Nesfatin-1

In this article, we review on the current concepts about Nesfatin-1 as a new anti-obesity treatment and evaluate the existing issues in the context of this knowledge and the available literature. The intent is to enable clinicians to know Nesfatin-1 as a new anti-obesity treatment and make rational decisions based on this perspective as possible clinical application. Future research should seek to clarify whether Nesfatin-1 would be beneficial in the management of obesity

Carotid intima-media thickness is predicted by combined eotaxin levels and severity of hepatic steatosis at ultrasonography in obese patients with Nonalcoholic Fatty Liver Disease.

BACKGROUND: Non-Alcoholic Fatty Liver Disease (NAFLD) is a distinct coronary artery disease (CAD) risk factor. The atherosclerotic process predisposing to CAD includes altered lipid profile and inflammatory processes. The available evidence suggests that increased circulating levels of eotaxin, an eosinophil chemoattractant cytokine implicated in allergic responses, are detected in the serum of patients with CAD. Relationships were sought between serum eotaxin on the one hand, and intima-media thickness--an early predictor of the atherosclerotic process, hepatic steatosis, arterial blood pressure values, as well as inflammation/immune markers and angiogenetic factors--on the other. METHODS: Eighty obese patients with NAFLD, diagnosed at ultrasonography, without evident cytolysis, formed our study population. Anthropometric measures, metabolic profile, serum concentrations of interleukin-1β, C-reactive protein, interleukin-6, fibrinogen, ferritin, TNF-α, spleen size, vascular endothelial growth factor, platelet-derived growth factor-BB and heat shock protein-70 were evaluated. RESULTS: Serum eotaxin concentrations were distinctly associated with TNF α, IL-6, IL-1β, VEGF and PDGF-BB levels but not with CRP, fibrinogen, heat shock protein-70 or spleen size. Among the metabolic and anthropometric parameters, a significant predictive power emerged when comparing eotaxin to insulin resistance, expressed as HOMA. NAFLD was distinctly associated with HOMA (P = 0.0005). Intima-media thickness was well predicted by both eotaxin levels and severity of NAFLD at ultrasonography, although no relation was detected between these last two variables. DISCUSSION AND CONCLUSION: A role for insulin resistance in mediating the interplay between eotaxin and other inflammation/immune parameters could be evidenced in the induction/maintenance of atherosclerosis of obese patients with NAFLD

Is serum Interleukin-17 associated with early atherosclerosis in obese patients?

Atherosclerosis is a chronic inflammatory process of the vessel walls, and CD4(+) T-cells are peculiar to both human and murine atherosclerotic lesions. There is a recent line of research favoring hypothetic allergic mechanisms in the genesis of atherosclerosis and, consequently, coronary artery disease (CAD), among which Interleukin (IL)-17 appears to be a key cytokine regulating local tissue inflammation. The objective was to add a piece of information on the role of IL-17 in the genesis of atherosclerosis. Eighty obese patients with normal liver enzyme levels but presenting with ultrasonographic evidence of NAFLD formed the population of this cross-sectional study. Anthropometric measures, data on excess adiposity, metabolic profile, serum concentrations of IL-17, eotaxin-3, IL-8, and CCL4/MIP1β, C-reactive protein, fibrinogen, ferritin, TNF-α, as well carotid intima-media thickness (IMT), a marker of atherosclerosis, and the main risk factors for CAD, such as blood pressure and smoking status, but also less determinant ones such as degree of NAFLD severity, Intramuscular Triglyceride storage and Resting Metabolic Rate were evaluated. Serum concentrations of Il-17 were detected as related to those of inflammatory cytokines, IL-6, IFN-γ and TNF-α. Furthermore, circulating levels of IL-17 were linked to those mirroring allergic process, IL-8, CCL4/MIP1β and eotaxin. Early atherosclerosis, evidenced as increased IMT, was not associated with circulating IL-17 levels. At multiple regression, IMT was predicted, other than by age, by the amount of the visceral adiposity, expressed as visceral adipose tissue at ultrasonography, and by serum eotaxin. In conclusion, a strong relationship was found between the IL-17-related chemokine eotaxin and IMT. The association found between the amount of visceral fat and circulating levels of eotaxin on the one hand, and IMT on the other, could reinforce the hypothesis that IL-17, released by the visceral adipose tissue, induces eotaxin secretion via the smooth muscle cells present in the atheromatosus vessels

Characteristics of Obese Patients (n 80).

<p>Values expressed as means plus/minus standard deviation or median plus 25–75 interquartile range, according to their distribution. Abbreviations: Waist Circumference WC, Body Mass Index BMI, Waist to Hip ratio WHR, Subcutaneous Adipose Tissue SAT, Visceral Adipose Tissue VAT, High Density Lipoprotein-cholesterol HDL, TriGlycerides TG, C Reactive Protein CRP, Spleen Longitudinal Diameter SLD, Tumor Necrosis Factor alpha TNF-α, Interleukin-6 IL-6, Interleukin-1β IL-1β, UltraSound US, ALanine aminoTransferase ALT, CHolinEsterase CHE, Alkaline Phosphatase AP, Gamma-Glutamyl Transglutaminase γ-GT, Vascular Endothelial Growth Factor VEGF, Platelet-Derived Growth Factor-BB PDGF-BB, Heat Shock Protein-70 HSP-70, High Density Lipoprotein cholesterol HDL, HOmeostatic Metabolic Assessment HOMA, Systolic Blood Pressure SPP, Diastolic Blood Pressure DBP, Intima-Media Thickness IMT.</p><p>Characteristics of Obese Patients (n 80).</p

Report of Predictions Using Eotaxin As Dependent Variable.

<p>Linear Regression with Coefficients and their Standard Error, 95% Confidence Intervals, t values and significance level expressed as P. Abbreviations: Waist Circumference WC, Body Mass Index BMI, Waist to Hip ratio WHR, Subcutaneous Adipose Tissue SAT, Visceral Adipose Tissue VAT, C Reactive Protein CRP, Spleen Longitudinal Diameter SLD, Tumor Necrosis Factor alpha TNF-α, Interleukin-6 IL-6, Interleukin-1β IL-1β, UltraSound US, ALanine aminoTransferase ALT, CHolinEsterase CHE, Alkaline Phosphatase AP, Gamma-Glutamyl Transglutaminase γ-GT, Vascular Endothelial Growth Factor VEGF, Platelet-Derived Growth Factor-BB PDGF-BB, Heat Shock Protein-70 HSP-70, High Density Lipoprotein HDL, HOmeostatic Metabolic Assessment HOMA, Systolic Blood Pressure SPP, Diastolic Blood Pressure DBP, Intima-Media Thickness IMT.</p><p>Report of Predictions Using Eotaxin As Dependent Variable.</p

Graphics of significant predictions between eotaxin and other independent variables.

<p>Eotaxin was well predicted by HOMA (r = 0.26, P = 0.019), VEGF (r = 0.27, P = 0.013), TNF-α (r = 0.405, P = 0.0002), IL-6 (r = 0.35, P = 0.0016), IL-1β (r = 0.38, P = 0.0005), PDGF-BB (r = 0.27, P = 0.015). Correlation coefficient r. The regression line is evidenced in blue; the 95% confidence in dark red and the 95% prediction in light red. Dependent Y =  Eotaxin.</p

Physicians’ Perceptions of Clinical Utility of a Digital Health Tool for Electronic Patient-Reported Outcome Monitoring in Real-Life Hematology Practice. Evidence From the GIMEMA-ALLIANCE Platform

Digital health tools are increasingly being used in cancer care and may include electronic patient-reported outcome (ePRO) monitoring systems. We examined physicians’ perceptions of usability and clinical utility of a digital health tool (GIMEMA-ALLIANCE platform) for ePRO monitoring in the real-life practice of patients with hematologic malignancies. This tool allows for the collection and assessment of ePROs with real-time graphical presentation of results to medical staff. Based on a predefined algorithm, automated alerts are sent to medical staff. Participating hematologists completed an online survey on their experience with the platform. Of the 201 patients invited to participate between December 2020 and June 2021 (cut-off date for current analysis), 180 (90%) agreed to enter the platform and had a median age of 57 years. Twenty-three hematologists with a median age of 42 years and an average of 17 years of experience in clinical practice were surveyed. All hematologists agreed or strongly agreed that the platform was easy to use, and 87%, agreed or strongly agreed that ePROs data were useful to enhance communication with their patients. The majority of physicians (78%) accessed the platform at least once per month to consult the symptom and health status profile of their patients. The frequency of access was independent of physician sex (p=0.393) and years of experience in clinical practice (p=0.404). In conclusion, our preliminary results support the clinical utility, from the perspective of the treating hematologist, of integrating ePROs into the routine cancer care of patients with hematologic malignancies