintained by the simultaneous administration of T09, but this increase has no specific effect on desaturase activity. T09 enhanced SREBP-1 in control animals and the mRNAs and activity of the three desaturases in control and type-1 diabetic rats, demonstrating a LXR/SREBP-1-mediated activation independent of insulin. However, simultaneous administration of insulin and T09 to diabetic rats led to a several-fold increase of the mRNAs of the desaturases, suggesting a strong synergic effect between insulin and LXR/retinoic X receptor (RXR). Moreover, this demonstrates the existence of an interaction between unsaturated fatty acids and cholesterol metabolism performed by the insulin/SREBP-1c system and LXR/RXR. PPAR-α also increased the expression and activity of the three desaturases independently of the insulinemia since it was equivalently evoked in streptozotocin diabetic rats. Besides, PPAR-α increased the palmitoylcoenzyme A elongase, evidencing a dual regulation in the fatty acid biosynthesis at the level of desaturases and elongases. The simultaneous administration of fenofibrate and T09 did not show additive effects on the mRNA expression and activity of the desaturases. Therefore, the results indicate a necessary sophisticated interaction of all these factors to produce the physiological effects.Instituto de Investigaciones Bioquímicas de La Plat

Adherence to growth hormone (GH) therapy in na\uefve to treatment GH-deficient children: data of the Italian Cohort from the Easypod Connect Observational Study (ECOS)

Background: With the use of non-objective measurement, adherence to growth hormone (GH) therapy has been reported suboptimal in a large proportion of patients, and poor adherence has been shown to affect short-term growth response in patients receiving GH treatment. Objective: The Easypod\u2122 electronic device allows objective measurement of adherence. In this study, we report 3-year prospective adherence data of the Italian cohort of na\uefve GH deficient (GHD) children extrapolated from the Easypod Connect Observational Study (ECOS) database. Patients and methods: Seventy-three GHD children na\uefve to GH treatment were included in the analysis. 22 Italian centers participated in the study. Results: Mean adherence rate was consistently above 85% across the 3-year observation period. Particularly, mean adherence was 88.5%, 86.6%, and 85.7% after 1, 2 and 3\ua0years, respectively. Mean (\ub1 SD) height-SDS increase after the first year was 0.41 (\ub1 0.38). Conclusions: The majority of na\uefve GHD children starting GH treatment with Easypod maintained an adherence rate > 85% up to 3\ua0years. Easypod is a useful tool to follow-up patients\u2019 adherence allowing timely intervention to improve optimal treatment for these patients

Adherence to growth hormone (GH) therapy in naïve to treatment GH-deficient children: data of the Italian Cohort from the Easypod Connect Observational Study (ECOS)

Background: With the use of non-objective measurement, adherence to growth hormone (GH) therapy has been reported suboptimal in a large proportion of patients, and poor adherence has been shown to affect short-term growth response in patients receiving GH treatment. Objective: The Easypod™ electronic device allows objective measurement of adherence. In this study, we report 3-year prospective adherence data of the Italian cohort of naïve GH deficient (GHD) children extrapolated from the Easypod Connect Observational Study (ECOS) database. Patients and methods: Seventy-three GHD children naïve to GH treatment were included in the analysis. 22 Italian centers participated in the study. Results: Mean adherence rate was consistently above 85% across the 3-year observation period. Particularly, mean adherence was 88.5%, 86.6%, and 85.7% after 1, 2 and 3 years, respectively. Mean (± SD) height-SDS increase after the first year was 0.41 (± 0.38). Conclusions: The majority of naïve GHD children starting GH treatment with Easypod maintained an adherence rate > 85% up to 3 years. Easypod is a useful tool to follow-up patients’ adherence allowing timely intervention to improve optimal treatment for these patients

Predicting the Effects of Supplemental EPA and DHA on the Omega-3 Index

Background: Supplemental long-chain omega-3 (n–3) fatty acids (EPA and DHA) raise erythrocyte EPA + DHA [omega-3 index (O3I)] concentrations, but the magnitude or variability of this effect is unclear. Objective: The purpose of this study was to model the effects of supplemental EPA + DHA on the O3I. Methods: Deidentified data from 1422 individuals from 14 published n–3 intervention trials were included. Variables considered included dose, baseline O3I, sex, age, weight, height, chemical form [ethyl ester (EE) compared with triglyceride (TG)], and duration of treatment. The O3I was measured by the same method in all included studies. Variables were selected by stepwise regression using the Bayesian information criterion. Results: Individuals supplemented with EPA + DHA (n = 846) took a mean ± SD of 1983 ± 1297 mg/d, and the placebo controls (n = 576) took none. The mean duration of supplementation was 13.6 ± 6.0 wk. The O3I increased from 4.9% ± 1.7% to 8.1% ± 2.7% in the supplemented individuals ( P \u3c 0.0001). The final model included dose, baseline O3I, and chemical formulation type (EE or TG), and these explained 62% of the variance in response (P \u3c 0.0001). The model predicted that the final O3I (and 95% CI) for a population like this, with a baseline concentration of 4.9%, given 850 mg/d of EPA + DHA EE would be ∼6.5% (95% CI: 6.3%, 6.7%). Gram for gram, TG-based supplements increased the O3I by about 1 percentage point more than EE products. Conclusions: Of the factors tested, only baseline O3I, dose, and chemical formulation were significant predictors of O3I response to supplementation. The model developed here can be used by researchers to help estimate the O3I response to a given EPA + DHA dose and chemical form

Effect of Omega-3 Dosage on Cardiovascular Outcomes : An Updated Meta-Analysis and Meta-Regression of Interventional Trials

Objectives:To quantify the effect of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids oncardiovascular disease (CVD) prevention and the effect of dosage. Methods:This study is designed as a random effects meta-analysis and meta-regression of ran-domized control trials with EPA/DHA supplementation. This is an update and expanded analysis ofa previously published meta-analysis which covers all randomized control trials with EPA/DHAinterventions and cardiovascular outcomes published before August 2019. The outcomes includedare myocardial infarction (MI), coronary heart disease (CHD) events, CVDevents (a composite ofMI, angina, stroke, heart failure, peripheral arterial disease, sudden death, and non-scheduledcardiovascular surgical interventions), CHD mortality and fatal MI. The strength of evidence wasassessed using the Grading of Recommendations Assessment, Development, and Evaluationframework. Results:A total of 40 studies with a combined 135,267 participants were included. Supplementationwas associated with reduced risk of MI (relative risk [RR], 0.87; 95% CI, 0.80 to 0.96), high certaintynumber needed to treat (NNT) of 272; CHD events (RR, 0.90; 95% CI, 0.84 to 0.97), high certaintyNNT of 192; fatal MI (RR, 0.65; 95% CI, 0.46 to 0.91]), moderate certainty NNT¼128; and CHDmortality (RR, 0.91; 95% CI, 0.85 to 0.98), low certainty NNT¼431, but not CVD events (RR, 0.95;95% CI, 0.90 to 1.00). The effect is dose dependent for CVD events and MI. Conclusion:Cardiovascular disease remains the leading cause of death worldwide. Supplementationwith EPA and DHA is an effective lifestyle strategy for CVD prevention, and the protective effectprobably increases with dosage.peerReviewe

Ampulla of Vater carcinoma: Molecular landscape and clinical implications

Ampulla of Vater is a peculiar anatomical structure, characterized by the crossroad of three distinct epithelia: Intestinal, ductal pancreatic and biliary. Adenocarcinomas arising in this area represent an opportunity to understand the comparative biology of all periampullary malignancies. These neoplasms can exhibit intestinal, pancreaticobiliary or mixed features, whereas the subclassification based on morphology and immunohistochemical features failed in demonstrating a robust prognostic reliability. In the last few years, the molecular landscape of this tumor entity has been uncovered, identifying alterations that may serve as prognostic and predictive biomarkers. In this review, the histological and genetic characteristics of ampullary carcinomas are discussed, taking into account the main clinical and therapeutic implications related to this tumor type as well

The first continental stratotype for four successive isotope stages of the Middle Pleistocene for the northern Mediterranean Basin: the Vallo di Diano, Campania, Italy)(French with abridged English

peer reviewedA 207 m long core was taken from the deposits of a palaeolake of a tectonic basin in the southern Apennines (Italy). Two glacial-interglacial cycles were recognized by palynological studies and variation of oxygen isotope ratio. Fourteen major tephra beds are present. The results of the multidisciplinary research place the studied sequence within the Middle Pleistocene.Une carotte de 207 m de longueur a été extraite des dépôts d'un paléolac d'origine tectonique de l'Apennin méridional (Italie). Deux cycles glaciaire-interglaciaire y ont été mis en évidence par la palynologie et les variations des rapports isotopiques de l'oxygène. Quatorse téphras sont présentes. L'ensemble des données permet de placer la séquence étudie dans le Pléistocène moyen