Adipokines, metabolic syndrome and rheumatic diseases

The metabolic syndrome (MetS) is a cluster of cardiometabolic disorders that result from the increasing prevalence of obesity. The major components of MetS include insulin resistance, central obesity, dyslipidemia, and hypertension. MetS identifies the central obesity with increased risk for cardiovascular diseases (CVDs) and type-2 diabetes mellitus (T2DM). Patients with rheumatic diseases, such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis, have increased prevalence of CVDs. Moreover, CVD risk is increased when obesity is present in these patients. However, traditional cardiovascular risk factors do not completely explain the enhanced cardiovascular risk in this population. Thus, MetS and the altered secretion patterns of proinflammatory adipokines present in obesity could be the link between CVDs and rheumatic diseases. Furthermore, adipokines have been linked to the pathogenesis of MetS and its comorbidities through their effects on vascular function and inflammation. In the present paper, we review recent evidence of the role played by adipokines in the modulation of MetS in the general population, and in patients with rheumatic diseases

The potential of lipocalin-2/NGAL as biomarker for inflammatory and metabolic diseases

Lipocalin-2 (LCN2), also known as neutrophil gelatinase-associated lipocalin (NGAL), is a secreted glycoprotein that belongs to a group of transporters of small lipophilic molecules in circulation. LCN2 has been recently characterized as an adipose-derived cytokine. This adipokine is believed to bind small substances, such as steroids and lipopolysaccharides, and has been reported to have roles in the induction of apoptosis in hematopoietic cells, transport of fatty acids and iron, modulation of inflammation, and metabolic homeostasis. Recently, LCN2 has emerged as a useful biomarker and rheumatic diseases. This review provides an overview of LCN2 in inflammation, immunity, and metabolism.Instituto de Salud Carlos III (ISCIII)Serivizo Galego de Saúde (SERGAS)Versus ArthritisDeanship of Scientific Research (DSR), King AbdulAziz UniversityXunta de Galicia/ESF (European Social Fund)Universidad de CoruñaGobierno de EspañaFundación IDIS-Ramón DomínguezRECTIS Programme/RIER/RD12/0009/0008ISCIII/PI14/00016ISCIII/PIE13/00024EU FP7/HEALTH.2012.2.4.5-2 305815Versus Arthritis/20194Deanship of Scientific Research (DSR), King AbdulAziz University/1-141/1434 HiCiComisión Europe

Identification of novel adipokines in the joint.Differential expression in healthy and osteoarthritis tissues

OBJECTIVES: Emerging data suggest that several metabolic factors, released mainly by white adipose tissue (WAT) and joint tissues, and collectively named adipokines, might have a role in the pathophysiology of OA. Recently, novel adipokines such as SERPINE2, WISP2, GPNMB and ITIH5 have been identified in WAT. The main goal of this study was to analyse the expression of these novel adipokines in synovium, infrapatellar fat pad and chondrocytes and to compare the expression of these molecules in healthy and OA tissues. METHODS: Synovial tissues, infrapatellar fat pad and chondrocytes were obtained from 36 OA patients (age 52-85; mean BMI 28.9) who underwent total knee replacement surgery. Healthy synovial tissues and infrapatellar fat pad were obtained from 15 traumatic knee patients (age 23-53; mean BMI 23.5). mRNA and protein expression were determined by qRT-PCR and western blot analysis respectively. RESULTS: All the novel adipokines, matter of our study, are expressed in OA synovium, infrapatellar fat pad and chondrocytes. Moreover, we detected a differential expression of SERPINE2 and ITIH5 in OA synovial tissues as compared to healthy samples. Finally, we also observed an increased expression of WISP2 in OA infrapatellar fat pad in comparison to healthy controls. CONCLUSIONS: In this study we demonstrated for the first time the expression of four novel adipokines in different joint tissues and how these molecules are differentially expressed in healthy and OA joint tissues.Xunta de Galicia/SERGASInstituto de Salud Carlos III (ISCIII)Fundación Ramón DomínguezMinisterio de Educación de Españ

Management of Open Fracture

Open fractures are common and their prevalence is increasing in elderly people. The burden of open fractures is high because of economic and social costs. Most open fractures occur in lower limbs. The use of validated protocols, will optimize our outcomes when treating open fractures. The first step began with the proper identification of the fracture characteristics and the hidden soft tissue injury. The use of an adequate and early antibiotic prophylaxis is mandatory and then, we have to perform adequate irrigation and debridement. Finally, we have to decide to temporally fix the fracture or proceed with the definitive fixation method. Recently, the creation of dedicated “orthoplastic” units has increased the outcomes in high-energy tibial fractures. These fractures should be managed in adequate trauma centers that should be used to face all the complications that will appear during the reconstruction procedure because complications can be as high as 50% in high-energy open fractures

Distal Femoral Fractures

Distal femur fractures are increasing injuries in our environment, due to their close relationship with the aging of the population. The diagnosis and treatment of these injuries have evolved in recent years, and the availability of new tools allows us to improve the results of our patients. Techniques such as dual nail-plate or plate-plate fixation emerge as an option in complications and complex fractures, and augmentation with PMMA may be an option in very low-density bones. To use these new techniques, anatomical knowledge, especially of the medial aspect of the femur, is essential. Many recent publications have studied the use of minimally invasive techniques with safe pathways. Throughout the following pages, we give a glimpse of the novelties in the treatment of these fractures, and we review the classic concepts

Pharmacological Extracts and Molecules from Virola Species: Traditional Uses, Phytochemistry, and Biological Activity

Virola is the largest genus of Myristicaceae in America, comprising about 60 species of medium-sized trees geographically spread from Mexico to southern Brazil. The plant species of this genus have been widely used in folk medicine for the treatment of several ailments, such as rheumatic pain, bronchial asthma, tumors in the joints, intestinal worms, halitosis, ulcers, and multiple infections, due to their pharmacological activity. This review presents an updated and comprehensive summary of Virola species, particularly their ethnomedicinal uses, phytochemistry, and biological activity, to support the safe medicinal use of plant extracts and provide guidance for future research. The Virola spp.’s ethnopharmacology, including in the treatment of stomach pain and gastric ulcers, as well as antimicrobial and tryponosomicidal activities, is attributable to the presence of a myriad of phytoconstituents, such as flavonoids, tannins, phenolic acids, lignans, arylalkanones, and sitosterol. Hence, such species yield potential leads or molecular scaffolds for the development of new pharmaceutical formulations, encouraging the elucidation of not-yet-understood action mechanisms and ascertaining their safety for humansThis work was supported by Xunta de Galicia (Servizo Galego de Saude, SERGAS), through a research-staff contract (ISCIII/SERGAS) to O.G. and F.L., who are Staff Personnel (I3SNS stable Researcher); by Instituto de Salud Carlos III (ISCIII) and by FEDER through a “Sara Borrell” Researcher contract to V.F. (CD16/00111); and a predoctoral research scholarship to C.R.-F. (Exp.18/00188). M.G.-R. is a recipient of a predoctoral contract funded by Xunta de Galicia (IN606A-2020/010). A.C.-B. is a recipient of a predoctoral contract funded by Secretaría de Estado de Universidades, Investigación, Desarrollo e Innovación, Ministerio de Universidades (FPU2018-04165). G.R.C. is a doctoral student of the Coordination for the Improvement of Higher Education Personnel (CAPES) with a doctoral scholarship (Finance Code 001). T.M.C.P. is a Research Productivity Fellow of the National Council for Scientific and Technological Development (CNPq), Brazil (TMCP 309277/2019-1). O.G. is a member of the RETICS Programme (RD16/0012/0014) (RIER: Red de Investigación en Inflamación y Enfermedades Reumáticas) via ISCIII and FEDER. F.L. is a member of CIBERCV (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares). ISCIII and FEDER also support O.G. and J.P. (PI17/00409 and PI20/00902). This work was supported by the Research Executive Agency of the European Union in the framework of the MSCA-RISE Action of the H2020 Programme (project number, 734899), and Xunta de Galicia, Consellería de Educación, Universidade e Formación Profesional, and Consellería de Economía, Emprego e Industria (GAIN) (GPC IN607B2019/10), supported O.G.S