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The autonomic nervous system in anorexia nervosa — an implication for the fat tissue

Andrzej Boryczko Kamil Skowron Magdalena Kurnik-Łucka Krzysztof Gil
Folia Medica Cracoviensia | 2023 | Vol. 63 | No 3 | 75-90 | DOI: 10.24425/fmc.2023.147215
Keywords anorexia nervosa eating disorders autonomic nervous system heart rate variability adipose tissue
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Abstract

Eating disorders are a heterogeneous group of diseases affecting mainly young people in devel-oped countries. Among them, anorexia nervosa (AN) is the one with the highest mortality, up to five times higher compared to healthy individuals. The etiology of this medical condition is complex and still un-certain. However, disturbances of the autonomic nervous system (ANS) and increased lipolysis resulting in a decrease of the adipose tissue volume are common findings among AN patients. Since ANS is directly connected to adipocyte tissue, thus significantly affecting the body’s metabolic homeostasis, we suspect that this relationship may be a potential pathophysiological underpinning for the development of AN. In this narrative review, we have analyzed scientific reports on ANS activity in AN considering different phases of the disease in humans as well as animal models. Due to the different effects of the disease itself on the ANS as well as specific variations within animal models, the common feature seems to be dysre-gulation of its function without the identification of one universal pattern. Nonetheless, higher norepi-nephrine concentrations have been reported in adipocyte tissue, suggesting local dominance of the sym-pathetic nervous system. Further studies should explore in depth the modulation of sympathetic in adipose tissue factor and help answer key questions that arise during this brief narrative review.
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Authors and Affiliations

Andrzej Boryczko
1 2
Kamil Skowron
1
Magdalena Kurnik-Łucka
1
Krzysztof Gil
1
  1. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  2. Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland

Hypersensitivity to polyethylene glycol (PEG)

Maria Czarnobilska Małgorzata Bulanda Magdalena Kurnik-Łucka Krzysztof Gil
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 4 | 55-69 | DOI: 10.24425/fmc.2021.140004
Keywords polyethylene glycol PEG hypersensitivity to PEG Covid-19 vaccine
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Abstract

The need for mass population vaccination against Covid-19 poses a public health problem. Allergic symptoms occurring after the 1st dose of the vaccine may result in resignation from the admin-istration of the 2nd dose. However, the majority of patients with mild and/or non-immediate symptoms may be safely vaccinated. The only absolute contraindication to administration of the vaccine is an anaphylactic reaction to any of its ingredients. Polyethylene glycol (PEG), widely used as an excipient in various vaccines, is considered the primary cause of allergic reactions associated with administration of Comirnaty (Pfizer/BioNTech) and Covid-19 Vaccine (Moderna) vaccines. However, hypersensitivity to PEG reported to date seems very rare, considering its widespread use in multiple everyday products, including medicines and cosmetics. In the paper, current literature data describing mechanisms of hy-persensitivity reactions to PEG, their clinical symptoms and diagnostic capabilities are presented. Un-doubtedly, the issue of hypersensitivity to PEG warrants further research, while patients with the diagnosis require individual diagnostic and therapeutic approach.
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Authors and Affiliations

Maria Czarnobilska
1
Małgorzata Bulanda
2
Magdalena Kurnik-Łucka
1
Krzysztof Gil
1
  1. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Kraków, Poland

Neglected workforce: pharmacists and their health-related quality of life

Magdalena Kurnik-Łucka Paweł Pasieka Agnieszka Górecka-Mazur Elżbieta Rząsa-Duran Jakub Pękala Krzysztof Gil
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 1 | 19-34 | DOI: 10.24425/fmc.2021.137210
Keywords health-related quality of life pharmacists SF-36 health survey
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Abstract

Background: pharmacists remain on the frontline of public health around the globe and their performance directly impacts patients’ safety. So far, to our knowledge, no European study has been dedicated to their heath-related quality of life (HQoL). Therefore, the primarily aim of our study was to evaluate HQoL of Polish pharmacists utilizing the SF-36 health survey with regard to anthropometric and lifestyle-related variables.
Methods: A total sample screened consisted of 1412 respondents, yet 765 pharmacists (mean age 40, 86.3% females) finally participated in the study. HQoL was assessed with the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).
Results: The lowest median scores were noted for general health (GH, 50.0) and vitality (V, 60.0) domains. No gender differences regarding physical and mental summary scores were found. Significant difference of HQoL was found among the assessed age groups in several domains, especially physical functioning (PF) and GH (p <0.001) scores, and especially in the group of 51–60-year-old-respondents. Correlations were found between PF (r = –0.29, p <0.001), GH (r = –0.25, p <0.001) and age as well PF (r = –0.27, p <0.001), GH (r = –0.21, p <0.001) and BMI. Self-assessed dietary habits were correlated with PF (r = 0.22, p <0.001), mental health (r = 0.25, p <0.001), GH (r = 0.27, p <0.001) and V (r = 0.30, p <0.001) scores.
Conclusions: The analysis indicates that pharmacists tend to have similar mental and physical burden according to SF-36, with age, BMI and dietary habits as predominant factors influencing their HQoL. The study presents unique values for future comparative analyses related, for instance, to the influence of the ongoing pandemic on HQoL of health-care providers.
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Authors and Affiliations

Magdalena Kurnik-Łucka
1
Paweł Pasieka
1
Agnieszka Górecka-Mazur
1
Elżbieta Rząsa-Duran
2
Jakub Pękala
1
Krzysztof Gil
1
  1. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  2. Pharmacists’ Chamber of Lesser Poland, Kraków, Poland

The Inhibitory Effect of Human Plasma Albumin and Haptoglobin on Platelet Aggregation and 5-HT Release

Nadia Khan Magdalena Kurnik-Łucka Gniewomir Latacz Krzysztof Gil Sheikh Arshad Saeed
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 3 | 5-16 | DOI: 10.24425/fmc.2022.142365
Keywords human plasma endogenous inhibitor of platelet aggregation (EIPA) arachidonic acid metabolism affinity chromatography albumin haptoglobin
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Abstract

Platelet aggregation contributes to the pathogenesis of cardiovascular diseases. After activation it leads to dense granule secretion and 5-HT release. The question arises; how platelet aggregation is endogenously controlled during blood circulation. In preliminary studies, we observed that human plate-lets aggregate more rapidly when suspended in buffer as compared to those suspended in plasma (PRP). These observations point to the presence of an endogenous substance that may inhibit arachidonic acid– induced platelet aggregation. An analysis of plasma Cohn fractions demonstrated that most of the plasma inhibitory activity was associated with albumin–rich and α-globulin rich protein fractions. The identity of plasma endogenous inhibitors of platelet aggregation (EIPA) was established by affinity chromatography on Cibacron Blue F3G-A for specific removal of albumin. The association of α-globulins to EIPA activity was recognized as due to haptoglobin by affinity chromatography on a column of hemoglobin-sepharose. In addition, we also found that the distribution of EIPA activity varies according to sex and physiological state. These findings reveal that EIPA may act by modulation of arachidonic acid metabolism or seques-tering the fatty acid substrate.
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Authors and Affiliations

Nadia Khan
1 2 3
Magdalena Kurnik-Łucka
2
Gniewomir Latacz
3
Krzysztof Gil
2
Sheikh Arshad Saeed
1
  1. Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), University of Karachi, Karachi, Pakistan
  2. Department of Pathophysiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Technology & Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland

Retrospective analysis of a case report of a left ovarian ectopic pregnancy after the former tubal

Anna Wrona Veronika Aleksandrovych Anna Gil Magdalena Kurnik-Łucka Jerzy A. Walocha Krzysztof Gil
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 4 | 121-135 | DOI: 10.24425/fmc.2022.142372
Keywords ectopic pregnancy ovary telocytes oviduct ovarian pregnancy
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Abstract

Up to 2% of pregnancies may be extrauterine. Despite reproductive problems, they might increase the risk of serious complications. We present a case report of a 31-year-old woman with two extrauterine pregnancies — tubal and ovarian, which occurred at the same side with little time difference. In addition, we aimed to examine possible reasons underlying this rare pathology. Thus, surgically removed tissue specimens were morphologically assessed and further compared with specimens from healthy control patients. Telocytes were analysed in detail due to their pivotal role in the female repro-ductive system. Our study had observational character and obvious limitations typical for a clinical case. Yet, such a clinical case of two ectopic pregnancies has not been previously reported in the literature.
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Authors and Affiliations

Anna Wrona
1
Veronika Aleksandrovych
2
Anna Gil
3
Magdalena Kurnik-Łucka
2
Jerzy A. Walocha
3
Krzysztof Gil
2
  1. Gynecology and Obstetrics Ward with Gynecologic Oncology Subdivision, J. Śniadecki’s Specialistic Hospital, Nowy Sącz, Poland
  2. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland

Aberrations in the female reproductive organs and a role of telocytes in a rat model of anorexia nervosa

Kamil Skowron Veronika Aleksandrovych Magdalena Kurnik-Łucka Paulina Stach Agnieszka Baranowska Beata Skowron Krzysztof Gil
Folia Medica Cracoviensia | 2018 | vol. 58 | No 3 | 115-125 | DOI: 10.24425/fmc.2018.125077
Keywords anorexia nervosa rat uterus ovaries telocytes
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Abstract

Background: Anorexia nervosa is a widely prevalent eating disorder that often leads to life-threatening complications. Since it mostly concerns females, many authors have focused on studying the reproductive system in anorexic women. Recently discovered telocytes may give a new insight into the pathophysiology of gynecological complications in these patients.

Material and Methods: We adopted an animal model of anorexia nervosa induced by voluntary physical activity. Sixteen female Wistar rats were divided into two groups: control and activity-based anorexia. When the weight loss of activity-based anorexia (ABA) rats reached 25% animals were euthanized. Size and weight measurements as well as histopathological analysis of the reproductive organs were performed. Additionally, we used immunohistochemical staining for detection of telocytes.

Results: Telocytes were identified in uteri of anorectic rats but no diff erences were observed when compared to the control group. Nevertheless, in the ABA group the weight of the uteri and the number of follicles in the ovaries decreased significantly.

Conclusions: Our rat model of anorexia nervosa mimics the effects of this eating disorder that occur in the female reproductive system since we reported ovarian dysfunction and uterine involution in the experimental animals. It supports its potential role in the further studies of anorexia pathophysiology and treatment possibilities.

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Authors and Affiliations

Kamil Skowron
Veronika Aleksandrovych
Magdalena Kurnik-Łucka
Paulina Stach
Agnieszka Baranowska
Beata Skowron
Krzysztof Gil

Expanded insights into the neural component of the activity-based anorexia animal model — morphological changes in the enteric nervous system and altered pain perception

Kamil Skowron Paulina Stach Magdalena Kurnik-Łucka Katarzyna Chwaleba Mateusz Giełczyński Wiktoria Suchy Veronika Aleksandrovych Michał Jurczyk Beata Kuśnierz-Cabala Krzysztof Gil
Folia Medica Cracoviensia | 2023 | Vol. 63 | No 1 | 53-78 | DOI: 10.24425/fmc.2023.145430
Keywords anorexia nervosa eating disorders activity-based anorexia animal model enteric nervous system gut-brain axis pain perception pain sensitivity
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Abstract

Anorexia nervosa (AN) is an eating disorder characterized by distinct etiopathogenetic concepts that are gradually being linked together to unravel the dominant pathophysiological pathways underlying the disease. Excessive food restrictions, often accompanied by over-exercise and undertaken to lose weight, lead to the development of numerous complications. The biological concept of neurohormonal dysfunc-tion in AN seems incomplete without demonstrating or excluding the role of the enteric nervous system (ENS). Using an animal model of activity-based anorexia (ABA), we conducted the preliminary assess-ment of the ENS structure. Here we show, in preparations stained by immunohistochemistry with anti- ChAT, anti-NOS, anti-PGP 9.5, anti-c-fos, and anti-TH antibodies, a lower density of cholinergic and nitrergic nerve fibers as well as reduced neuronal activity in myenteric plexus. Such structural and functional damage to the ENS may be responsible for a number of gastrointestinal symptoms that worsen the course of the disease. In addition, we expanded the study to address the unresolved issue of mechanical and thermal pain sensitivity in AN. The Von Frey and hot plate tests revealed, that in ABA animals, the pain threshold for mechanical stimulus decreases while for thermal increases. In this way, we have sig-nificantly supplemented the background of AN with potentially observable nervous system changes which may influence the evolution of the therapeutic approach in the future.
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Authors and Affiliations

Kamil Skowron
1
Paulina Stach
1
Magdalena Kurnik-Łucka
1
Katarzyna Chwaleba
1
Mateusz Giełczyński
1
Wiktoria Suchy
1
Veronika Aleksandrovych
1
Michał Jurczyk
1
Beata Kuśnierz-Cabala
2
Krzysztof Gil
1
  1. Department of Pathophysiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  2. Chair of Clinical Biochemistry, Department of Diagnostics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

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