Journal of physiology and pharmacology : an official journal of the Polish Physiological Society
-
J. Physiol. Pharmacol. · Apr 2020
ReviewRenin-angiotensin system inhibitors in management of hypertension during the COVID-19 pandemic.
COVID-19, which is caused by the single-stranded RNA severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has introduced significant therapeutic dilemmas in several areas. One of these is concern regarding the use of renin-angiotensin system (RAS) inhibitors. Dysfunction of the RAS has been observed in COVID-19 patients, but whether RAS inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type-1 receptor blockers (ARBs), are associated with improved or worse clinical outcomes, remains unclear. ⋯ While the SARS-CoV-2 viral load remains the highest in upper respiratory tract of COVID-19 patients, it has also been reported in multiple sites in COVID-19, and patients not infrequently require the Intensive Care Units (ICU) admission. However, despite the theoretical concerns of possible increased ACE2 expression by RAS blockade, there is no evidence that RAS inhibitors are harmful during COVID-19 infection, and indeed they have been shown to be beneficial in some animal studies. In this review we summarise the pathophysiology of the interaction between RAS, ACEIs/ARBs inhibitors and COVID-19, and conclude, on the basis of current data, that RAS blockade should be maintained during the current coronavirus pandemic.
-
J. Physiol. Pharmacol. · Aug 2017
ReviewCrataegus special extract WS 1442: up-to-date review of experimental and clinical experiences.
Extracts and tinctures made from Crataegus spp. (Hawthorn) have been used as cardioprotective remedies since ancient times. WS 1442 special extract, manufactured by Dr. W. ⋯ Moreover, WS 1442 also carries proven vasorelaxant activity, via affecting eNOS synthase, and prevents ischemic heart tissue swelling by influence on calcium signaling pathways, and thus detain hyperpermeability of endothelium. Actions of WS 1442 special extract were investigated in in vitro as well as in vivo studies including large clinical trials. In this review authors present current state of knowledge about possible beneficial effects of WS 1442 special extract on cardiovascular system.
-
J. Physiol. Pharmacol. · Dec 2011
ReviewStress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options.
Stress, which is defined as an acute threat to homeostasis, shows both short- and long-term effects on the functions of the gastrointestinal tract. Exposure to stress results in alterations of the brain-gut interactions ("brain-gut axis") ultimately leading to the development of a broad array of gastrointestinal disorders including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other functional gastrointestinal diseases, food antigen-related adverse responses, peptic ulcer and gastroesophageal reflux disease (GERD). The major effects of stress on gut physiology include: 1) alterations in gastrointestinal motility; 2) increase in visceral perception; 3) changes in gastrointestinal secretion; 4) increase in intestinal permeability; 5) negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow; and 6) negative effects on intestinal microbiota. ⋯ Additionally, melatonin an important mediator of brain gut axis has been shown to exhibit important protective effects against stress-induced lesions in the gastrointestinal tract. Finally, probiotics may profoundly affect the brain-gut interactions ("microbiome-gut-brain axis") and attenuate the development of stress-induced disorders in both the upper and lower gastrointestinal tract. Further studies on the brain-gut axis are needed to open new therapeutic avenues in the future.
-
J. Physiol. Pharmacol. · Nov 2009
ReviewStatistical analysis of chronic obstructive pulmonary disease exacerbations in clinical studies: expectations and limitations.
Acute exacerbations of chronic obstructive pulmonary disease (COPD) occur more frequently with increasing COPD severity and are associated with increased morbidity, reduced quality of life, and increased risk of mortality. The prevention and assessment of exacerbations, as a clinically and therapeutically relevant parameter, is a central aspect of clinical COPD studies. The aim of this review is to identify pitfalls in the analysis of the parameter of exacerbation and to describe the criteria that need to be considered in the statistical analysis of exacerbation studies.
-
The outcome of patients with idiopathic pulmonary fibrosis (IPF), which represents the most common type of idiopathic pulmonary pneumonias, is poor. Breathlessness and coughing are usually progressive and about 50% of he patients die within 3 years after diagnosis. The effect of medical treatment in terms of survival is disappointing. ⋯ The therapy of sleep disorders and sleep disordered breathing in IPF is individual. But in the absence of an effective treatment of IPF, optimization of sleep and life quality by the treatment of sleep disorders seems to be a primary goal. Further studies are needed to determine special sleep-related treatment effects.