Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets - Immune, Endocrine & Metabolic Disorders) - Volume 15, Issue 1, 2015

This editorial overview is aimed at reviewing all the work published by the Journal Endocrine Metabolic Immune Disorders-Drug Targets over the period 2012-2014. The main body of publications has been divided either into a section based on special issues and meeting proceedings or various specific sections according to different types of pathologies related to the field of endocrine metabolic immune disorder-drug targeting.

Non-communicable diseases (NCDs) also known as chronic diseases last for a long time and progress generally slow. Major non-communicable diseases are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. Unhealthy lifestyles and food behaviours play an important role for determining such diseases. The change in unhealthy behaviours or the maintenance of healthy lifestyles has enormous value in the reduction of diseases and longer life expectancy not only on an individual level but for the community as a whole. Recent meta-analyses reported Mediterranean diet to be an optimal diet when adopted as a whole, in order to preserve and maintain a good health status. A greater adherence score to the Mediterranean diet (2-point increase) was related to induce an 8% reduction in overall mortality, a 10% reduced risk of CVD and a 4% reduction in neoplastic diseases. However, there is no direct method in quantifying and evaluating adherence, therefore a large number of indirect indices in several studies have been proposed, with a last unifying score. Recently more and more e-health techniques such as web communication or desktop publishing (DVDs and so on) are being used, obtaining good results in the Mediterranean diet adherence. For successfully changing the unhealthy lifestyles and food behaviours of the population, interventions at all levels are needed with the cooperation of Institutions, mass media, agricultural and food industry and healthcare professionals guided by expert scientific societies.

Low-grade chronic inflammation is an underlying pathophysiological mechanism linking risk factors and/or metabolic disorders to increased risk of chronic degenerative disease. A meat-based pattern, as the Western type diet, is positively linked to higher levels of some important biomarkers of inflammation, such as C-reactive protein (CRP), interleukin-6 and fibrinogen. Conversely, a Mediterranean-like eating behavior is associated with lower degree of these biomarkers thus suggesting an anti-inflammatory action of its main food components. This chapter goes through the most important investigations addressing the relationship between dietary habits and subclinical inflammation. Attention was focussed on the findings from the Moli-sani study: this is a large prospective cohort study that recruited 24,325 men and women from the general population of the Molise Region, a Southern Italian area, with the aim of investigating genetic and environmental risk/protection factors for cardiovascular and tumor disease. For the first time, the Moli-sani study carefully investigated the Mediterranean diet as an environmental determinant of both platelet and white blood cell counts, starting from the hypothesis that a diet rich in healthy compounds could favorably influence the production and/or the clearance of these two cellular biomarkers of lowgrade inflammation. Additionally, evidence from this large Italian cohort showed that a Mediterranean-like diet was closely associated with relatively lower values of glucose, lipids, CRP, blood pressure and 10-year cardiovascular risk, while the consumption of healthy foods with high rather than low content in antioxidant vitamins and phytochemicals was associated with lower blood pressure and CRP plasma levels at least in men.

The host immune system is regulated not only by endogenous factors, such as cytokines and chemokines, but also by exogenous factors, such as commensal bacteria and dietary materials. Vitamins are vital nutrients that are mainly derived from the diet and commensal bacteria. Accumulating evidence has revealed specific functions of vitamins in the control of host immunity. In agreement with their vital roles in the appropriate maintenance of immunity, excessive or insufficient intake of vitamins leads to the development of immune diseases or susceptibility to infection. In this review, we focus on the diverse but specific immunologic functions of vitamins in regulating host immune responses and their association with immune and infectious diseases.

Stress proteins or heat shock proteins (HSPs) have a critical role in gut health and immune regulation. They have a functional significance as molecular chaperones for cell skeleton proteins and intercellular tight junction proteins. Herewith HSPs ensure gut epithelium integrity and effective intestinal barrier function. In addition, stress protein molecules such as HSP70 are a target for anti-inflammatory regulatory T cells (Tregs). Inflamed sites in the body feature inflammatory-stress induced enhanced levels of HSPs, which enable the immune system to target Tregs selectively to sites of inflammation. We have shown in experimental models of inflammatory diseases that both microbial HSP and endogenous (self) HSP molecules are capable of inducing the expansion of disease suppressive Tregs. Since the gut associated lymphoid tissue (GALT) is well poised towards the induction of regulation and tolerance, we set out to promote HSP expression and induction of Tregs in the gut lymphoid tissues by the oral administration of HSP co-inducing compounds. For the identification, selection and characterization of such compounds we have developed assay systems, such as reporter cell-lines, HSP specific T cell hybridomas and a transgenic mouse model (expression a HSP specific T cell receptor). The introduction of HSP coinducers into the diet constitutes a novel food based preventive or possibly even therapeutic approach in inflammatory diseases.

There are numerous reports that show the benefits on the health attributed to the probiotic consumptions. Most of the studies were performed using animal models and only some of them were validated in controlled human trials. The present review is divided in two sections. In the first section we describe how the probiotic microorganisms can interact with the intestinal epithelial cells that are the first line of cell in the mucosal site, focusing in the studies of two probiotic strains: Lactobacillus casei DN-114001 (actually Lactobacillus paracasei CNCMI-1518) and Lactobacillus casei CRL 431. Then we describe same beneficial effects attributed to probiotic administration and the administration of fermented milks containing these microorganisms or potential probiotic yoghurt, principally on the immune system and on the intestinal barrier in different experimental mouse models like enteropathogenic infection, malnutrition, cancer and intestinal inflammation.

The consumption of unbalanced meals, consisting of foods rich in lipids and/or carbohydrates and calories, has been associated to a postprandial metabolic stress that involves the increase of the production of free radicals and proinflammatory markers. Growing evidence suggest that dietary polyphenols contained in fruit-derived products, such as fruit juices, are involved in the role played by plant foods in disease prevention. Their association to a calorie-dense meal may help to attenuate the onset of postprandial metabolic and inflammatory stress. The available evidence in the literature investigating the effects of polyphenols rich fruit juices on the modulation of postprandial-induced metabolic stress in humans will be presented and discussed.

The present review evaluates the relationship between type 2 diabetes mellitus and individual or combined vitamins. Antioxidant vitamins A, C and E are found decreased in diabetic subjects, possibly due to an increased need to control the excessive oxidative stress produced by abnormalities in glucose metabolism. On the other hand, retinol binding protein exerts a modulating effect, as it has adipokine functions. With respect to the B group vitamins, thiamin, pyridoxine and biotin have been found decreased but the mechanisms are not clear, however supplementation has shown some improvement of the metabolic control in diabetic patients. The absorption of folic acid and vitamin B12 is importantly decreased by the prolongued use of metformin, which is the first choice drug in uncomplicated diabetes, thus these two nutrients have been found deficient in the disease and most probably need to be supplemented regularly. On the other hand, vitamin D is considered a risk factor for the development of diabetes as well as its complications, particularly cardiovascular ones. Although some studies have found an association of vitamin K intake with glucose metabolism further research is needed. Studies on the use of multivitamin supplements have shown unconclusive results. After reviewing the evidence, no real recommendation on the use of vitamin supplements in type 2 diabetes mellitus can be issued, however patients using metformin during prolongued periods may need folic acid and vitamin B12.

Objective: The present study was planned to focus on comparative effects of telmisartan vs lisinopril on blood pressure in patients of metabolic syndrome Methods: The study was carried out on 62 patients of metabolic syndrome from Dec 2010 to Oct 2012 in OPD of Institute. There were two groups, A and B. Group A- Telmisartan (31 patients) and Group B- Lisinopril (31 patients) receiving Telmisartan 40 mg and lisinopril 5 mg orally once a day respectively for 12 weeks. The diagnosis of essential hypertension was made by the physician based on two measurements of blood pressure on two different occasions using auscultatory method and was done at initial stage and repeated after 6 weeks and 12 weeks of treatment in Group A and Group B patients. Key findings: Our study found that telmisartan or lisinopril treatment for 12 weeks leads to statistically significant (p<0.001) reduction in both SBP and DBP at 6 and 12 weeks when compared with baseline, whereas comparison between telmisartan and lisinopril treatment failed to show any statistically significant effect. Conclusion: Treatment of metabolic patients with telmisartan or lisinopril for the management of hypertension reduced both Systolic blood pressure (SBP) as well as Diastolic blood pressure (DBP) statistically significantly during 12 weeks treatment. However, telmisartan and lisinopril treatment were found effective.

Dietary isoflavones are considered to be cardioprotective because of their structural similarity to estrogen. Equol is a metabolite of daidzein that is more potent than daidzein itself. The effect of equol on endothelial function and oxidative stress remains unclear. The objective of this study was to determine the effect of 100 mg/day soy isoflavone supplementation on the following markers: vascular cell adhesion molecule-1 (VCAM-1) and nitric oxide (NO) as markers of vascular endothelial function, and malonyldialdehyde (MDA) as oxidative stress marker in equol-producing postmenopausal women. A stratified randomized double blind controlled trial was conducted among 190 postmenopausal Indonesian women aged 47 to 60 years. They were stratified into equol producers and equol nonproducers. The random allocation of intervention was carried out separately in each stratum. The intervention group received tablets consisting of 100 mg soy isoflavones and calcium carbonate 500 mg, and the control group received 500 mg calcium carbonate. The concentrations of VCAM-1, NO and MDA were measured at baseline and post-supplementation at 6 months. After 6 months of supplementation the MDA concentrations were significantly lower in the soy-isoflavone equol producers compared with equol nonproducers (p=0.021). Similar results were also found for VCAM-1 and NO concentrations, but these were statistically not significant (p = 0.413 and p= 0.724, respectively). This study demonstrates that isoflavone supplementation in postmenopausal women with equol-producer status had a more beneficial effect by decreasing the MDA concentration, but did not improve VCAM-1 and NO concentrations.