Evaluation of the effectiveness of Ferzym administration in digestive diseases

Department of Pediatrics, Nicolae Testemitsanu State University of Medicine and Pharmacy, Institute of Mother and Child, Chisinau, the Republic of MoldovaAbstract Background: Assessing effectiveness of the next generation probiotic Ferzym in conjunction with other probiotics for correction of the microbiocenotic status in different digestive disorders. Material and methods: 120 children aged between 6 months and 17 years, with the mean age of 9.3 ± 0.61 years, were included in the study, being admitted to Gastroenterology Department of Institute of Mother and Child. The research methods included: thorough anamnesis of the disease and comprehensive clinical examination. The clinical testing procedure included a clinical monitoring during the 10-day inpatient treatment and 1 month after the outpatient treatment. Results: A more favorable clinical and progressive improvement curve was observed in children who received Ferzym. Both the stool consistency and frequency improved faster. It has been recorded a gradual and continuous remission of the abdominal pain and decrease of the discomfort up to the 10th day of treatment. The final segment of the “treatment with probiotics” curve confirms the assumption that treatment effectiveness is maintained for about 10 days, so that it can cover the acute period of disturbances. Conclusions: Ferzym is practically the only solution in the intestinal microbiocenosis control in children with intestinal malabsorption and Coeliac disease, as the capsule does not contain dismulate gluten. Efficacy of Ferzym indicated to children with digestive disorders is a priority over the biological non-sorbit preparations and monocompetent ones because Ferzym regulates the microbiocenotic status of the small intestine and colon

Afectarea multisistemică în bolile inflamatorii intestinale şi boala celiacă la copii

Institutul Mamei şi Copilului, secţia gastroenterologie, Republica MoldovaActualitatea. Maladiile inflamatorii intestinale şi boala celiacă sunt entităţi patologice actuale, atît prin creşterea constantă a incidenţei, cît şi prin afectarea sistemică a majoritatea organelor. Acestea ducînd la necesitatea abordării multidisciplinare a cazurilor diagnosticate, în care doar o echipă formată din gastroenterolog, endoscopist, radiolog, reumatolog, alergolog, dermatolog poate realiza cu succes managementul de conduită al pacienţilor. Scopul. Evaluarea manifestărilor clinice extraintestinale în bolile inflamatorii intestinale şi boala celiacă la copii Material şi metode. Studiu prospectiv a pacienţilor cu maladii inflamatorii intestinale (41 copii), colită ulceroasă 36 (87,8%) copii şi boala Crohn 5 (12,2%) copii şi studiu retrospectiv a pacienţilor cu boala celiacă (84 copii). Rezultatele obţinute: La pacienţii cu boli infl amatorii intestinale au fost prezente următoarele manifestări extraintestinale: osteoarticulare 22%, prin afectarea articulaţiilor talocrurale 22%, genunchilor 14,6%, radiocarpală 4,9%, antibraţului 4,9%, manifestări mucocutanate 14,6%, cu stomatită aftoasă 12,2%, dermatită atopică 4,9%, manifestări endocrine 7,3%, patologia glandei tiroide 7,3%, retard pubertar 4,8%, manifestări hematologice 43,9%, afecţiuni hepatobiliare, prin colangită sclerozantă primară 2,4%. La pacienţii cu boala celiacă au fost prezente în 39,95% manifestări osteomusculare, cu afectare articulară 22,6%, hipoplazie dentară 17,3%; manifestări mucocutanate – 62,5%, hipecheratoză cutanată 31%, stomatită, glosită, gingivită 25%; manifestări neurologice - 70,23%, hiperexcitabilitate 60,71%; epilepsie 3,57%, manifestări endocrine – 57,14%, patologia glandei tiroide 33,3%, retard pubertar 23,8%, manifestări hematologice - 25%, anemie 23,8%, sindrom hemoragic 1,19%. Concluzii. Ponderea manifestărilor extraintestinale, în studiu nostru, este de 51,2% pentru bolile infl amatorii intestinale şi 86,9% pentru boala celiacă, comparativ cu literatura de specialitate 25-60%. Aceşti copii necesitînd o prudenţă semnifi cativă din partea specialiştilor în evitarea lacunelor de diagnostic, deoarece identificarea precoce a manifestărilor extraintestinale ar permite ameliorarea evoluţiei maladiilor de bază, cu ameliorarea semnificativă a calităţii vieţii acestor copii

Заболеваемость желудочно-кишечного тракта у детей Республики Молдова

The article presents the morbidity analysis of gastrointestinal pathologies among the children’s population in Moldova during the period of 2006-2011 in terms of statistical indicators of such digestive diseases as gastritis and duodenitis, gallstones, pancreatitis, stomach and duodenal ulcers as well as inflammatory bowel diseases (ulcerative colitis and Crohn’s disease). The data of National Bureau of Statistics, National Center of Health Management and other investigations, containing official data, have been used. During these 5 years both the prevalence and incidence of the digestive pathologies were rising, taking the second and the third places in the rating of the first three nosologies being after respiratory diseases and injuries. Yet, the trigger factors as well as the relapses of gastrointestinal and hepatobiliary diseases remain completely neglected in clinical assessments and in the management of children’s behaviour. Thus, maintaining the health of children is crucial to the health condition and longevity of future adults. After the multidimensional analysis of the indicators a number of proposals have been outlined to reduce the level of digestive diseases morbidity.В статье приводится анализ патологий желудочно-кишечного тракта у детей Республики Молдова на период 2006-2011 гг. Использованы статистические показатели таких пищеварительных заболеваний как гастрит, язва желудка и двенадцатиперстной кишки, желчно-каменная болезнь, панкреатит, язва и воспалительные заболевания кишечника (язвенный колит и болезнь Крона). Задействованы данные Национального Бюро Статистики, Национального Центра Менеджмента Здравоохранения, а также результаты других исследований, содержащих официальные данные. На протяжении этих 5-ти лет, как распространенность, так и рост заболеваемости патологиями пищеварительной системы постоянно увеличиваются, занимая вторую и третью позиции после заболеваний дыхательных путей и травм в рейтинге первых трех нозологий. Несмотря на это, факторы вызывающие данные патологии, а также рецидивирующие желудочно-кишечные и гепатобилиарные заболевания остаются полностью без внимания в. клинических исследованиях и, соответственно, терапевтическое поведение детей не корректируется должным образом. А поддержание здоровья ребенка является решающим для состояния здоровья и долголетия будущего взрослого. После многомерного анализа показателей приведен ряд предложений для снижения порога заболеваемости пищеварительными патологиями

Photochemoprevention of cutaneous neoplasia through natural products

Non-melanoma skin cancers such as squamous cell carcinoma and basal cell carcinoma are the most common types of human tumors, representing 30% of the new cases of malignancies diagnosed each year. Ultraviolet radiation (UV) from the sun is a major cause of non-melanoma skin cancer in humans. The prevention and mainly the photochemoprevention with natural products represent a simple but very effective strategy in the management of cutaneous neoplasia. Here we review the progress in the research of new and existing agents developed to protect the skin exposed to UV. We also discuss the current state of knowledge on their photosuppression mechanism in humans as well as in animal models, and efficiency in cancer preventio

Iodide excess exerts oxidative stress in some target tissues of the thyroid hormones

Environmental iodine deficiency continues to be a significant public health problem worldwide. On the other hand, iodide excess results principally from the use of iodine -containing medicinal preparations or radiographic contrast media. For this reason we intended to explore iodide excess impairment on prooxidant/antioxidant balance of the thyroid gland, hepatic tissue and in blood and the effect of selenium administration on oxidative stress markers under the same circumstances. Experiments were performed for 10 days with white, male, Wistar rats, as follows: group 1: control -normal iodine supply group; 2: high iodine diet, group; 3: high iodine diet and selenium; group 4: high iodine diet and Carbimasole. Oxidative stress markers such as lipid peroxides were determined in thyroid gland, hepatic tissue and in blood. Measuring H+ donor ability of the sera and catalase activity in thyroid gland and in hepatic tissue assessed antioxidant defense. Iodide excess had prooxidant effects, leading to an increased lipid peroxides level and catalase activity in target tissues and in blood and to a decreased H+ donor ability of the sera. Selenium supplementation had opposite effects. Present data allow us to conclude that the alterations due to iodide excess in thyroid gland, hepatic tissue and in blood are mediated through oxidative stress

Efects of PDT with 5-aminolevulinic acid and chitosan on Walker carcinosarcoma

Porphyrins and new chitosan hydrogels based composites with porphyrins are used as active cytotoxic antitumor agents in photodynamic therapy (PDT). Aim: The present study evaluates the effects of photodynamic therapy (PDT) with 5-aminolevulinic acid (5-ALA) and 5-ALA associated with chitosan (CS) using Walker carcinosarcoma in rats as experimental model. Methods: The animals were irradiated with red light (l = 685 nm, D = 50 J/cm2, 15 min) 3 h after i.p. administration of 5-ALA (250 mg/kg b.w.) or a mixture of 5-ALA (250 mg/kg b.w.) and CS (1.5 mg/kg b.w.). The animals were sacrificed at 1, 3, 6, 24 h and 14 days after the treatment. The effects of PDT were investigated by morphological studies, monitoring the 5-ALA induced protoporphyrin IX (Pp IX) level in tumor tissue and serum, MMP 2 and 9 (gelatinases) activity in tumor and malondialdehyde level (MDA), marker of the lipoperoxidation process, in tumor and serum. Results: Zymography revealed an increased activity of MMP 2 in tumors from animals treated with 5-ALA PDT. PDT with 5-ALA induced a higher lipid peroxidation in tumor tissue compared with 5-ALA-CS. CS associated to 5 ALA PDT enhanced the accumulation of PS in tumors inducing earlier necrotic changes. In the same time CS reduced MMP 2 activity. Conclusion: Our results suggest that MMPs activation and oxygen reactive species are involved in PDT effects.Порфирины и новые соединения, основу которых составляют гидрогели хитозана с порфиринами, используются как активные цитотоксические противоопухолевые препараты при фотодинамической терапии (PDT). Цель: оценить действие PDT с 5-аминолевуленовой кислотой (5-ALA) и 5-ALA, ассоциированной с хитозаном (CS), на клетки карциносаркомы Уокера. Методы: крыс облучали красным светом (λ = 685 нм, D = 50 Дж/см2 , 15 мин) 3 ч после внутрибрюшинного введения 5-ALA (250 мг/кг) или смеси 5-ALA (250 мг/кг) и CS (1,5 мг/кг). Подопытных животных забивали через 1 ч, 3 ч, 6 ч, 24 ч и 14 дней после воздействия PDT. Эффект PDT определяли с помощью морфологических исследований, регистрируя уровень протопорфирина IX (Pp IX), вызываемого 5-ALA, в опухолевой ткани и сыворотке крови, активность MMP 2 и 9 (желатиназы) в опухоли и уровень малонового диальдегида (MDA), маркера процесса перекисного окисления липидов, в опухоли и сыворотке крови. Результаты: зимографические исследования показали повышенную активность MMP 2 в опухолях животных, которых подвергали 5-ALA PDT. PDT с 5-ALA вызывала повышенный уровень перекисного окисления липидов в опухолевой ткани по сравнению с 5-ALA-CS. CS с 5 ALA PDT усиливал накопление фотосенсибилизирующего вещества (PS) в опухолях, вызывая более ранние некротические изменения. В то же время CS снижал активность MMP 2. Выводы: полученные результаты позволяют предположить, что для проявления эффектов PDT необходимы активация MMP и образование активных форм кислорода

The dynamics of reactive oxygen species in photodynamic therapy with tetra sulfophenyl-porphyrin

Photodynamic therapy (PDT) is a promising therapy especially in skin cancer, using the systemic administration of a photosensitizer (PS), followed by the local irradiation of the tumor with visible light. The antitumor effects of PDT are determined especially by the generation of cytotoxic reactive oxygen species (ROS). The 5,10,15,20-tetrasulfophenyl-porphyrin (TSPP) is a synthetic photosensitizer, which proved its efficiency in in vitro studies. Our study evaluates the effects of PDT with TSPP upon the tumor levels of ROS and upon the metalloproteinases 2 (MMP2) activities on Wistar male rats bearing 256 Walker carcinosarcoma in correlation with the accumulation of PS in the tumor and with the intratumor histological alterations. The evaluations were performed dynamically, at 3 hours, 6 hours, 24 hours and 14 days after the PDT with TSPP. Our results emphasize that 24 hours after the PDT with TSPP, the ROS generation increases, as revealed by protein carbonyls and malondialdehyde levels and the antioxidant capacity (hydrogen donors, thiol groups) decreases in the tumor tissue. These parameters were correlated with the appearance of the histological disorders. The MMP-2 activity increases exponentially in the 24 hours — 14 days post PDT interval. PDT with TSPP offers, in vivo, consistent results regarding ROS generation, MMP2 activation and cytotoxic capacity

Possible in vivo mechanisms involved in photodynamic therapy using tetrapyrrolic macrocycles

Photodynamic therapy (PDT) mediated by oxidative stress causes direct tumor cell damage as well as microvascular injury. To improve this treatment new photosensitizers are being synthesized and tested. We evaluated the effects of PDT with 5,10,15,20-tetrakis(4-methoxyphenyl)-porphyrin (TMPP) and its zinc complex (ZnTMPP) on tumor levels of malondialdehyde (MDA), reduced glutathione (GSH) and cytokines, and on the activity of caspase-3 and metalloproteases (MMP-2 and -9) and attempted to correlate them with the histological alterations of tumors in 3-month-old male Wistar rats, 180 ± 20 g, bearing Walker 256 carcinosarcoma. Rats were randomly divided into five groups: group 1, ZnTMPP+irradiation (IR) 10 mg/kg body weight; group 2, TMPP+IR 10 mg/kg body weight; group 3, 5-aminolevulinic acid (5-ALA+IR) 250 mg/kg body weight; group 4, control, no treatment; group 5, only IR. The tumors were irradiated for 15 min with red light (100 J/cm², 10 kHz, 685 nm) 24 h after drug administration. Tumor tissue levels of MDA (1.1 ± 0.7 in ZnTMPP vs 0.1 ± 0.04 nmol/mg protein in control) and TNF-&#945; (43.5 ± 31.2 in ZnTMPP vs 17.3 ± 1.2 pg/mg protein in control) were significantly higher in treated tumors than in controls. Higher caspase-3 activity (1.9 ± 0.9 in TMPP vs 1.1 ± 0.6 OD/mg protein in control) as well as the activation of MMP-2 (P < 0.05) were also observed in tumors. These parameters were correlated (Spearman correlation, P < 0.05) with the histological alterations. These results suggest that PDT activates the innate immune system and that the effects of PDT with TMPP and ZnTMPP are mediated by reactive oxygen species, which induce cell membrane damage and apoptosis