Oral chondroitin sulfate and prebiotics for the treatment of canine Inflammatory Bowel Disease: a randomized, controlled clinical trial

BACKGROUND Canine inflammatory bowel disease (IBD) is a chronic enteropathy of unknown etiology, although microbiome dysbiosis, genetic susceptibility, and dietary and/or environmental factors are hypothesized to be involved in its pathogenesis. Since some of the current therapies are associated with severe side effects, novel therapeutic modalities are needed. A new oral supplement for long-term management of canine IBD containing chondroitin sulfate (CS) and prebiotics (resistant starch, β-glucans and mannaoligosaccharides) was developed to target intestinal inflammation and oxidative stress, and restore normobiosis, without exhibiting any side effects. This double-blinded, randomized, placebo-controlled trial in dogs with IBD aims to evaluate the effects of 180 days administration of this supplement together with a hydrolyzed diet on clinical signs, intestinal histology, gut microbiota, and serum biomarkers of inflammation and oxidative stress. RESULTS Twenty-seven client-owned biopsy-confirmed IBD dogs were included in the study, switched to the same hydrolyzed diet and classified into one of two groups: supplement and placebo. Initially, there were no significant differences between groups (p > 0.05) for any of the studied parameters. Final data analysis (supplement: n = 9; placebo: n = 10) showed a significant decrease in canine IBD activity index (CIBDAI) score in both groups after treatment (p < 0.001). After treatment, a significant decrease (1.53-fold; p < 0.01) in histologic score was seen only in the supplement group. When groups were compared, the supplement group showed significantly higher serum cholesterol (p < 0.05) and paraoxonase-1 (PON1) levels after 60 days of treatment (p < 0.01), and the placebo group showed significantly reduced serum total antioxidant capacity (TAC) levels after 120 days (p < 0.05). No significant differences were found between groups at any time point for CIBDAI, WSAVA histologic score and fecal microbiota evaluated by PCR-restriction fragment length polymorphism (PCR-RFLP). No side effects were reported in any group. CONCLUSIONS The combined administration of the supplement with hydrolyzed diet over 180 days was safe and induced improvements in selected serum biomarkers, possibly suggesting a reduction in disease activity. This study was likely underpowered, therefore larger studies are warranted in order to demonstrate a supplemental effect to dietary treatment of this supplement on intestinal histology and CIBDAI

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

Representações do corpo: com a palavra um grupo de adolescentes de classes populares Representations of the body: with the word one group of adolescents from popular classes

Diante da grande preocupação com a estética corporal demonstrada por um grupo de adolescentes de classes populares, o presente estudo teve como objetivo conhecer e analisar as suas representações sociais de corpo. Tratou-se de investigação de abordagem qualitativa realizada com adolescentes trabalhadores vinculados ao Centro Salesiano do Menor, em Vitória (ES). Uma amostra aleatória foi selecionada de um grupo de 334 sujeitos. Oito meninas e sete meninos foram abordados por meio de entrevista não-estruturada. A partir da análise de suas falas, foi realizada uma categorização e utilizada a teoria das representações sociais para sua discussão. Os resultados apontaram que a percepção de corpo, tanto para meninos quanto para as meninas, está voltada para as idéias de proporcionalidade, normalidade e perfeição. Quanto às consequências de não ter o corpo ideal, ambos apontaram situações como exclusão, doenças, infelicidade e até morte. Aprofundar o conhecimento sobre a percepção, os pensamentos e sentimentos dos adolescentes relativos ao corpo pode contribuir para subsidiar intervenções nesse grupo, ampliando significativamente o âmbito de atuação dos profissionais na área da saúde.<br>In view of the great body aesthetic concern demonstrated by a group of adolescents from popular classes, this study had the purpose of getting to know and analyze the social representations of the body. It investigated the qualitative approach carried out with adolescent workers from the Centro Salesiano do Menor, in Vitória, Espírito Santo State. A random sample was selected from a group of 334 individuals. Eight girls and seven boys were approached by means of non-structured interview. From the analysis of their speeches, a categorization was performed and the theory of the Social Representations was used for discussion. The results pointed out that body perception, for boys as well as for girls, are focused on the ideas of proportionality, normality and perfection. Regarding the consequences of not having an ideal body, both stated situations such as: exclusion, illnesses, unhappiness and even death. In-depth knowledge on opinion, thoughts and feelings of the adolescents relative to the body, may contribute to subside interventions in this group, extending significantly the scope of professional performance in the health secto

Personalizing health care: feasibility and future implications

Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients