Role of the insulin-like growth factor system in neurodegenerative disease

The insulin-like growth factor (IGF) system has paracrine and endocrine roles in the central nervous system. There is evidence that IGF signalling pathways have roles in the pathophysiology of neurodegenerative disease. This review focusses on Alzheimer’s disease and Parkinson’s disease, the two most common neurodegenerative disorders that are increasing in prevalence globally in relation to the aging population and the increasing prevalence of obesity and type 2 diabetes. Rodent models used in the study of the molecular pathways involved in neurodegeneration are described. However, currently, no animal model fully replicates these diseases. Mice with triple mutations in APP, PSEN and MAPT show promise as models for the testing of novel Alzheimer’s therapies. While a causal relationship is not proven, the fact that age, obesity and T2D are risk factors in both strengthens the case for the involvement of the IGF system in these disorders. The IGF system is an attractive target for new approaches to management; however, there are gaps in our understanding that first need to be addressed. These include a focus beyond IGF-I on other members of the IGF system, including IGF-II, IGF-binding proteins and the type 2 IGF receptor

Effect of Ghrelin on Hepatic IGF-Binding Protein-1 Production

Ghrelin plays key roles in energy homeostasis by central and peripheral actions that include effects on insulin signalling pathways in liver. Insulin is an important inhibitor of production by hepatocytes of insulin-like growth factor-binding protein-1 (IGFBP-1) which has an endocrine role to inhibit IGF availability. The effects of ghrelin, insulin, an AMPK activator, and an AMPK inhibitor on IGFBP-1 secretion were studied in H4-II-E rat liver cells. Ghrelin (100 nM) blocked the inhibitory effect of a maximally effective concentration of insulin (10 ng/mL) on IGFBP-1 secretion during a 5 h incubation period (P < 0.001) in the absence and presence of an AMPK inhibitor. Ghrelin, alone, had no effect on IGFBP-1 production, but enhanced secretion independently of insulin under conditions of AMPK activation (P < 0.001). In conclusion, IGFBP-1 is identified as a novel target of ghrelin action in liver that may contribute to its metabolic effects in obesity

‘Pilates’ in 2024:useful clinical tool or commercial catchphrase?

The system of exercise created by Joseph Pilates is practiced as Comprehensive Pilates today. The original method involved specifically designed exercises, most of which required access to a range of apparatus. Today, practices that are unrecognisable as Pilates’ original method now dominate the fitness industry, with substantially modified exercises and an emphasis on matwork. While the number of health publications reporting the use of Pilates is increasing exponentially, there is lack of clarity as to which exercises and pieces of apparatus are used in each study. The changing landscape of Pilates, that includes the introduction of Reformer-only classes, adds complexity. In this article, we describe the spectrum of Pilates-related practice and describe an approach to more clearly define the terms for professionals, practitioners and researchers, and for the public. We recommend that, in addition to the term Comprehensive Pilates, Pilates-based matwork is reserved for programmes that do not use apparatus but employ a variety of mat exercises, based on those originally developed by Joseph Pilates. If the exercises are not close to those originally described Pilates, whether or not apparatus is used, the term Pilates should not be used as a label, particularly in the context of alternative, complementary and integrative medicine

Effect of the ‘Pilates stance’ and Pilates-based matwork training on measurements of height, waist circumference, and interscapular distance

BackgroundStandardised guidelines for stance are used to improve interobserver reliability in anthropometric measurements in clinical practice. A key feature of the stance in Pilates is the ‘drawing in and up’ of the abdomen. The aim of this study was to study the impact of the Pilates stance on height, waist circumference and interscapular distance, compared to that recommended in clinical practice.Methods48 healthy females (median age 60 years) were assessed before and after 10-week Pilates-based matwork training. One Pilates expert and one novice took independent measurements of weight, height, waist circumference and interscapular distance (ISD).ResultsPilates stance, compared to Normal, increased height by up to 2.7 cm and decreased waist up to 5.2 cm (each P &lt; 0.001, repeated measures ANOVA). ISD decreased up to 14 mm (P &lt; 0.001) and this decrease was greater after training (P &lt; 0.001). After controlling for age and length of time learning Pilates, greater baseline ISD predicted a greater change in ISD after the intervention. Effect of Pilates stance was greater when the expert took the measurements (each P ≤ 0.001).ConclusionsActivation of trunk muscles in the Pilates stance increases height and decreases waist circumference, compared to the stance recommended in UK healthcare settings. A decrease in ISD was observed, which was greater after a Pilates-based matwork programme. There are significant inter-observer differences, therefore current clinical guidelines for stance are recommended for repeated anthropometry. The value of the Pilates stance in improving posture and the role of ISD as a marker, should be further studied in various contexts, including clinical settings

Developing and sustaining a culture of innovation in Health Higher Education literature review.

This literature review set out to review the recent literature on cultures of innovation and summarise how they are developed, sustained and extended, including the associated barriers and enablers, in a way that is relevant to health HE and which can be used to inform future practice. The review addressed the following questions:•How is innovation defined and conceptualised?•How is innovation developed?•How is innovation evaluated and disseminated? And included in this, what is the impact on the student experience, the staff, the institution and beyond the institution?•How is a culture of innovation sustained, embedded and extended?•What are the enablers and barriers to the development of a culture of innovation