No abstract

Syzygium cumini is used worldwide for the treatment of metabolic syndrome-associated outcomes. Previously, we described the antihypertriglyceridemic effect of the hydroethanolic extract of S. cumini leaf (HESc) in monosodium L-glutamate- (MSG-) induced obese rats. This study sought to investigate the molecular mechanisms underlying the antihypertriglyceridemic effect of HESc in MSG-obese rats. Newborn male Wistar rats were injected subcutaneously with MSG (4.0 g/kg/day, obese group) or saline 1.25% (1.0 mL/kg/day, lean group), from 2nd through 10th postnatal day. At 8 weeks old, obese rats started to be orally treated with HESc (0.5 or 1.0 g/kg/day, n=7) or saline 0.9% (1 mL/kg/day, n=7). Lean rats received saline solution (1 mL/kg/day, n=7). Upon 8-week treatment, animals were euthanized for blood and tissue collection. Another set of adult nonobese Wistar rats was used for the assessment of HESc acute effects on Triton WR1339-induced hypertriglyceridemia. HESc reduced weight gain, as well as adipose tissue fat pads, without altering food intake of obese rats. HESc restored fasting serum glucose, triglycerides, total cholesterol, and free fatty acids, as well as insulin sensitivity, to levels similar to lean rats. Additionally, HESc halved the triglyceride content into very low-density lipoprotein particles, as well as healed liver steatosis, in obese rats. Hepatic protein expression of the endoplasmic reticulum chaperone GRP94 was decreased by HESc, which also downregulated the hepatic triglyceride secretion pathway by reducing the splicing of X-box binding protein 1 (XBP-1s), as well as protein disulfide isomerase (PDI) and microsomal triglyceride transfer protein (MTP) translational levels. This action was further corroborated by the acute inhibitory effect of HESc on triglyceride accumulation on Triton WR1339-treated rats. Our data support the downregulation of the XBP-1s/PDI/MTP axis in the liver of MSG-obese rats as a novel feasible mechanism for the antihypertriglyceridemic effect promoted by the polyphenolic phytocomplex present in S. cumini leaf.

Objetivo: relatar a experiência da implantação e processo de trabalho no programa Força Estadual de Saúde do Maranhão. Método: relato de experiência dos profissionais integrantes da equipe da Força Estadual de Saúde do Maranhão em um dos municípios de menor índice de desenvolvimento humano do estado. Resultados: o programa é formado por equipes de caráter interdisciplinar, pautando o processo de trabalho na assistência à saúde e no apoio institucional à gestão municipal para reverter indicadores de saúde como morbimortalidade infantil e materna, taxas de internação por complicações de doenças crônicas e controle de endemias negligenciadas. O apoio institucional foi fundamentado na metodologia Paideia, método reverso da procura de casos e com implementação da Planificação da Atenção à Saúde. Conclusão: o programa possui papel inovador no fortalecimento da atenção primária em saúde, com modelo de cuidado integral ao indivíduo e promovendo articulação com diversos atores envolvidos na organização e processo de trabalho em saúde.Palavras-chave: Atenção Primária à Saúde. Fortalecimento Institucional. Sistema Único de Saúde.