Mikołaj Asztabski

Inflammatory bowel disease (IBD) — ulcerative colitis (UC) and Crohn's disease (CD) — comprises chronic, immune-mediated disorders of the gastrointestinal tract whose pathophysiological impact extends beyond the intestinal mucosa. A growing body of epidemiological evidence, including large-scale meta-analyses, indicates that patients with IBD carry an elevated risk of cardiovascular events, including coronary artery disease, stroke, heart failure (HF), venous thromboembolism (VTE), and atrial fibrillation (AF), despite a relatively lower prevalence of classical atherosclerotic risk factors in this population. This risk is particularly pronounced during periods of active, uncontrolled intestinal inflammation and in younger patients, in whom the contribution of the inflammatory process to overall cardiovascular risk is proportionally greatest. This review summarizes current evidence on the epidemiology of this association and the pathophysiological mechanisms linking chronic intestinal inflammation to vascular injury, including endothelial dysfunction, a prothrombotic state, gut microbiota dysbiosis and its metabolites — notably trimethylamine N-oxide (TMAO) — and inflammatory biomarkers. The differential impact of IBD pharmacotherapy on cardiovascular risk is also addressed, with particular emphasis on Janus kinase (JAK) inhibitors, associated with an elevated risk of thromboembolic complications, in contrast to biologic agents, which in several observational studies have demonstrated a potentially cardioprotective effect. The risk profile of TNF-α inhibitors in patients with coexisting heart failure is discussed separately. Finally, recommendations for cardiovascular risk stratification and prophylaxis in this population are presented, incorporating recent dedicated expert position statements from scientific societies, alongside directions for future investigation. Methods and Materials A systematic review of the scientific literature concerning the risk of cardiovascular events in patients with a diagnosed inflammatory bowel disease was conducted. Randomized controlled trials, meta-analyses, and [observational] studies were analyzed… Conclusions Particular attention should be paid to the assessment of cardiovascular event risk in patients with inflammatory bowel disease, especially in those who have had the disease for many years. Patients with inflammatory bowel disease [have an] increased risk of cardiovascular events, which is primarily attributable to chronic inflammation acting on the vascular wall through endothelial dysfunction, activation of coagulation, and disturbances of the gut microbiota, with the risk correlating more strongly with disease activity than with the diagnosis itself.

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder marked by memory impairment, cognitive deterioration, and neurobiological changes, notably the accumulation of amyloid-beta (Aβ) and tau pathology. Recent data suggests that consistent physical activity (PA) may delay the onset and progression of Alzheimer's disease (AD) through various neuroprotective mechanisms. This research synthesizes results from 31 contemporary investigations encompassing both human and animal subjects. The focus is on the impact of physical activity on brain-derived neurotrophic factor (BDNF) expression, cerebral blood flow, inflammation reduction, and proteinopathy management. Brain-Derived Neurotrophic Factor (BDNF) is crucial for maintaining synaptic plasticity and promoting neurogenesis in the hippocampus, both of which are significantly compromised in Alzheimer's Disease (AD). PA-induced elevations in BDNF enhance cognitive resilience and neuronal integrity. Furthermore, exercise has been shown to enhance cerebral perfusion, so improving the delivery of oxygen and nutrients while promoting the disposal of waste, including glymphatic flow. The anti-inflammatory effects of PA entail the downregulation of pro-inflammatory cytokines (e.g., IL-6, TNF-α) and the upregulation of anti-inflammatory mediators, which alleviate chronic neuroinflammation commonly seen in Alzheimer's disease. Furthermore, PA appears to reduce oxidative stress by enhancing innate antioxidant systems, including superoxide dismutase and glutathione peroxidase. PA may significantly affect essential pathophysiological features of AD, such as amyloid-beta buildup and tau hyperphosphorylation, by promoting proteostasis and stimulating autophagy. Research from both preclinical and clinical studies repeatedly reveals associations between regular physical activity and improved cognitive function, augmented brain structural integrity, and less neurodegeneration. The data indicate that physical activity serves as a cost-effective, accessible, and non-pharmacological intervention with significant neuroprotective potential to reduce the risk of Alzheimer's disease and delay its development.

Introduction: The human skin microbiome is essential for maintaining skin homeostasis, modulating the immune response, and protecting against external threats. In recent years, researchers have increasingly focused on prebiotics and postbiotics bioactive chemicals that promote the proliferation of beneficial microorganisms or are produced by them as potential regulators of skin health. Although probiotics have attracted considerable interest as therapeutic agents, recent attention has focused on prebiotics, which selectively stimulate beneficial microbial populations, and postbiotics nonviable microbial products or metabolites with biological activity. Materials and Methods: This narrative review was based on an extensive analysis of the scientific literature published between 2010 and 2024. References were selected from sources such as PubMed, Scopus, and Google Scholar. The review focused on studies examining the mechanisms of action, clinical outcomes, and potential of prebiotics and postbiotics in the treatment or management of dermatological conditions. Results: The reviewed studies indicate that prebiotics and postbiotics can influence the skin microbiome by increasing microbial diversity, restoring barrier function, and reducing inflammatory responses. Evidence supports their effectiveness as supplements in the treatment of acne vulgaris, atopic dermatitis, psoriasis, and rosacea. Furthermore, their inclusion in cosmetic formulations appears to improve hydration, reduce transepidermal water loss, and enhance the skin's innate defense mechanisms. Conclusions: Prebiotics and postbiotics represent a potential microbiome-targeted therapeutic approach to dermatological problems, both cosmetic and medical. Their incorporation into dermatological and cosmetological techniques may facilitate personalized, non-invasive, and preventative skin care approaches. However, additional, standardized, large-scale clinical trials are necessary to confirm their long-term safety and efficacy.

Jaskra to postępująca neuropatia nerwu wzrokowego, która nieleczona prowadzi do nieodwracalnej ślepoty. Schorzenie to zajmuje drugie miejsce na świecie wśród przyczyn trwałej utraty wzroku. Choć podstawowym celem leczenia jest obniżenie ciśnienia śródgałkowego, to coraz większą uwagę zwraca się na strategie neuroprotekcyjne, mające na celu ochronę komórek zwojowych siatkówki przed degeneracją. Celem niniejszej pracy jest przegląd dostępnych metod neuroprotekcji w jaskrze. Omówiono w niej zarówno farmakologiczne podejścia, obejmujące inhibitory kinazy Rho, antagonistów glutaminianu (memantynę, cytykolinę), agonistów receptorów adrenergicznych (brymonidynę), statyny, czynniki neurotroficzne, antyoksydanty, kanabinoidy, preparaty roślinne (Ginkgo biloba, hupercyna A), jak i nowoczesne terapie oparte na komórkach macierzystych. Uwzględniono również mechanizmy działania tych substancji oraz aktualny stan badań klinicznych. Choć wiele z opisanych metod uzyskało obiecujące wyniki w modelach eksperymentalnych, to skuteczność kliniczna większości interwencji pozostaje przedmiotem dalszych badań.

The COVID-19 pandemic has underscored the critical role of public health education in promoting maternal and neonatal well-being. This systematic review examines the impact of SARS-CoV-2 infection and COVID-19 vaccination on breastfeeding practices, with a focus on viral transmission, the transfer of antibodies, and the broader implications for health education and early physical development. A comprehensive literature search covering studies from 2020 to 2024 was conducted. The review analyzed research on the presence of SARS-CoV-2 in breast milk, antibody responses following natural infection and vaccination, and the subsequent effects on newborn health. The results indicate that active transmission of SARS-CoV-2 via breast milk is extremely rare, with detected viral RNA not corresponding to infectious virus particles. Importantly, breast milk from both infected and vaccinated mothers contains significant levels of IgA and IgG antibodies, which confer passive immunity to newborns. Beyond immediate nutritional and immunological benefits, breastfeeding plays a pivotal role in fostering early physical development—a foundation that may influence later engagement in sports and active lifestyles. Moreover, the excellent safety profile of COVID-19 vaccines for breastfeeding women reinforces the integration of vaccination into public health education strategies aimed at promoting comprehensive maternal and child health. These findings support the continued promotion of breastfeeding during the COVID-19 pandemic, not only for its direct health benefits but also for its broader educational and developmental impacts. The study advocates for interdisciplinary public health initiatives that integrate health education, vaccination campaigns, and the encouragement of early physical activity as essential elements in optimizing long-term health outcomes. Objective: The aim of this study is to provide an in-depth analysis of the impact of SARS-CoV-2 infection and COVID-19 vaccination on breastfeeding, with a focus on the potential transmission of the virus and the transfer of antibodies through breast milk to newborns. Materials and Methods: A systematic review of current scientific literature from 2020 to 2024 was conducted, focusing on studies examining the presence of SARS-CoV-2 in breast milk, levels of anti SARS-CoV-2 antibodies after infection and vaccination, and the clinical implications for newborn health. The search utilized a combination of keywords and logical operators such as "SARS-CoV-2, "“COVID-19, "“coronavirus, "“breastfeeding, "“lactation, "“human milk, " “transmission, "“antibodies, "“vaccination, " and”immunization." Electronic databases searched included PubMed, Scopus, Web of Science, and Embase. The review encompassed publications released from January 2020 to September 2024. Conclusions: The analysis of available data indicates that the transmission of active virus through breast milk is extremely rare and does not pose a significant risk to the newborn. Detection of viral RNA in breast milk does not equate to the presence of replication-competent virus. Additionally, studies have shown that breast milk from both SARS-CoV-2-infected and COVID-19-vaccinated mothers contains specific antibodies, predominantly IgA and IgG. These antibodies may provide passive immunity to the newborn, potentially protecting against infection or mitigating disease severity. COVID-19 vaccination in breastfeeding women has been proven safe, with no significant adverse effects observed in mothers or their infants. The findings suggest that the benefits of breastfeeding outweigh the potential risks of SARS-CoV-2 transmission. Breastfeeding is recommended both during maternal infection and after COVID-19 vaccination. The available scientific evidence supports policies promoting breastfeeding as a safe and beneficial practice in the context of the COVID-19 pandemic.

Background: Metabolic syndrome (MetS) is one of the most serious public-health challenges, affecting approximately 25 % of the adult population worldwide and more than doubling the risk of cardiovascular disease (CVD). It is characterised by the coexistence of abdominal obesity, insulin resistance, dyslipidemia and arterial hypertension, which translates into markedly increased mortality risk. Physical activity (PA) has been identified as a key modifiable factor in the prevention and treatment of this cluster of disorders. The aim of this review is to discuss in detail the impact of various forms of PA on the components of MetS and on CVD risk. Methods and Materials: A systematic review of the scientific literature was carried out, analysing randomised trials, meta-analyses and observational studies that assessed the effectiveness of aerobic, resistance and high-intensity interval training. Conclusions: Regular PA exerts a multidirectional influence on all components of MetS, effectively reducing abdominal obesity, insulin resistance, dyslipidemia and hypertension. Aerobic training shows the greatest efficacy in improving metabolic parameters, whereas the combination of aerobic and resistance modalities provides the most favourable therapeutic outcomes. In secondary prevention of CVD, PA achieves effectiveness comparable to pharmacotherapy and significantly surpasses it in post-stroke patients. The underlying mechanisms include improvements in insulin sensitivity, enhanced glucose uptake by skeletal muscle, and beneficial modulation of adipokine and cytokine profiles. The review underlines the importance of regular PA as a public-health strategy and highlights the need for further research aimed at optimising intervention programs.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder in reproductive age women, marked by insulin resistance, hyperandrogenism, menstrual irregularities, and increased cardiometabolic risk. This review synthesizes current evidence on the clinical effectiveness of metformin versus alternative strategies across anthropometric, glycemic, and lipid outcomes in women with PCOS. This narrative review synthesizes secondary data from systematic reviews and meta-analyses retrieved from PubMed and Google Scholar, comparing metformin with other interventions in reproductive-age women with PCOS across anthropometric, glucose, or lipid outcomes. Metformin showed modest benefits in reducing body mass index, body weight, and waist circumference, with greater effects in overweight and obese individuals. Combined therapies, especially with glucagon-like peptide-1 receptor agonists, were more effective than metformin alone. In glucose metabolism, metformin outperformed placebo and oral contraceptives in reducing fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance, especially in women with higher insulin resistance. Effects on lipid profiles were moderate; metformin lowered total cholesterol, low-density lipoprotein cholesterol, and triglycerides, particularly when combined with statins. Its effect on high-density lipoprotein cholesterol was limited and sometimes less favorable than that of oral contraceptives. Metformin remains a core treatment in PCOS, with consistent, modest benefits across metabolic and anthropometric domains. Its effectiveness improves when matched to patient profiles and combined with other agents or lifestyle changes.