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Article: Lung NETs and GEPNETs: One Cancer with Different Origins or Two Distinct Cancers?

Evangelou, Georgios / Vamvakaris, Ioannis / Papafili, Anastasia / Anagnostakis, Maximilian / Peppa, Melpomeni

2024 Volume 16, Issue 6

Abstract: Lung neuroendocrine tumors (LNETs) and gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are two distinct types of neuroendocrine tumors (NETs) that have traditionally been treated as a single entity despite originating from different sources. ... ...

Abstract	Lung neuroendocrine tumors (LNETs) and gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are two distinct types of neuroendocrine tumors (NETs) that have traditionally been treated as a single entity despite originating from different sources. Although they share certain phenotypic characteristics and the expression of neuroendocrine markers, they exhibit differences in their microenvironment, molecular mutations, and responses to various therapeutic regimens. Recent research has explored the genetic alterations in these tumors, revealing dissimilarities in the frequently mutated genes, the role of EGFR in carcinogenesis, the presence of transcription factors, and the immunogenicity of the tumor and its microenvironment. Spread Through Air Spaces (STAS), a phenomenon unique to lung carcinomas, appears to play a crucial role in LNET prognosis. These distinctions are also evident in the cascade response of lung and GI tract neuroendocrine tumors to somatostatin analogs, Peptide Receptor Radionuclide Therapy (PRRT), chemotherapy, and immunotherapy. Identifying similarities and differences between the two groups may improve our understanding of the underlying mechanisms and facilitate the development of more effective treatment strategies.
Language	English
Publishing date	2024-03-17
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16061177
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Article ; Online: Experimental Animal Studies Support the Role of Dietary Advanced Glycation End Products in Health and Disease.

Peppa, Melpomeni / Mavroeidi, Ioanna

Nutrients

2021 Volume 13, Issue 10

Abstract: The increased incidence of obesity, diabetes mellitus, aging, and associated comorbidities indicates the interplay between genetic and environmental influences. Several dietary components have been identified to play a role in the pathogenesis of the so- ... ...

Abstract	The increased incidence of obesity, diabetes mellitus, aging, and associated comorbidities indicates the interplay between genetic and environmental influences. Several dietary components have been identified to play a role in the pathogenesis of the so-called "modern diseases", and their complications including advanced glycation end products (AGEs), which are generated during the food preparation and processing. Diet-derived advanced glycation end products (dAGEs) can be absorbed in the gastrointestinal system and contribute to the total body AGEs' homeostasis, partially excreted in the urine, while a significant amount accumulates to various tissues. Various in vitro, in vivo, and clinical studies support that dAGEs play an important role in health and disease, in a similar way to those endogenously formed. Animal studies using wild type, as well as experimental, animal models have shown that dAGEs contribute significantly to the pathogenesis of various diseases and their complications, and are involved in the changes related to the aging process. In addition, they support that dAGEs' restriction reduces insulin resistance, oxidative stress, and inflammation; restores immune alterations; and prevents or delays the progression of aging, obesity, diabetes mellitus, and their complications. These data can be extrapolated in humans and strongly support that dAGEs' restriction should be considered as an alternative therapeutic intervention.
MeSH term(s)	Animals ; Bone and Bones/metabolism ; Diabetes Mellitus/etiology ; Diabetes Mellitus/metabolism ; Dietary Supplements ; Disease Susceptibility ; Glycation End Products, Advanced/administration & dosage ; Glycation End Products, Advanced/metabolism ; Health Impact Assessment ; Homeostasis ; Humans ; Models, Animal ; Muscles/metabolism ; Obesity/etiology ; Obesity/metabolism ; Organ Specificity ; Oxidative Stress
Chemical Substances	Glycation End Products, Advanced
Language	English
Publishing date	2021-09-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13103467
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Article ; Online: Endocrinopathies in beta thalassemia: a narrative review.

Venou, Theodora-Maria / Barmpageorgopoulou, Fani / Peppa, Melpomeni / Vlachaki, Efthimia

Hormones (Athens, Greece)

2023

Abstract: Beta thalassemia is the most common genetic blood disorder, characterized by reduced production or complete absence of beta-globin chains. The combination of systematic red blood cell transfusion and iron chelation therapy is the most readily available ... ...

Abstract	Beta thalassemia is the most common genetic blood disorder, characterized by reduced production or complete absence of beta-globin chains. The combination of systematic red blood cell transfusion and iron chelation therapy is the most readily available supportive treatment and one that has considerably prolonged the survival of thalassemia patients. Despite this, the development of endocrine abnormalities correlated with beta thalassemia still exists and is mostly associated with iron overload, chronic anemia, and hypoxia. A multifactorial approach has been employed to investigate other factors involved in the pathogenesis of endocrinopathies, including genotype, liver disease, HCV, splenectomy, socioeconomic factors, chelation therapy, and deficiency of elements. The development of specific biomarkers for predicting endocrinopathy risk has been the subject of extensive discussion. The objective of the present narrative review is to present recent data on endocrinopathies in beta thalassemia patients, including the prevalence, the proposed pathogenetic mechanisms, the risk factors, the diagnostic methods applied, and finally the recommended treatment options.
Language	English
Publishing date	2023-12-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2075912-5
ISSN	2520-8721 ; 1109-3099
ISSN (online)	2520-8721
ISSN	1109-3099
DOI	10.1007/s42000-023-00515-w
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Article: Experimental Animal Studies Support the Role of Dietary Advanced Glycation End Products in Health and Disease

Peppa, Melpomeni / Mavroeidi, Ioanna

Nutrients. 2021 Sept. 29, v. 13, no. 10

2021

Abstract	The increased incidence of obesity, diabetes mellitus, aging, and associated comorbidities indicates the interplay between genetic and environmental influences. Several dietary components have been identified to play a role in the pathogenesis of the so-called “modern diseases”, and their complications including advanced glycation end products (AGEs), which are generated during the food preparation and processing. Diet-derived advanced glycation end products (dAGEs) can be absorbed in the gastrointestinal system and contribute to the total body AGEs’ homeostasis, partially excreted in the urine, while a significant amount accumulates to various tissues. Various in vitro, in vivo, and clinical studies support that dAGEs play an important role in health and disease, in a similar way to those endogenously formed. Animal studies using wild type, as well as experimental, animal models have shown that dAGEs contribute significantly to the pathogenesis of various diseases and their complications, and are involved in the changes related to the aging process. In addition, they support that dAGEs’ restriction reduces insulin resistance, oxidative stress, and inflammation; restores immune alterations; and prevents or delays the progression of aging, obesity, diabetes mellitus, and their complications. These data can be extrapolated in humans and strongly support that dAGEs’ restriction should be considered as an alternative therapeutic intervention.
Keywords	diabetes mellitus ; food preparation ; gastrointestinal system ; homeostasis ; inflammation ; insulin resistance ; laboratory animals ; obesity ; oxidative stress ; pathogenesis ; therapeutics ; urine
Language	English
Dates of publication	2021-0929
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13103467
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: A modern web-based health promotion program for patients in Greece with diabetes 2 and obesity: an interventional study.

Chrysi, Maria S / Michopoulos, Ioannis / Dimitriadis, George / Peppa, Melpomeni

BMC public health

2023 Volume 23, Issue 1, Page(s) 639

Abstract: Background: Health promotion programs are most beneficial in chronic diseases such as diabetes and morbid obesity, which can be positively affected by changes in attitudes, beliefs, and lifestyle.: Objectives: This study aimed to develop an internet- ... ...

Abstract	Background: Health promotion programs are most beneficial in chronic diseases such as diabetes and morbid obesity, which can be positively affected by changes in attitudes, beliefs, and lifestyle. Objectives: This study aimed to develop an internet-based modern Health Promotion model using interactive online applications through continuing education and participation. Methods: The goal was to positively impact knowledge, behavior, and quality of life for patients with obesity and/or diabetes. This is a prospective interventional study on patients with obesity or type 2 diabetes. Seventeen two patients who met the inclusion criteria were distributed randomly into two groups (control and intervention) from 2019 to 2021 in Greece. All the participants were given questionaries concerning quality of life anxiety and depression (HADS) attitudes and beliefs, knowledge about their condition and general questions to establish a baseline. A traditional health promotion model was followed for the control group. For participants in the intervention group, a web-based health promotion program was created according to the goals of the research. Participants were instructed to log on 1-2 times a week for 5-15 min, with the understanding that the research team would be monitoring their activities. The website included two knowledge games and personalized educational material based on their needs. Results: The sample comprised 72 patients (36 in control and 36 in the intervention groups). The mean age was 47.8 years for the control group and 42.7 years for the intervention group (p = 0.293). Both study groups had a significant increase in knowledge score on diabetes (Control group:3,24, Intervention group 11,88 p < 0,001) and obesity (Control group:4,9, Intervention group 51,63 p < 0,001) along with a positive attitude score towards fighting obesity (Control group: 1,8, Intervention group 13,6 p < 0,001). Still, the overall change was more remarkable for the intervention group, as indicated by the significant interaction effect of the analysis. Anxiety was decreased only in the intervention group (Control group:0,11, Intervention group - 0,17 p < 0,005). Analysis for QOL during follow-up showed that Physical Health and Level of Independence was improved in both study groups but the degree of improvement was more significant in the intervention group (Control group 0,31,Intervention group 0,73 p < 0,001). Psychological Health was improved only in the intervention group, with better scores at 6 and 12 months compared to controls (Control group 0,28,Intervention group 1,42 p < 0,001). Furthermore, Social relationships were improved only in the intervention group (Control group 0,02, Intervention group 0,56 p < 0,001). Conclusions: The results of the present study showed that the participants in the intervention group showed significant improvement in knowledge, attitudes, and beliefs after using the internet as a learning tool. The intervention group also showed significantly reduced anxiety and depression arising from chronic illness. All of this resulted in an improved quality of life regarding physical Health, mental Health, and social relationships. Technology and online-based health promotion programs can revolutionize how we approach the prevention and management of chronic and terminal illnesses by improving accessibility, personalizing care, increasing engagement and motivation, improving data analysis, and disease management.
MeSH term(s)	Humans ; Middle Aged ; Chronic Disease ; Diabetes Mellitus, Type 2/therapy ; Greece ; Health Promotion/methods ; Internet ; Obesity/therapy ; Prospective Studies ; Quality of Life
Language	English
Publishing date	2023-04-03
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-15557-3
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Article ; Online: A modern web-based health promotion program for patients in Greece with diabetes 2 and obesity

Maria S. Chrysi / Ioannis Michopoulos / George Dimitriadis / Melpomeni Peppa

BMC Public Health, Vol 23, Iss 1, Pp 1-

an interventional study

2023 Volume 9

Abstract: Abstract Background Health promotion programs are most beneficial in chronic diseases such as diabetes and morbid obesity, which can be positively affected by changes in attitudes, beliefs, and lifestyle. Objectives This study aimed to develop an ... ...

Abstract	Abstract Background Health promotion programs are most beneficial in chronic diseases such as diabetes and morbid obesity, which can be positively affected by changes in attitudes, beliefs, and lifestyle. Objectives This study aimed to develop an internet-based modern Health Promotion model using interactive online applications through continuing education and participation. Methods The goal was to positively impact knowledge, behavior, and quality of life for patients with obesity and/or diabetes. This is a prospective interventional study on patients with obesity or type 2 diabetes. Seventeen two patients who met the inclusion criteria were distributed randomly into two groups (control and intervention) from 2019 to 2021 in Greece. All the participants were given questionaries concerning quality of life anxiety and depression (HADS) attitudes and beliefs, knowledge about their condition and general questions to establish a baseline. A traditional health promotion model was followed for the control group. For participants in the intervention group, a web-based health promotion program was created according to the goals of the research. Participants were instructed to log on 1–2 times a week for 5–15 min, with the understanding that the research team would be monitoring their activities. The website included two knowledge games and personalized educational material based on their needs. Results The sample comprised 72 patients (36 in control and 36 in the intervention groups). The mean age was 47.8 years for the control group and 42.7 years for the intervention group (p = 0.293). Both study groups had a significant increase in knowledge score on diabetes (Control group:3,24, Intervention group 11,88 p < 0,001) and obesity (Control group:4,9, Intervention group 51,63 p < 0,001) along with a positive attitude score towards fighting obesity (Control group: 1,8, Intervention group 13,6 p < 0,001). Still, the overall change was more remarkable for the intervention group, as indicated by the significant ...
Keywords	Health promotion ; Obesity ; Diabetes ; Interactive website ; Public aspects of medicine ; RA1-1270
Subject code	796
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Managing diabetes in ageing patients during the COVID-19 pandemic.

Armeni, Eleni / Paschou, Stavroula A / Peppa, Melpomeni

Maturitas

2020 Volume 145, Page(s) 89–90

Language	English
Publishing date	2020-11-17
Publishing country	Ireland
Document type	Editorial
ZDB-ID	80460-5
ISSN	1873-4111 ; 0378-5122
ISSN (online)	1873-4111
ISSN	0378-5122
DOI	10.1016/j.maturitas.2020.11.002
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Article ; Online: Secondary diabetes mellitus in acromegaly.

Moustaki, Melpomeni / Paschou, Stavroula A / Xekouki, Paraskevi / Kotsa, Kalliopi / Peppa, Melpomeni / Psaltopoulou, Theodora / Kalantaridou, Sophia / Vryonidou, Andromachi

Endocrine

2023 Volume 81, Issue 1, Page(s) 1–15

Abstract: Secondary diabetes mellitus (DM) is a common complication of acromegaly, encountered in up to 55% of cases. Vice versa, the prevalence of acromegaly is markedly higher in cohorts of patients with type 2 DM (T2DM). The presence of secondary DM depends ... ...

Abstract	Secondary diabetes mellitus (DM) is a common complication of acromegaly, encountered in up to 55% of cases. Vice versa, the prevalence of acromegaly is markedly higher in cohorts of patients with type 2 DM (T2DM). The presence of secondary DM depends primarily on acromegaly status and is associated with increased cardiovascular morbidity, malignancy rate and overall mortality. The principal pathophysiologic mechanism is increased insulin resistance due to excessive lipolysis and altered fat distribution, reflected at the presence of intermuscular fat and attenuated, dysfunctional adipose tissue. Insulin resistance is ascribed to the direct, diabetogenic effects of growth hormone (GH), which prevail over the insulin-sensitizing effects of insulin-like growth factor 1 (IGF-1), probably due to higher glucometabolic potency of GH, IGF-1 resistance, or both. Inversely, GH and IGF-1 act synergistically in increasing insulin secretion. Hyperinsulinemia in portal vein leads to enhanced responsiveness of liver GH receptors and IGF-1 production, pointing towards a mutually amplifying loop between GH-IGF-1 axis and insulin. Secondary DM occurs upon beta cell exhaustion, principally due to gluco-lipo-toxicity. Somatostatin analogues inhibit insulin secretion; especially pasireotide (PASI) impairs glycaemic profile in up to 75% of cases, establishing a separate pathophysiologic entity, PASI-induced DM. In contrast, pegvisomant and dopamine agonizts improve insulin sensitivity. In turn, metformin, pioglitazone and sodium-glucose transporters 2 inhibitors might be disease-modifying by counteracting hyperinsulinemia or acting pleiotropically. Large, prospective cohort studies are needed to validate the above notions and define optimal DM management in acromegaly.
MeSH term(s)	Humans ; Acromegaly/complications ; Acromegaly/metabolism ; Insulin-Like Growth Factor I/metabolism ; Insulin Resistance ; Prospective Studies ; Human Growth Hormone ; Growth Hormone ; Insulin ; Diabetes Mellitus
Chemical Substances	Insulin-Like Growth Factor I (67763-96-6) ; Human Growth Hormone (12629-01-5) ; Growth Hormone (9002-72-6) ; Insulin
Language	English
Publishing date	2023-03-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1194484-5
ISSN	1559-0100 ; 1355-008X ; 0969-711X
ISSN (online)	1559-0100
ISSN	1355-008X ; 0969-711X
DOI	10.1007/s12020-023-03339-1
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Article ; Online: The Role of the Glycemic Index and Glycemic Load in the Dietary Approach of Gestational Diabetes Mellitus.

Mavroeidi, Ioanna / Manta, Aspasia / Asimakopoulou, Athina / Syrigos, Alexandros / Paschou, Stavroula A / Vlachaki, Efthimia / Nastos, Constantinos / Kalantaridou, Sophia / Peppa, Melpomeni

Nutrients

2024 Volume 16, Issue 3

Abstract: Gestational diabetes mellitus (GDM) is a common metabolic disorder that often develops during pregnancy, characterized by glucose intolerance and insulin resistance (IR). To ensure the well-being of both the mother and the fetus, the body undergoes ... ...

Abstract	Gestational diabetes mellitus (GDM) is a common metabolic disorder that often develops during pregnancy, characterized by glucose intolerance and insulin resistance (IR). To ensure the well-being of both the mother and the fetus, the body undergoes multiple metabolic and immunological changes that result in peripheral IR and, under certain hereditary or acquired abnormalities, GDM in predisposed women. The adverse short- and long-term effects of GDM impact both the mother and the fetus. Nutrition seems to play an important role to prevent GDM or improve its evolution. An emphasis has been given to the proportion of carbohydrates (CHO) relative to protein and lipids, as well as dietary patterns, in GDM. The effects of CHO on postprandial glucose concentrations are reflected in the glycemic index (GI) and glycemic load (GL). Diets rich in GI and GL may induce or exacerbate IR, whereas diets low in GI and GL appear to enhance insulin sensitivity and improve glycemic control. These positive outcomes may be attributed to direct interactions with insulin and glucose homeostasis or indirect effects through improved body composition and weight management. This comprehensive narrative review aims to explore the significance of nutrition, with a focus on the critical evaluation of GI and GL in the dietary management of women with GDM.
MeSH term(s)	Pregnancy ; Female ; Humans ; Diabetes, Gestational/prevention & control ; Glycemic Index ; Glycemic Load ; Diet ; Insulin Resistance ; Insulin ; Glucose ; Blood Glucose/metabolism ; Dietary Carbohydrates
Chemical Substances	Insulin ; Glucose (IY9XDZ35W2) ; Blood Glucose ; Dietary Carbohydrates
Language	English
Publishing date	2024-01-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu16030399
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Article ; Online: Food Cravings and Obesity in Women with Polycystic Ovary Syndrome: Pathophysiological and Therapeutic Considerations.

Stefanaki, Katerina / Karagiannakis, Dimitrios S / Peppa, Melpomeni / Vryonidou, Andromachi / Kalantaridou, Sophia / Goulis, Dimitrios G / Psaltopoulou, Theodora / Paschou, Stavroula A

Nutrients

2024 Volume 16, Issue 7

Abstract: Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, constitutes a metabolic disorder frequently associated with obesity and insulin resistance (IR). Furthermore, women with PCOS often suffer from excessive ... ...

Abstract	Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, constitutes a metabolic disorder frequently associated with obesity and insulin resistance (IR). Furthermore, women with PCOS often suffer from excessive anxiety and depression, elicited by low self-esteem due to obesity, acne, and hirsutism. These mood disorders are commonly associated with food cravings and binge eating. Hypothalamic signaling regulates appetite and satiety, deteriorating excessive food consumption. However, the hypothalamic function is incapable of compensating for surplus food in women with PCOS, leading to the aggravation of obesity and a vicious circle. Hyperandrogenism, IR, the reduced secretion of cholecystokinin postprandially, and leptin resistance defined by leptin receptors' knockout in the hypothalamus have been implicated in the pathogenesis of hypothalamic dysfunction and appetite dysregulation. Diet modifications, exercise, and psychological and medical interventions have been applied to alleviate food disorders, interrupting the vicious circle. Cognitive-behavioral intervention seems to be the mainstay of treatment, while the role of medical agents, such as GLP-1 analogs and naltrexone/bupropion, has emerged.
MeSH term(s)	Female ; Humans ; Polycystic Ovary Syndrome/complications ; Polycystic Ovary Syndrome/therapy ; Craving ; Obesity/complications ; Obesity/therapy ; Appetite ; Acne Vulgaris
Language	English
Publishing date	2024-04-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu16071049
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