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  1. Pivotal Role of Liver PPARs Activity Bed-side Evaluation in Monitoring glucidic and lipidic Metabolism.

    Sergio Stagnaro, Biophysical semeiotics Laboratory Research

    2 June 2007

    Sirs,

    in my view, in the primary prevention of all components of metabolic syndrome, and particularly hyperinsulinaemia-insulinresistance, IGT, and type 2 diabetes, first of all, doctors have to recognize on very large scale Pre-Metabolic syndrome, classic and variant, I described earlier (See web site www.semeioticabiofisica.it/microangiologia.it, Pre-Metabolic Syndrome, URL http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%20engl.doc After that, doctors have to monitor at the bed-side pre-metabolic syndrome initial evolution to metabolic syndrome, since the well-known diabetes complications begin notoriously years or decades before diabetes onset. Among a lot of biophysical-semeiotic methods, different in technical difficulty, but similarly reliable and useful, peroxisome proliferator-activated receptors (PPARs) clinical evaluation proved to be really efficacious. Regarding such as assessment, I suggest two methods, based on melatonin and respectively thyroide hormone secretion, which allow doctors to evaluate at the bed-side the activity of these nuclear receptors in individuals involved by Pre-Metabolic Syndrome (1). In a few words, PPARs are members of the nuclear receptor family that regulates the expression of genes that control fatty acid synthesis, storage, catabolism, as well as glucose homeostasis and insulin sensitivity. PPARs, as heterodimers acting with another member of the nuclear receptor family, the retinoid X receptor (RXR-ROR), stimulated also by melatonin (2, 3, 4), hooking onto peroxisome proliferator response elements (PPREs), binding finally the P450 4A1 and 4A6 genes. In addition, recent data suggest that PPAR alpha and gamma activation decreases atherosclerosis progression not only by correcting metabolic disorders, but also through direct effects on the vascular wall (ibidem). PPARs modulate the recruitment of leukocytes to endothelial cells, control the inflammatory response and lipid homeostasis of monocytes/macrophages and regulate inflammatory cytokine production by smooth muscle cells. In conclusion, Biophysical-Semeiotic Evaluating PPARs activity, described for the first time from clinical view-point, represents a paramount event in Preventive Medicine.

    1) Stagnaro Sergio. Bed-Side Biophysical-Semeiotic Evaluation of PPARs Activity.

    http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/PPARs%20BS%20Evaluation%

    2) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

    3) Stagnaro S., Stagnaro-Neri M., La Melatonina nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. Ediz. Travel Factory, Roma, 2004.

    4) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ediz. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

    Competing interests

    None declared

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