The thyroid gland plays a major role in the human body; it produces the hormones necessary for appropriate energy levels and an active life. These hormones have a critical impact on early brain development and somatic growth. At the same time, the thyroid is highly vulnerable to autoimmune thyroid diseases (AITDs). They arise due to the complex interplay of genetic, environmental, and endogenous factors, and the specific combination is required to initiate thyroid autoimmunity. When the thyroid cell becomes the target of autoimmunity, it interacts with the immune system and appears to affect disease progression. It can produce different growth factors, adhesion molecules, and a large array of cytokines. Preventable environmental factors, including high iodine intake, selenium deficiency, and pollutants such as tobacco smoke, as well as infectious diseases and certain drugs, have been implicated in the development of AITDs in genetically predisposed individuals. The susceptibility of the thyroid to AITDs may come from the complexity of hormonal synthesis, peculiar oligoelement requirements, and specific capabilities of the thyroid cell’s defense system. An improved understanding of this interplay could yield novel treatment pathways, some of which might be as simple as identifying the need to avoid smoking or to control the intake of some nutrients.

In order to better understand the global approach and country differences in physicians’ usage, knowledge, and attitudes towards natural remedies and homeopathy in pediatric practice, an online survey involving 582 general pediatricians and general practitioners treating pediatric diseases was conducted in 6 countries. Overall, 17% of the pediatric prescriptions refer to phytotherapy and 15% refer to homeopathic preparations. Natural remedies and homeopathic preparations are more frequently used in upper respiratory tract infections, infant colic, sleep disturbances, and recurrent infections. In the majority of cases, they are used together with chemical drugs. Both treatment options are typically used if parents are concerned about side effects of conventional drugs or prefer natural remedies for themselves. Physicians express high interest in natural remedies and homeopathy; however, their knowledge is variable. Lack of proven efficacy, knowledge on mechanism of action, and information on indications are main factors that limit their usage.

The territory of Bulgaria covers part of the active continental margin of the Eurasian plate. Several first-order tectonic units may be distmguished: Moesian platform, paraautochthonous margin of the platform, zone of Mid-Mesozoic collage units, Late Cretaceous island-arc system and a system of Cenozoic collisional and post-collisional grabens. The Alpine magmatism is genetically related to the evolution of the Eurasian margin and the Tethyan ocean south of it. The earliest Alpine magmatic activity is represented by Triassic, basic and intermediate, strongly altered volcanics (NW Bulgaria, in boreholes). They are related to initial, embryonal rifting of the Moesian platform. The Triassic and Jurassic-Lower Cretaceous small bodies of basic volcamcs in the SE collage units are interpreted as ensimatic. During the Upper Cretaceous an ensialic island-arc system originated. The related intensive magmatism formed the Srednogoric volcano-intrusive zone (SVIZ). The magmatic rocks are products of complex differentiation processes. Their formation was accompanied by deep-water sedimentation. All magmatic groups, according to SiO2 content, occur. By the K2O/SiO2 ratio they belong to the TH, CA, HKCA, SH, HKTR (high-K transitional) and BG (bulgaritic) series. Longitudinal and transversal zonahties may be traced. In a global aspect SVIZ is one of the most ancient segments of the Alpine-Himalayan volcano-intrusive belt. The bulgaritic petrochemical trend is related to the earliest generation of K-cnriched magmas in the Mediterranean region. The products of the collisional magmatism are exposed in the Macedonian-Rhodope-North Aegean volcanic zone (MRNAVZ) located south of the Late Cretaceous island arc. It originated during the Eocene-Oligocene (37-25 Ma) as a result of the collision between Eurasia and the Apulian promontory of Africa. The magmatic rocks belong dominantly to the intermediate and acid groups and to the CA, HKCA and SH series. The distribution of intermediate and acid rocks in this zone is controlled by the thickness of the crust. In the Eastern and Central Rhodopes the K-content increases from south to north. The volcanic activity in the zone occurred in conditions of intensive block orogeny and was accompanied by terrigenous molasse sedimentation. During the Neogene a zone of transversal faulting developed in the collisional orogen (remainding of Himalayan-type orogen) and parts of the Moesian platform. This zone is marked by small bodies of basic and ultrabasic, Na-alkalinc and subalkalinc rocks. The K-content increases in southward direction, toward the collisional front.

The immune response can be triggered by molecules derived from microorganisms (PAMP) or from molecules derived from damaged or dead host cells, known as the damage-associated molecular-pattern molecules (DAMP). Their immune effects are accompanied by altered redox environment. The level of stable end products of nitric oxide (NO)- plasma nitrate and nitrite (NOx), carbonyl groups (PCO) and nitrotyrosine (NTY), in relation to the metabolism of dsRNAs (poly I:C and poly A:U) and xanthine oxidase (XO activity), in plasma of type2 diabetic patients was determined. Thirty-six patients with type 2 diabetes (age group 34-66 years, 19 male and 17 female) were allocated to the study. Diabetic patients had a significantly higher level of plasma NOx products, NTY and PCO, fructosamine (FA) and XO activity indicating about altered redox environment. The concentration of circulating ribonucleic acids (CNAs) was significantly higher in type 2 diabetic patients, which was accompanied by a significantly decreased activity of RNase against double stranded RNA forms (poly I:C and poly A:U), compared to control samples. To determine whether CNAs, as possible DAMP molecules, are capable of exerting effect on inflammatory and host antiviral response, the effect of isolated CNAs on NF-kappaB, Bcl-2, Bax, MDA-5 and IRF-3 regulation was evaluated in culture of fresh isolated thymocytes. Circulating nucleic acids isolated from type 2 diabetic patients were able to upregulate NF-kappaB more than control RNA samples. In the same experimental conditions the mild Bcl-2 upregulation, followed by the marked Bax upregulation, was demonstrated. Since the Bcl-2/Bax ratio was lower in type 2 diabetic samples, obtained results may implicate that CNAs may exert proapoptotic response in type 2 diabetes. The CNAs isolated from diabetic patients were able to downregulate MDA-5 and IRF-3, very important subjects of the surveillance and cellular anti-viral response. The major findings of the present study are that impaired dsRNA metabolism may lead to increased level of different sized RNAs in type 2 diabetic patients. Acting as possible DAMP molecules, they may contribute to higher susceptibility of immune cells to inflammatory cascade via NF-kappaB activation, and possible MDA-5/IRF-3 axis downregulation, what may have an influence on further ineffective response against different pathogens.

Adipose tissue is not only the main organ for energy storage, but it also has endocrine properties, producing “adipokines” responsible for energy homeostasis, insulin sensitivity, and inflammation. Leptin, produced by adipocytes, is the key hormone in appetite regulation and suppression of orexigenic, hypothalamic neuropeptide Y (NPY). We wanted to establish and compare levels of leptin and NPY in different obesity types in childhood, and to investigate their correlations with auxological parameters. Twenty-one obese children (seven girls and 14 boys), divided into two groups, were compared with 14 controls. The mean age of the study group was 10.81 ± 3.69 years and the mean puberty stage was 2.21. The mean body mass index (BMI) was 32.80 kg/m (range 23.30– 47.02) and the mean overweight 30.73 kg (range 8.00–74.00). The mean leptin level was higher in boys and in the group with central obesity, but was not significant. Leptin/NPY ratio and leptin/BMI ratio was also higher in the central obesity group and there was a more significant difference compared with controls. We found significant correlation of the leptin level with body mass (BM), body mass excess (BME), and BMI (p < 0.05). The mean leptin level in obese children was very high (36.39 ng/ml). Leptin and NPY levels showed inverse values in two different obesity types. Results are suggestive for leptin resistance rather than leptin deficiency in our group of obese children. Orexitropic signaling proteins correlated significantly with auxological parameters. Determination of the leptin and NPY concentrations provided evidence that obesity represents disease with neuroendocrine dysfunction and high leptin/NPY ratio, which could be a useful marker for central obesity.