Dr. Pablo Castro a clinical perspective for the eradication of chronic diseases
The Centre for advanced studies of chronic diseases (ACCDIS) It develops research linked to cardiovascular disease and cancer, two of the leading causes of mortality in Chile. In this sense, ACCDiS has served as a threshold for a multidisciplinary team of researchers, who from different perspectives, They provide new knowledge and ideas to advance in the medical and scientific challenge of these chronic diseases as relevant.
Under this scenario, the Dr is. Pablo Castro Galvez, who is chief physician of diseases cardiovascular of the Pontificia Universidad Católica of Chile Division (Red de Salud UC CHRISTUS-PUC). The also academic in the Faculty of Medicine of the PUC, is a researcher at our Center. In his work, It incorporates all the clinical gaze implied in the research associated with cardiovascular diseases.
Dr. Castro was formed in the area of Cardiology from PUC, Subsequently he joined sub - specialize in coronary intensive care heart failure and transplantation. He attended studies at the University of Alabama, Birmingham, United States.
Below is the interview made by ACCDiS to the Dr. Pablo Castro.
How was your experience within ACCDiS?
The formation of this Center allowed us to meet and interact with new researchers, so it has been created a fairly large group of scientists and doctors from the two of the country's largest universities. This has allowed us to deepen research and create new ones, that has translated into a greater generation of knowledge and scientific productivity, which has grown considerably thanks to ACCDiS.
We have dealt with the study of cardiovascular disease from the basic and clinical perspective by Dr. Sergio Lavandero, Director of the Center, for several years now. ACCDiS begins its operations in 2015 so it was motivating to further investigate with the Dr. Laundry and other scientists who make up the Group.
With what large areas is linked the work done in ACCDiS?
This Center has a tight bond with the two major chronic diseases of high mortality in our country, which are the cancer and cardiovascular diseases. In this sense, There are some similarities in the genesis of both, This common factor or trigger would be for example, chronic inflammation. The inflammation is produced many times, by risk factors that the patient may have, including obesity, hypertension, smoking and sedentary lifestyle.
All these pathologies may be influenced by a genetic condition that carries the subject, as well as, by environmental factors that may occur in a given geographical area.
The experience of Molina
To better analyze risk factors surrounding these diseases form, We conducted a survey in the city of Molina, It is one of the areas of our country where concentrates a high rate of mortality from cardiovascular disease and cancer. In this way, We have been able to study and keep track of the population, characterizing his condition of health and disease. Like this, We identified factors that may influence the genesis of these diseases in Molina, These factors may be different to other geographical country or even surrounding areas.
Molina is an agricultural area where pesticide use, which may influence, for this reason, environmental factors including possible pollution in the area being considered. For the time being, There is a basal assessment carried out with a health survey, follow patients over time and. Blood samples have also been taken, urine and saliva, in order to find markers that precede the appearance of any particular disease.
How does the research linked to the cardiovascular area in the commune of Molina?
With Dr. Sergio Lavandero, We have studied patients who have established cardiovascular disease, for example heart failure. In them we studied blood samples to identify different biomarkers that identify the ill subject. In the town of Molina, the idea is to anticipate the disease, so we are doing studies of cardiac images and biomarkers. Are evaluating both traditional, as new or emerging, It could be years before the disease already present in the individual and be the result of genetica-ambiental interaction. This would have implications on the preventive approach to these diseases.
We are measuring markers of chronic inflammation, resistance to insulin and fibrosis markers, among others. We also determine epigenetic markers, which regulate the expression of a gene. Among them are the so-called micro RNA, which modulate the expression of genes and affect this code or not, for a protein and will express the disease. The idea in the town of Molina, It is to identify early those who may develop disease in the future.
So far it is very interesting that in the town of Molina, many residents who consider healthy themselves and do not have an established disease, do not possess all the factors that are ideal to protect cardiovascular health. These include the absence of smoking, IMC< 25, healthy diet score, a total cholesterol <200 mmHg, a blood sugar <100 mg/dl and PA<120/70 mmHg. They are subjects that are at risk, and in fact when studies have been conducted them with images of echocardiography Doppler with strain, to evaluate the structure and function of the heart, a significant proportion of them, and are supposedly healthy, they have alterations in cardiac function when using this methodology.
For example, We have seen a change in the function of the left atrium. These subjects in other parts of the heart work normally, However, If they became a conventional test, without these parameters measurement, These early abnormalities are not detected during. Left atrial dysfunction in asymptomatic population, with high incidence of cardiovascular events, It would be an early event in the damage that would occur later.
The importance of the ventricles
The majority of cardiovascular diseases affect the function of the ventricles, especially the left ventricle, because this is not contracted or not relax well, sometimes because there are areas of previous infarction, or because the ventricle walls are thickened or more rigid, as for example in hypertension.
Usually when there are pathologies of the ventricles, There are pathologies of the Atria, What are cavities that receive blood before moving on to the ventricles. However, It seems that in some subjects the first abnormality manifests itself in the left atrium, which deteriorates in a premature way. Is why we think that the left atrium, in some situations, It is more sensitive to the damage that the ventricles, This possibly because the left atrium has a structure more thin and sensitive.
Interestingly, We have been working with researchers in determinations of cardiac function in experimental models with heart failure, for example, in models of partial aortic artery ligation, This leads to a pressure overload on the left ventricle, which reacts to increasing the thickness of your wall (hypertrophy) or are fibrous. We are also working in different cultures of cells that make up the heart. In these, We evaluate the structure and cell function, as the function of the structures that produce energy for contraction of the heart. It is as well as, We study the function and structure of the mitochondria, Since it is produced the necessary energy so that the cardiomyocyte shrinks.
Mitochondria are found in the interior of the cardiac cell, at first it was believed that mitochondria was a static organelle, However, It has been described and we have confirmed it recently, These structures are fairly dynamic, They divide and merge. This latter varies in relation to pathology and metabolic needs. Cardiomyocytes require lots of energy for contraction and much of this energy, It is generated at the level of the mitochondrial respiratory chain, This works best when the mitochondria are fused or United. The metabolic activity occurring in the cardiomyocyte is very important for contraction and relaxation processes (cardiovascular function).
Improve the function of mitochondria is a new way to address the treatment of heart disease.
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Journalist: Patricio Grunert Alarcón. ®
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