Metabolički sindrom, aktivnost osi hipotalamus -hipofiza-nadbubrežna žlijezda i medijatori upale u depresivnom poremećaju

Depression has been associated with various cardiovascular risk factors such as hypertension, obesity, atherogenic dyslipidemia and hyperglycemia. In depressive disorder, hyperactivity of the hypothalamic-pituitary-adrenal (HP A) axis and changes in the immune system have been observed. On the other hand, somatic diseases such as obesity, hyperlipidemia, hypertension and diabetes mellitus type 2 are now perceived as important comorbid conditions in patients with depression. The pathogenesis of the metabolic syndrome and depression is complex and poorly researched; however, it is considered that the interaction of chronic stress, psychotrauma, hypercotisolism and disturbed immune functions contribute to the development of these disorders. The aim of the study was to investigate the relationship between depression and metabolic syndrome regarding the HP A axis dysfunction and altered inflammatory processes. Literature search in Medline and other databases included articles written in English published between 1985 and 2012. Analysis of the literature was conducted using a systematic approach with the search terms such as depression, metabolic syndrome, inflammation, cytokines, glucocorticoids, cortisol, and HP A axis. In conclusion, the relationship between depression and metabolic syndrome is still a subject of controversy. Further prospective studies are required to clarify the possible causal relationship between depression and metabolic syndrome and its components. Furthermore, it is important to explore the possibility of a common biologic mechanism in the pathogenesis of these two disorders, in which special attention should be paid to the immune system function, especially the possible specific mechanisms by which cytokines can induce and maintain depressive symptoms and metabolic disorders. The data presented here emphasize the importance of recognition and treatment of depressive disorders with consequent reduction in the incidence of metabolic syndrome, but also the need of regular search for metabolic disorders and their treatment to avoid all of these adverse effects and maybe reduce the incidence of depressive disorders.Depresija je povezana s različitim kardiovaskularnim rizičnim čimbenicima kao što su hipertenzija, pretilost, aterogena dislipidemija i hiperglikemija. U depresivnom poremećaju su uočeni hiperaktivnost osi hipotalamus-hipofiza-nadbubrežna žlijezda (HHN ) i promjene u imunom sustavu. S druge strane, somatske bolesti kao što su pretilost, hiperlipidemija, hipertenzija i dijabetes melitus tipa 2 sada se shvaćaju kao važna komorbidna stanja u bolesnika s depresijom. Patogeneza metaboličkog sindroma i depresije je složena i nedovoljno istražena. Smatra se da interakcija kroničnog stresa, psihotraume, hiperkortizolizma i poremećene funkcije imunog sustava može doprinijeti razvoju ove bolesti. Cilj ovoga istraživanja bio je ispitati odnos između depresije i metaboličkog sindroma u odnosu na disfunkciju osi HHN i promjene u upalnim procesima. Pretraživanje literature na Medlineu i drugim bazama podataka obuhvaćalo je radove na engleskom jeziku objavljene između 1985. i 2012. godine. Analiza literature je provedena pomoću sustavnog pristupa s terminima pretraživanja kao što su depresija, metabolički sindrom, upala, citokini, glukokortikoidi, kortizol i os HHN . Zaključno, odnos između depresije i metaboličkog sindroma je još uvijek predmet proturječja. Potrebne su daljnje prospektivne studije u svrhu utvrđivanja moguće uzročno-posljedične veze između depresije i metaboličkog sindroma i njegovih sastavnica. Nadalje je važno istražiti mogućnost zajedničkog biološkog mehanizma u patogenezi ovih dviju bolesti, pričem pozornost treba naročito posvetiti funkcioniranju imunog sustava, a osobito mogućim specifičnim mehanizmima kojima citokini mogu inducirati i održavati depresivne simptome i metaboličke poremećaje. Podaci izneseni ovdje naglašavaju važnost prepoznavanja i liječenja depresivnog poremećaja s posljedičnim smanjenjem učestalosti metaboličkog sindroma, ali potrebu redovitog traganja za metaboličkim poremećajima i njihovim liječenjem kako bi se izbjegli svi njihovi negativni učinci i tako možda smanjila učestalost depresivnog poremećaja

THE IMPACT OF SOCIO-ECONOMIC PROCESSES ON THE HEALTH OF THE ADULT POPULATION

Background: A cross-sectional study in the Primary Care Medical Centre Mostar and Regional Medical Center "Safet Mujić" was conducted. Family physicians randomly surveyed, examined, and analyzed laboratory tests from 300 subjects divided into three age groups from 20-39, 40-54 and 55-65 years, totally 100 subjects. Data for age, sex, smoking status, alcohol consumption, body mass index, blood pressure, blood glucose, triglycerides and cholesterol, and the presence of chronic non-communicable diseases, including diagnosis of depression and the presence of stress were entered in medical records. Results: Levels of cholesterol were significantly higher in rural population as well as among students, and high triglyceride levels most frequently were presented in the student population. A group of farmers had a significantly higher prevalence of hypertension, DM and CVD compared to other investigated groups. The largest number of smokers and people who drink alcohol was present in group with the highest incomes, while obesity was significantly expressed in people with lower incomes. The group of examinees with the highest incomes had the greatest exposure to stress. Conclusions: Socioeconomic processes have an impact on risk behavior of the adult population, and the presence of a number of chronic diseases that are accompanied with increased laboratory blood glucose, cholesterol and triglycerides levels

The Revolving Door of Adenovirus Cell Entry: Not All Pathways Are Equal

Adenoviruses represent exceptional candidates for wide-ranging therapeutic applications, from vectors for gene therapy to oncolytics for cancer treatments. The first ever commercial gene therapy medicine was based on a recombinant adenovirus vector, while most recently, adenoviral vectors have proven critical as vaccine platforms in effectively controlling the global coronavirus pandemic. Here, we discuss factors involved in adenovirus cell binding, entry, and trafficking ; how they influence efficiency of adenovirus-based vectors ; and how they can be manipulated to enhance efficacy of genetically modified adenoviral variants. We focus particularly on endocytosis and how different adenovirus serotypes employ different endocytic pathways to gain cell entry, and thus, have different intracellular trafficking pathways that subsequently trigger different host antiviral responses. In the context of gene therapy, the final goal of the adenovirus vector is to efficiently deliver therapeutic transgenes into the target cell nucleus, thus allowing its functional expression. Aberrant or inefficient endocytosis can impede this goal, therefore, it should be considered when designing and constructing adenovirus-based vectors

THE IMPACT OF SOCIO-ECONOMIC PROCESSES ON THE HEALTH OF THE ADULT POPULATION

Background: A cross-sectional study in the Primary Care Medical Centre Mostar and Regional Medical Center "Safet Mujić" was conducted. Family physicians randomly surveyed, examined, and analyzed laboratory tests from 300 subjects divided into three age groups from 20-39, 40-54 and 55-65 years, totally 100 subjects. Data for age, sex, smoking status, alcohol consumption, body mass index, blood pressure, blood glucose, triglycerides and cholesterol, and the presence of chronic non-communicable diseases, including diagnosis of depression and the presence of stress were entered in medical records. Results: Levels of cholesterol were significantly higher in rural population as well as among students, and high triglyceride levels most frequently were presented in the student population. A group of farmers had a significantly higher prevalence of hypertension, DM and CVD compared to other investigated groups. The largest number of smokers and people who drink alcohol was present in group with the highest incomes, while obesity was significantly expressed in people with lower incomes. The group of examinees with the highest incomes had the greatest exposure to stress. Conclusions: Socioeconomic processes have an impact on risk behavior of the adult population, and the presence of a number of chronic diseases that are accompanied with increased laboratory blood glucose, cholesterol and triglycerides levels