Gut microbiota is an endocrine organ

The gut microbiota affects the processes of food digestion, intestinal peristalsis, controls the work of the intestinal epithelium, has protective properties against pathogenic microorganisms, activating local immunity and stimulating the secretion of mucus by intestinal cells. Besides the gut microbiota participates in the metabolism of proteins, fats and carbohydrates, mediates the processes of gluconeogenesis, glycogenolysis, lipogenesis and lipolysis, and affects on feelings of hunger and satiety. All these processes occur because the gut microbiota produces active metabolites throughout their life activity. Gut microbiota and active metabolites of the gut microbiota activate the synthesis of hormones. The gut microbiota affects the synthesis of hormones such as glucagon-like peptide-1, glucagon-like peptide-2, YY-peptide, glucose-dependent insu-linotropic peptide, ghrelin, leptin, cholecystokinin, serotonin, and insulin. Disturbance of the secretion of these hormones is one of the links in the pathogenesis of endocrine diseases such as diabetes and obesity. Thus, the gut microbiota is an endocrine organ. Changes in the composition and functions of the gut microbiota lead to metabolic disorders.This article describes the effect of gut germs and active metabolites of the gut microbiota on the synthesis hormones by means of receptor mechanisms, genes, and enzymes

Clinical and Morphological Features of Myocardial Damage and the Course of Fulminant Myocarditis on the Background of СOVID-19, Diagnosis and Treatment Tactics

In a review article based on my own clinical experience of managing patients with acute myocardial injury and fulminant myocarditis, taking into account expert recommendations on the clinical treatment of myocardial damage associated with novel coronavirus infection a National clinical geriatric medical research center, division of cardiovascular diseases, the Chinese geriatrics society, Department of cardiology, Beijing Medical Association and European clinics discusses the pathogenesis, diagnosis and treatment of myocardial damage and FM patients, infected with SARS-CoV-2 in the context of the COVID-19 pandemic. Clinical features and diagnostic criteria are presented, including screening tests of markers of myocardial damage in the form of a highly sensitive troponin test, a natriuretic peptide. The article discusses in detail the pathogenesis and mechanisms of myocardial damage, including immune mechanisms, cytokine storm, systemic inflammation with macro- and microvascular dysfunction and the development of myocardial dysfunction with acute heart failure, hypotension, cardiogenic shock and/or life-threatening heart rhythm disorders caused by hypoxia and metabolic disorders at the cellular level. Features of the clinical course of fulminant myocarditis in infected patients (SARS-CoV-2) in the conditions of the COVID-19 pandemic are presented. For the first time, a detailed histo-morphological analysis of pathological myocardial injuries and complications is presented on the basis of unique autopsy material on post-mortem diagnostics of various pathoanatomic autopsies of those who died from COVID-19 in Moscow. Based on the clinical, functional and morphological material, the Protocol of etiopathogenetic treatment is presented. The basis of standard therapy is considered antiviral drugs, immunoglobulin G, the use of monoclonal antibodies to interleukin-6, anticoagulants, glucocorticoids, depending on the clinical situation, cardioprotectors and symptomatic treatment are recommended to maintain the heart, which in combination can achieve a certain clinical effectiveness. As adjuvant cardioprotective targeted therapy, the sodium salt of phosphocreatine is considered in order to preserve the myocardium, maintain its contractility and vital activity