Rola insuliny i wybranych adipocytokin u pacjentek z zespołem policystycznych jajników (PCOS)

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. It is manifested by hyperandrogenism, polycystic ovaries on ultrasound, oligomenorrhoea and anovulation. PCOS patients are more vulnerable to metabolic disorders: insulin resistance, obesity, endothelium dysfunction, atherosclerosis, and activation of proinflammatory factors. This association shows that PCOS might be an ovarian manifestation of a metabolic syndrome. Insulin resistance is also strongly correlated with reproductive failure. Approximately 100 factors, secreted in adipose tissue, are responsible for its regulation. Adipocytokines have been found to play an important role in regulating insulin sensitivity. Abnormal levels of adipokines are detected in patients with insulin resistance. Studies indicate that these factors, and their different activity in PCOS women, may affect changes observed in their metabolism and, especially, may participate in the development of insulin resistance. There are several adipokines whose role has been thoroughly investigated and many that we still know very little about, for example apelin and visfatin. Counseling PCOS patients about the possibility of developing metabolic syndrome, diabetes mellitus, and cardiovascular diseases should be a standard of care.Zespół policystycznych jajników (PCOS) jest najczęstszą endokrynopatią wśród kobiet w wieku rozrodczym. Manifestuje się hiperandrogenizmem, obrazem policystycznych jajników w ultrasonografii, zaburzeniami miesiączkowania o typie rzadkich miesiączek lub zaburzeniami owulacji. Pacjentki z PCOS są bardziej narażone na zaburzenia metaboliczne: insulinooporność, otyłość, nieprawidłowości endothelium, miażdżycę i aktywację czynników prozapalnych. Te zależności mogą świadczyć o tym, że PCOS może być jajnikową postacią zespołu metabolicznego. Insulinooporność silnie koreluje również z zaburzeniami rozrodu. Istnieje około 100 czynników produkowanych przez tkankę tłuszczową, odpowiedzialnych za funkcje regulacyjne. Adipocytokiny są ważnymi czynnikami regulującymi wrażliwość organizmu na insulinę. U pacjentek z insulinoopornością zauważalne są nieprawidłowe poziomy adipocytokin. Badania pokazują, że te czynniki i ich odmienna aktywność u kobiet z PCOS, może mieć wpływ na zmiany w ich metabolizmie, a w szczególności w rozwoju insulinooporności. Istnieje wiele adipokin, których rola jest dobrze poznana, lecz nadal rola wielu z nich jest niedostatecznie zbadana: między innymi apeliny i wisfatyny. Ocena czynników ryzyka zaburzeń metabolicznych, cukrzycy oraz choroby sercowo-naczyniowej powinna być standardem u kobiet z PCOS

Zastosowanie selektywnych modulatorów receptora progesteronowego w leczeniu mięśniaków macicy oraz ich przyszłość w ginekologii

Uterine leiomyomata are benign, monoclonal tumors arising from smooth muscle cells, which belong to one of the most common pathologies of the female genital system. Current pharmacotherapies (oral contraceptives, progestins, GnRH analogs) are ineffective or of limited use for long-term treatment. Although there is still much debate regarding their etiology, it is very likely that progesterone and progesterone receptor play a key role in their development. Profound importance of progesterone in the female reproductive system has led to discovery of synthetic progesterone receptor ligands, which can poses the activity ranging from pure agonist activity, trough mixed agonist/antagonist activity, to pure antagonist activity. Development of selective progesterone receptor modulators (SPRM) has created new therapeutic options and has great potential in a number of gynecologic indications. So far, ulipristal acetate has been approved for emergency contraception, mifepristone as a progesterone receptor antagonist because of the unique property of this compound for termination of pregnancy. Recently, the European Commission has authorized ulipristal acetate for the pre-operative treatment of uterine fibroids. Superior efficacy of ulipristal acetate versus placebo, to reduce excessive uterine bleeding and to reduce total fibroid volume prior to surgery was demonstrated. Moreover, non-inferior efficacy of ulipristal acetate versus Gonadotropin Releasing Hormone (GnRH)-agonist to reduce excessive uterine bleeding prior to surgery of uterine fibroids has been documented. Ulipristal acetate is also characterized by a superior side-effect profile in comparison to leuprolide acetate in terms of serum estradiol levels and the proportion of patients with moderate-to-severe hot flashes during treatment. Regarding safety profile, except elevation of liver enzymes after telapristone and onapristone treatment, to date no serious untoward effects of other SPRM have been reported. The issue of endometrial effects of these compounds remains to be resolved, although observation that intrinsic agonist activity of SPRM prevents endometrial proliferation may suggest future use of these agents in prevention of endometrial hyperplasia. Other promising applications, including endometriosis, endometrial cancer, Cushing’s disease, Alzheimer disease or long-term contraception, are currently in development.Mięśniaki macicy to łagodne, monoklonalne guzy wywodzące się z komórek mięśni gładkich należące do najczęstszych patologii układu rozrodczego kobiet. Ich etiologia pozostaje ciągle tematem otwartej debaty, jakkolwiek wydaje się, iż kluczową rolę w ich rozwoju odgrywa progesteron oraz receptor progesteronowy. Dotychczasowe zachowawcze metody leczenia mięśniaków (doustna antykoncepcja, gestageny lub analogi GnRH) są nieskuteczne bądź niemożliwe do stosowania w długotrwałej terapii. Pojawienie się selektywnych modulatorów receptora progesteronowego (SPRM) otworzyło nowe możliwości terapeutyczne. Obecnie preparaty te są zarejestrowane w doraźnej antykoncepcji, terminacji ciąży i w leczeniu mięśniaków. Ponadto na etapie badań klinicznych trwają próby zastosowania SPRM w leczeniu endometriozy, raka endometrium, choroby Cushinga, choroby Alzheimera czy w długotrwałej antykoncepcji

Differentiation of flea communities infesting small mammals across selected habitats of the Baltic coast, central lowlands, and southern mountains of Poland

Only a few studies comparing flea composition on the coast and in the mountains have been conducted. We investigated differences in flea communities infesting small mammals in selected habitats in northern, central and southern Poland. We predicted: (1) a greater number of flea species in the southeastern Poland and a lower number in the north; (2) a greater number of flea species in fertile and wet habitats than in poor and arid habitats; (3) a low similarity of flea species between flea communities in western and eastern Poland. We found negative effect of increasing latitude on flea species richness. We suppose that the mountains providing a variety of environments and the limits of the geographic ranges of several flea subspecies in southeastern Poland, result in a higher number of flea species. There was positive effect of increasing wetness of habitat on flea species richness. We found a high diversity in flea species composition between western and eastern Poland (beta diversity = 11) and between central and eastern Poland (beta diversity = 12). Re-colonization of Poland by small mammals and their ectoparasites from different (western and eastern) refugies can affect on this high diversity of flea species.grant no. SFRH/BD/ 31602/2006 from the Science and Technology Foundation (Portuguese Ministry of Science, Technology and Higher Education); budget of the Department of Systematic Zoology (Faculty of Biology AMU, Poznań)Parasitology Researc