Background. Type 2 diabetes is a chronic metabolic disorder associated with impaired insulin secretion and insulin resistance, leading to persistent hyperglycemia and multiple complications. Despite advances in pharmacotherapy, many patients fail to achieve optimal metabolic control, highlighting the need for novel therapeutic approaches. Aim. The aim of this study was to present the current state of knowledge regarding cotadutide as a potential therapeutic option in the treatment of type 2 diabetes, with particular emphasis on its mechanism of action, clinical efficacy, and safety profile. Materials and methods. A narrative review of available literature was conducted, including clinical trials, meta-analyses, and preclinical studies evaluating the efficacy and safety of cotadutide in patients with type 2 diabetes and related metabolic disorders. Results. Cotadutide is a dual GLP-1 and glucagon agonist, that demonstrates a significant improvement regarding glycemia, body weight reduction and positive influence on metabolic parameters, in comparison to placebo. Clinical trials showed decrease in HbA1c, body weight and albuminuria, as well as potential benefits in liver and kidney function. The most common adverse effects involve the gastrointestinal tract. Conclusions. Cotadutide is a promising factor in diabetes type 2 treatment. It shows a broad spectrum of positive effects on metabolic parameters. However, further analysis and large-scale, long-term studies are required to establish its efficacy and safety.
Introduction: Axenfeld-Rieger syndrome (ARS) is a rare congenital disorder characterized by anterior segment dysgenesis and diverse systemic anomalies. Mutations in genes such as PITX2 and FOXC1 are most commonly implicated in its pathogenesis. The condition significantly affects vision, primarily due to structural disruption of the visual axis and the high incidence of secondary glaucoma. Aim of the study: The purpose of this study is to provide an updated overview of Axenfeld-Rieger syndrome, with emphasis on its historical background, genetic mechanisms, clinical manifestations, and current therapeutic strategies. Research materials and methods: A systematic review of scientific and medical literature was conducted using PubMed and Google Scholar databases. Conclusions: Genetic testing and comprehensive clinical evaluation are crucial for accurate diagnosis and optimal management of ARS. Due to its multisystem nature, care should be coordinated within a multidisciplinary framework. Early recognition of glaucoma and other systemic manifestations is essential to improve long-term outcomes.
The ketogenic diet, a high-fat, low-carbohydrate dietary approach, is increasingly used as a therapeutic strategy for the treatment of drug-resistant epilepsy and neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease. The primary mechanism of the ketogenic diet is the induction of a state of ketosis, during which the brain begins to use ketone bodies. Not only do ketones replace glucose as a fuel but also exhibit a number of neuroprotective effects, such as reducing oxidative stress, stabilising mitochondrial function, mitigating excitotoxicity, reducing neuroinflammatory signalling pathways, and stimulating autophagy. In drug-resistant epilepsy, the ketogenic diet can significantly reduce seizure frequency, especially in children with metabolic syndromes (glucose transporter type 1 deficiency syndrome, pyruvate dehydrogenase complex deficiency). In Alzheimer’s disease, the ketogenic diet improves cerebral metabolism, reduces β-amyloid deposition, and supports cognitive function, especially in the early stages of the disease. In Parkinson’s disease, a reduction in non-motor symptoms, improvement in mood and mitochondrial function, and potential modulation of the gut microbiota have been observed. However, it should be noted that the ketogenic diet is not without side effects, which include gastrointestinal disorders, hypoglycaemia, lipid abnormalities, kidney stones, micronutrient deficiencies, and possible stunted growth in children. Contraindications, on the other hand, include metabolic diseases, liver and kidney failure, type 1 diabetes, and pregnancy. In conclusion, the ketogenic diet is a promising non-pharmacological therapeutic option in neurology. However, its use requires individual assessment, specialised supervision, and further multicentre studies to confirm long-term efficacy and safety.
Introduction: The microbiota of the nose and paranasal sinuses plays a crucial role in maintaining the proper function of the mucous membrane of the upper respiratory tract. It consists of diverse bacteria, viruses, fungi, and other microorganisms. Dysbiosis, i.e. imbalance in the microbiota, can lead to diseases such as chronic rhinosinusitis (CRS). Modern techniques of genetic analysis allow a better understanding of the microbiota's impact on the human immune system. Aim: This review aims to analyze current research on the role of microbiota and dysbiosis and their impact on CRS, as well as present therapeutic possibilities related to microbiotal modulation, such as probiotics. Materials and methods: A literature review was conducted using PubMed and Google Scholar databases, focusing on articles published between 2016 and 2024. Both experimental and clinical studies analyzing the composition of nasal and paranasal sinus microbiota and its changes in CRS patients were included. Discussion: The nasal and paranasal sinus microbiota is characterized by high diversity. In healthy individuals, predominant microorganisms include the bacteria of genera Staphylococcus, Corynebacterium, and Propionibacterium. In CRS, decreased microbiotal diversity and increased numbers of pathogens such as S. aureus and P. aeruginosa are observed. Dysbiosis can lead to chronic inflammation, including through the disruption of the mucosal barrier and the suppression of the immune system. Probiotics can restore the microbiotal balance, reduce inflammation, strengthen the epithelial barrier, and alleviate symptoms of CRS. Conclusions: The microbiota plays a crucial role in otolaryngological health, its disturbances possibly leading to CRS. Understanding the mechanisms by which the microbiota influences human health opens new therapeutic avenues, including the use of probiotics.
Introduction: Granulomatosis with polyangiitis (GPA) is a rare, multi-organ autoimmune disease characterized by necrotizing inflammation predominantly affecting small- and medium-sized blood vessels, often leading to severe complications. In most GPA patients, otolaryngological symptoms are evident at the time of presentation to a physician.Aim: This study aims to review the diagnosis, differential diagnosis, and modern treatment methods for GPA, particularly from an otolaryngological perspective.Materials and methods: A comprehensive review of current scientific literature was conducted using PubMed and Google Scholar databases, focusing on articles published between 2016 and 2025. A critical evaluation of diagnostic methods, including ANCA antibody detection, imaging studies, and histopathology, was performed. The efficacy of immunosuppressive and biological therapies was also assessed.Results: GPA most commonly presents with sinonasal symptoms, such as chronic nasal discharge, epistaxis, and, in severe cases, nasal deformities like septal perforation or saddle-nose deformity. Diagnosis relies on detecting PR3-ANCA antibodies and histopathologically confirming granulomas with vascular necrosis. Treatment involves glucocorticosteroids and immunosuppressive agents, such as cyclophosphamide and rituximab, which achieve remission in most patients. Modern biological therapies, including interleukin-5 inhibitors, show promising results in refractory disease cases.Conclusions: Granulomatosis with polyangiitis remains a diagnostic and therapeutic challenge. Early recognition of otolaryngological symptoms and a multidisciplinary approach to treatment are crucial for improving patient outcomes. Advances in modern therapeutic approaches, such as rituximab and mepolizumab, have significantly improved prognosis and quality of life for patients, although disease relapses remain a considerable challenge.
