Inflammatory bowel disease (IBD) comprises ulcerative colitis (UC) and Crohn’s disease (CD). IBD etiopathology is multifactorial and involves alteration of immune cells and chronic activation of the inflammatory cascade against yet unknown environmental factors that trigger the disease. IBD therapy aims at improving the quality of life and reducing the risk of disease-related complications to avoid the need for surgery. There is no specific cure for IBDs, and the focus of therapy is supportive measures and use of anti-inflammatory and immunosuppressive drugs. Glucocorticoids (GCs) are powerful anti-inflammatory and immunomodulatory agents used to treat many acute and chronic inflammatory diseases. GCs remain basic treatment for moderate-to-severe IBD, but their use is limited by several important adverse drug effects. Topical administration of a second-generation of GCs, such as budesonide and beclomethasone dipropionate (BDP), represents a valid alternative to use of older, systemic GCs. Administration of second-generation GCs shows promisingly high topical activity and less systemic toxicity, but maintenance therapy with these new GCs in IBD patients is associated with multiple adverse effects. In this review, we make a comparative analysis of the efficacy of first-generation and second-generation GCs in IBD treatment. Unraveling GC biology at the molecular level to uncouple their clinical benefits from detrimental effects is important. One approach is to consider new GC mediators, such as glucocorticoid-induced leucine zipper, which may have similar anti-inflammatory properties, but avoids the side effects of GCs. This in-depth analysis can help to improve the development and the clinical outcomes of GC therapies in IBD.

Latinx transmasculine men (LTM) can be at a particularly high risk for cervical cancer as they lie at the intersection of two health disparity populations (gender and ethnic minorities). Previous research using self-report measures has documented how negative interactions with providers are a key barrier for cervical cancer screening among LTM. However, no research to date has examined, via direct observation, cervical cancer preventive behaviors in clinical interactions with LTM. Thus, the objective of this study was to examine cervical cancer preventive behaviors in clinical interactions between medical students and an LTM. The team implemented standardized patient simulations (simulations of clinical interactions with actors portraying the role of a patient), self-report measures, and observational techniques. A total of 37 medical students participated in the study. The results were mixed with some key behaviors neglected (i.e., asking if the patient preferred to collect the HPV test sample by himself), while others were enacted (i.e., checking family history of cervical cancer). Further research is needed to better understand behaviors in clinical interactions with LTM as well as how to improve them.

Alzheimer’s disease (AD) is the most frequent cause of dementia worldwide and represents one of the leading factors for severe disability in older persons. Although its etiology is not fully known yet, AD may develop due to multiple factors, including inflammation and oxidative stress, conditions where microRNAs (miRNAs) seem to play a pivotal role as a molecular switch. All these aspects may be modulated by nutritional factors. Among them, vitamin E has been widely studied in AD, given the plausibility of its various biological functions in influencing neurodegeneration. From a cohort of old-aged people, we measured eight vitamin E forms (tocopherols and tocotrienols), thirty cytokines/chemokines, and thirteen exosome-extracted miRNAs in plasma of subjects suffering from subjects affected by AD and age-matched healthy controls (HC). The sample population included 80 subjects (40 AD and 40 HC) with a mean age of 77.6 ± 3.8 years, mostly women (45; 56.2%). Of the vitamin E forms, only α-tocopherol differed between groups, with significantly lower levels in AD. Regarding the examined inflammatory molecules, G-CSF, GM-CSF, INF-α2, IL-3, and IL-8 were significantly higher and IL-17 lower in AD than HC. Among all miRNAs examined, AD showed downregulation of miR-9, miR-21, miR29-b, miR-122, and miR-132 compared to controls. MiR-122 positively and significantly correlated with some inflammatory molecules (GM-CSF, INF-α2, IL-1α, IL-8, and MIP-1β) as well as with α-tocopherol even after correction for age and gender. A final binary logistic regression analysis showed that α-tocopherol serum levels were associated with a higher AD probability and partially mediated by miR-122. Our results suggest an interplay between α-tocopherol, inflammatory molecules, and microRNAs in AD, where miR-122 may be a good candidate as modulating factor.

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Endokrinní nebo také Graves-Basedowova orbitopatie (EO) je závažná, progresivní oční komplikace asociovaná s autoimunitním onemocněním štítné žlázy. Typickými příznaky jsou retrakce horního víčka, periorbitální edém, porucha pohyblivosti očního bulbu, diplopie, zánětlivý otok měkkých tkání orbity vedoucí k protruzi oka a ve vážnějších případech až ztráta zraku v důsledku útlaku zrakového nervu či poškození rohovky. Standardem léčby je kortikoterapie, podání per os je limitováno nežádoucími účinky, proto je upřednostňováno podání v podobě intravenózního pulzu. V roce 2016 bylo vydáno jednotné doporučení European Thyroid Association a European Group on Graves´ Orbithopaty (EUGOGO) pro endokrinní orbitopatii a také doporučení American Thyroid Association pro léčbu hypertyreózy, které zahrnuje léčbu EO. Klíčová slova: endokrinní orbitopatie, kortikoterapie, rituximab, doporučené postupy. Commentary on the new guidelines for endocrine orbitopathy Endocrine or Graves-Basedow Orbitopathy (EO) is a serious, progressive ocular complication associated with autoimmune thyroid disease. Typical symptoms include upper eyelid retraction, periorbital edema, bulb disorder, diplopia, inflammation of the orbital soft tissue leading to the eyeball protrusion and in more serious cases, loss of vision due to optic nerve suppression or corneal damage. The standard of treatment is corticotherapy, the administration of per os is limited by the side effects, therefore intravenous pulses are preferred. In 2016, a single recommendation was issued by the European Thyroid Association and the European Group on Graves Orbithopathies (EUGOGO) for Endocrine Orbitopathy, as well as the recommendations of the American Thyroid Association for the Treatment of Hyperthyroidism, which mentions the treatment of EO.