Metabolic therapy: cardioprotective effects of orotic acid and its derivatives

Metabolic therapy involves the administration of a substance normally found in the human body to enhance cellular reactions involved in the pathogenesis of disease. Myocardial ischaemia/reperfusion injury represents a leading cause of morbidity and mortality, also in cardiovascular disease. Therapeutic strategies aimed at limiting cardiomyocyte death during the postischaemic reperfusion and in the perioperative settings are nowadays extensively studied. Conceived originally as a dietary constituent (known as vitamin B13) only, it is now apparent that most orotic acid is synthesized in the human body where it arises as an intermediate in the biosynthetic pathway of pyrimidine nucleotides. Previous investigations in the heart suggest that orotate and its derivatives could be of significant clinical benefit in the treatment of heart disease. The present brief review is concerned with the current knowledge of the major effects of these compounds in both experimental and clinical cardiology. The potential mechanisms and biochemical pathways responsible for cardioprotection are highlighted.Biomedical Reviews 2010; 21: 47-55

Recommendations for the diagnosis of pediatric tuberculosis

Tuberculosis (TB) is still the world's second most frequent cause of death due to infectious diseases after HIV infection, and this has aroused greater interest in identifying and managing exposed subjects, whether they are simply infected or have developed one of the clinical variants of the disease. Unfortunately, not even the latest laboratory techniques are always successful in identifying affected children because they are more likely to have negative cultures and tuberculin skin test results, equivocal chest X-ray findings, and atypical clinical manifestations than adults. Furthermore, they are at greater risk of progressing from infection to active disease, particularly if they are very young. Consequently, pediatricians have to use different diagnostic strategies that specifically address the needs of children. This document describes the recommendations of a group of scientific societies concerning the signs and symptoms suggesting pediatric TB, and the diagnostic approach towards children with suspected disease

Monoamine Oxidase-Related Vascular Oxidative Stress in Diseases Associated with Inflammatory Burden

Monoamine oxidases (MAO) with 2 isoforms, A and B, located at the outer mitochondrial membrane are flavoenzyme membranes with a major role in the metabolism of monoaminergic neurotransmitters and biogenic amines in the central nervous system and peripheral tissues, respectively. In the process of oxidative deamination, aldehydes, hydrogen peroxide, and ammonia are constantly generated as potential deleterious by-products. While being systematically studied for decades as sources of reactive oxygen species in brain diseases, compelling evidence nowadays supports the role of MAO-related oxidative stress in cardiovascular and metabolic pathologies. Indeed, oxidative stress and chronic inflammation are the most common pathomechanisms of the main noncommunicable diseases of our century. MAO inhibition with the new generation of reversible and selective drugs has recently emerged as a pharmacological strategy aimed at mitigating both processes. The aim of this minireview is to summarize available information regarding the contribution of MAO to the vascular oxidative stress and endothelial dysfunction in hypertension, metabolic disorders, and chronic kidney disease, all conditions associated with increased inflammatory burden