Analysis Of Scientific Reports Research Articles

Proteolysis and deficiency of α1-proteinase inhibitor in SARS-CoV-2 infection

The SARS-CoV-2 pandemia had stimulated the numerous publications emergence on the α1-proteinase inhibitor (α1-PI, α1-antitrypsin), primarily when it was found that high mortality in some regions corresponded to the regions with deficient α1-PI alleles. By analogy with the last century's data, when the root cause of the α1-antitrypsin, genetic deficiency leading to the elastase activation in pulmonary emphysema, was proven. It is evident that proteolysis hyperactivation in COVID-19 may be associated with α1-PI impaired functions. The purpose of this review is to systematize scientific data, critical directions for translational studies on the role of α1-PI in SARS-CoV-2-induced proteolysis hyperactivation as a diagnostic marker and a target in therapy. This review describes the proteinase-dependent stages of a viral infection: the reception and virus penetration into the cell, the plasma aldosterone-angiotensin-renin, kinins, blood clotting systems imbalance. The ACE2, TMPRSS, ADAM17, furin, cathepsins, trypsin- and elastase-like serine proteinases role in the virus tropism, proteolytic cascades activation in blood, and the COVID-19-dependent complications is presented. The analysis of scientific reports on the α1-PI implementation in the SARS-CoV-2-induced inflammation, the links with the infection severity, and comorbidities were carried out. Particular attention is paid to the acquired α1-PI deficiency in assessing the patients with the proteolysis overactivation and chronic non-inflammatory diseases that are accompanied by the risk factors for the comorbidities progression, and the long-term consequences of COVID-19 initiation. Analyzed data on the search and proteases inhibitory drugs usage in the bronchopulmonary cardiovascular pathologies therapy are essential. It becomes evident the antiviral, anti-inflammatory, anticoagulant, anti-apoptotic effect of α1-PI. The prominent data and prospects for its application as a targeted drug in the SARS-CoV-2 acquired pneumonia and related disorders are presented.

Evaluating the mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies

Spine joint manipulation is a form of treatment for spinal pain with various etiologies. The most common form of these maneuvers is: HVLA – (High Velocity Low Amplitude); (ICD-9 No. 93.62) which is widely used in everyday clinical practice. HVLA utilizes a mechanical manipulative stimulus characterized by high speed, short duration and low amplitude of displacement of joint surfaces with respect to each other. Despite the long history of use, the mechanisms of their biological impact are still insufficiently explained. In the review, the hypotheses concerning the therapeutic mechanism of HVLA impact were verified based on the analysis of scientific reports available in PubMed database. Reports have been discussed presenting theoretical mechanisms of influence of HVLA techniques and experimental work taking up the issues of manipulation carried out on animal material. The following keywords were used for search: HVLA, spine manipulation, experimental studies, osteopathic treatment. Particular attention was focused on the research examining basic biological mechanisms being the basis for explaining the observed clinical effects. The analysis of scientific reports in recent years has shown that there is no direct evidence pointing to the need for obtaining the phenomenon of cavitation during HVLA procedures. Moreover, studies on an animal model prove that HVLA are safe and non-invasive procedures from the point of view of biomechanics. They inhibit the development of hyperalgesia and allodynia as confirmed by immunohistochemical studies. Previous experimental studies have shown clearly that more than one biological mechanism is responsible for the obtained effects of HVLA therapy, and the patients' reactions to therapy are complex and individually variable.

Medical Students Can Help Avoid the Expert Bias in Medicine

Background: Applying the principles of Evidence Based Health Care (EBHC) in an academic environment we became aware of important differences between medical students and the users of clinical research. The latter may be clinicians, educators, guideline developers, or industry managers. These users are adapted to the system and have some kind of conflict of interest: they are either biased by patients’ demands, by main stream thinking, by medical standards and/or by economic interests. All are under time pressure, want to avoid conflicts with their employer and the analysis of scientific reports may not really be their main focus. Medical students were not exposed to these confounders. Methods: Medical students under professional supervision completed critical assessments of more than 100 published studies. Their analyses were limited to identification of mistakes, bias and errors using a check list of potential weaknesses in design and conduct but included the feedback to the academic supervisors. Results: Medical students trained in Evidence Based Medicine are capable of identifying problems in clinical trials by the systematic application of an assessment checklist. Conclusion: In our approach we demonstrate that students can assist health care professionals and academic teachers with the assessment of clinical evidence. The premise of the approach is that the final appraisals, which involve consideration of clinical, practical and value issues, necessarily reside with the academic teachers, writers of guidelines or industry managers who constitute the active users of research.