Abstract:
:Reversing chronic conditions remains an elusive goal of medicine. The modern medical paradigm based on blocking overactive pathways or augmenting deficient pathways offers symptomatic benefit, but tolerance to therapy can develop and treatment cessation can produce rebound symptoms due to compensatory mechanisms. We propose a paradoxical strategy for treating chronic conditions based on harnessing compensatory mechanisms for therapeutic benefit. Many current drugs may be repurposed for a paradoxical indication where the therapeutic effect is derived from compensatory response, rather than drug effect. For example, although exercise is associated with acute adrenergia, paradoxical downregulation of baseline sympathovagal ratio occurs as a remodeling response. For conditions that manifest chronic sympathetic bias such as cardiovascular diseases, judicious administration of adrenergic agonists may induce compensatory downregulation of baseline sympathovagal ratio. The concept may generalize to many other diseases, especially those involving pathways which exhibit strong homeostatic tendencies such as the neurologic, immune, and endocrine systems. Careful consideration of chronobiologic features is necessary to optimize dosing strategies for modulating compensatory responses, and eccentric dosing schedules, shorter-acting formulations, or pulsatile delivery may be desirable in some cases. To what extent the effect of desensitization to current therapy is mistaken for disease progression in conditions such as diabetes, myopia, depression, and hypertension warrants investigation. The merits of combining behavioral and drug therapies such as diet-insulin therapy for diabetes and exercise-beta-blockade for cardiovascular disease should be revisited since there is a risk for exacerbating the underlying dysfunction. The reduced dynamic range of various environmental experiences and the tendency to revert to the mean through medical intervention, thermoregulation, and other modern lifestyle changes may play under-recognized roles in human diseases. Perhaps alternating agonists and antagonist may exercise the entire dynamic range of pathways and improve health.
journal_name
Med Hypothesesjournal_title
Medical hypothesesauthors
Yun AJ,Lee PY,Bazar KAdoi
10.1016/j.mehy.2004.09.007keywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
1050-9issue
5eissn
0306-9877issn
1532-2777pii
S0306-9877(04)00519-5journal_volume
64pub_type
杂志文章abstract::Abdominal aortic aneurysms (AAAs) have traditionally been attributed to atherosclerosis, although there is increasing epidemiological, biochemical and genetic evidence that aneurysmal arterial disease is different from occlusive atherosclerosis. One of the most consistent biochemical findings in the aneurysmal aorta i...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/0306-9877(95)90193-0
更新日期:1995-07-01 00:00:00
abstract::The Sudden Infant Death Syndrome (SIDS) is responsible for the death of 10,000 infants annually in the U.S.A. The cause of these deaths is not known; all SIDS infants studied died during sleep in a silent fashion and there are no specific lesions observable post mortem. It may be of significance, however, that nearly ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/0306-9877(87)90195-2
更新日期:1987-03-01 00:00:00
abstract::Interferon-alpha (IFN) is widely used in the treatment of certain cancers and viral infections, including hepatitis C (HCV). Unfortunately, depression is a common side effect of IFN therapy, affecting approximately a third of HCV patients receiving IFN therapy. Studies have shown that selective serotonin reuptake inhi...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2005.01.026
更新日期:2005-01-01 00:00:00
abstract::Previous papers of our group have reported that, in the first stages of nutritional recovery, the needs of undernourished infants, in terms of Protein Calories percentage (P%) were higher than normal, and similar to those of other mammals which double their birth weight faster than man. During this period, a high diet...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/0306-9877(85)90045-3
更新日期:1985-10-01 00:00:00
abstract::Daily disturbances of the earth's magnetic field produce variations in geomagnetic activity (GMA) that are reportedly associated with widespread effects on human health and behaviour. Some of these effects could be mediated by an established influence of GMA on the secretion of melatonin. There is evidence from unrela...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2009.01.047
更新日期:2009-07-01 00:00:00
abstract::Incretin hormones have trophic effects on beta cell function that can aid prevention and treatment of diabetes. cAMP is the primary mediator of these effects, and has been shown to potentiate glucose-stimulated insulin secretion, promote proper beta cells differentiation by increasing expression of the crucial transcr...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2004.04.031
更新日期:2006-01-01 00:00:00
abstract::Autism is a severe developmental disability believed to have multiple etiologies. This paper outlines the possibility of a subacute, chronic tetanus infection of the intestinal tract as the underlying cause for symptoms of autism observed in some individuals. A significant percentage of individuals with autism have a ...
journal_title:Medical hypotheses
pub_type: 杂志文章,评审
doi:10.1016/s0306-9877(98)90107-4
更新日期:1998-08-01 00:00:00
abstract::For many years, the ketogenic diet, including recent variants such the medium-chain triglyceride (MCT) diet, has been used with good clinical results in the management of refractory epilepsies, particularly in children. The antiepileptic effects of the diet, like the antiepileptic effects of starvation, have been attr...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2007.05.054
更新日期:2008-01-01 00:00:00
abstract::Toll-like receptor 7 is critical in recognition of single strand RNA viruses, including SARS CoV-2, and generation of anti-viral immunity. Coronaviruses evolved strategies to dampen the host immunity. Herein, we discuss the potential use of TLR7 agonists in the early stages of COVID-19 treatment. ...
journal_title:Medical hypotheses
pub_type: 信件
doi:10.1016/j.mehy.2020.110202
更新日期:2020-11-01 00:00:00
abstract::In light of the progressive, pubertal increases in serum gonadotropin (FSH, LH) levels coinciding with the peak incidence of simple goiters; the common alpha subunits associated with the gonadotropins, TSH and hCG; the ability of LH and hCG to bind to thyroid TSH receptors and affect thyroid function; and, the probabl...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/0306-9877(83)90003-8
更新日期:1983-04-01 00:00:00
abstract::Guinea-pigs sensitised to ovalbumen excrete the antigen in their urine in a therapeutic concentration which prevents anaphylactic death after injection of a challenge dose of the ovalbumen. Sublingual administration of the correct dose of urine from allergic patients also provides therapeutic control of their allergic...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/0306-9877(83)90076-2
更新日期:1983-10-01 00:00:00
abstract::In the last decades, relevant efforts have been made to reduce the cancer incidence in the European Union. The prevention programmes against cancer have obtained satisfactory results except for colorectal cancer (CRC). Identification of risk factors is primordial to plan preventive strategies for CRC. We hypothesize t...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2007.03.041
更新日期:2008-01-01 00:00:00
abstract::Preliminary reports have suggested that chronic, intermittent electrical stimulation of the cervical vagus nerve (VNS) is an effective treatment for patients who suffered from medically refractory epilepsy. But the traditional VNS is an invasive and implantable procedure that will bring some injury to the patient. Ana...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2011.04.021
更新日期:2011-08-01 00:00:00
abstract::The resonator theory claims that light scattering by the melanin granules of the retinal pigment epithelium causes light to be reflected back through the outer segment of the cones, in a direction opposite that of the incident light. These two opposite directed wave motions may produce standing waves inside the cone o...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/0306-9877(92)90046-f
更新日期:1992-02-01 00:00:00
abstract::Medical Hypotheses exists to give ideas and speculations in medicine a fair hearing. Doing this is not easy. Most conventional journals would regard some of what is published here as questionable, most referees would reject it as 'unproven'. We have more liberal standards, for reasons we have presented before. But we ...
journal_title:Medical hypotheses
pub_type: 社论
doi:10.1016/j.mehy.2004.10.003
更新日期:2005-01-01 00:00:00
abstract::Narcolepsy type 1 is a lifelong sleep disorder characterized by the loss of hypocretin-producing neurons in the brain. Environmental agents, including influenza, neurotoxic metals, and combustion smoke, have been implicated in the pathogenesis, especially in carriers of the human leukocyte antigen class II DQB1*06:02 ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2019.109294
更新日期:2019-10-01 00:00:00
abstract::It has been suggested that dopamine may play an important role in human evolution and adaptive behaviors. Recent studies have revealed an association between the dopamine system and social support among healthy individuals. However, the underlying mechanism remains unclear. In the present study, we propose a dopamine ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2011.07.030
更新日期:2011-11-01 00:00:00
abstract::Both epidemiological and experimental studies have shown that impaired growth in utero due to maternal malnutrition, resulting in low birth weight, is associated with a high incidence of glucose intolerance, insulin resistance, and type 2 diabetes in adult life. Maternal malnutrition is a worldwide problem and unavoid...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2005.12.024
更新日期:2006-01-01 00:00:00
abstract::An unconventional interaction between a patient and parasites was recently reported, in which parasitic cells invaded host's tissues, establishing several tumors. This finding raises various intriguing hypotheses on unpredicted forms of interplay between a patient and infecting parasites. Here we present four unusual ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2016.06.012
更新日期:2016-09-01 00:00:00
abstract::It is postulated that the induction of immunological tolerance to chemical carcinogens is due to the penetration of carcinogens and its albumin and DNA adducts from the maternal organism into the embryo. Maternal serum lgG-antibodies to carcinogens promote the transportation of carcinogens and adducts into the embryo ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1054/mehy.2000.1393
更新日期:2001-07-01 00:00:00
abstract::Postoperative cognitive dysfunction (POCD) is reported to occur frequently after all types especially cardiac surgery in elderly patients. It can be short-term or long-term and some cases even develop into Alzheimer's disease (AD). Although multi-risk factors associated with POCD have been identified, the etiology and...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2011.02.010
更新日期:2011-05-01 00:00:00
abstract::Dental tissues contains stem cells or progenitors that have high proliferative capacity, are clonogenic in vitro and demonstrate the ability to differentiate to multiple type cells involving neurons, bone, cartilage, fat and smooth muscle. Numerous experiments have demonstrated that the multipotent stem cells are not ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2013.07.032
更新日期:2013-10-01 00:00:00
abstract::At the end of 2019, an emerging outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that first reported from Wuhan, China. The first manifestations of patients infected with SARS-CoV-2 was flu-like symptoms, while other type of manifestations, especially gastrointestinal manifestations were...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2020.110476
更新日期:2020-12-31 00:00:00
abstract::Random connection weight disturbances within an assembly of artificial neural networks (ANN) drive a progression of activation patterns that are tantamount to the memories and ideas nucleating within the brain's cortex. The numerical evaluation of these pattern-based notions by another, more placid system of ANNs gove...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2016.07.010
更新日期:2016-09-01 00:00:00
abstract::A novel substance-attributed biophysical theory of brain-mind unity is presented. We separate spiritualism and matters of the soul from the medical sphere. Biophysical principles are responsible for the body's operational regimen (BOR) in the homeostatic state which allows for materialization and emergence of the mind...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1054/mehy.1999.0852
更新日期:2000-03-01 00:00:00
abstract::The treatment and prevention of migraine within the last decade has become largely pharmacological. While there is little doubt that the advent of drugs (e.g. triptans) has helped many migraine sufferers to lead a normal life, there is still little knowledge with respect to the factors responsible for precipitating a ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2016.10.029
更新日期:2016-12-01 00:00:00
abstract::Parkinson's disease is one of the mostly seen neurological disease. It affects to nervous system and hinders people's vital activities. The majority of Parkinson's patients lose their ability to speak, write and balance. Many machine learning methods have been proposed to automatically diagnose Parkinson's disease usi...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2019.109483
更新日期:2020-02-01 00:00:00
abstract::The constant level of various proteins including albumin and cellular components in intravascular pool in vivo is strictly controlled by an unknown homeostatic mechanism, although there are fluctuations seen in pathologic conditions. Because the majority of the IgG in the serum is regarded as self-reactive natural aut...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2006.04.011
更新日期:2006-01-01 00:00:00
abstract::Lymphocytes of the CD8 phenotype play an important role in controlling viral burden in HIV-1 infection. Cytotoxic CD8+ T lymphocytes (CTL) can kill HIV-infected cells and in addition, are able to secrete a soluble factor that inhibits HIV replication. In most cases, HIV-infected individuals experience an unexplained C...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/0306-9877(94)90093-0
更新日期:1994-03-01 00:00:00
abstract::For American medical historiography, to borrow from Dickens, these are the best of times and the worst of times. These are the times when rigorous scholarship has been brought to bear on the field (with great improvement in the quality of research) and when medicine is disappearing from its own history. These are the ...
journal_title:Medical hypotheses
pub_type: 历史文章,杂志文章
doi:10.1016/0306-9877(92)90079-r
更新日期:1992-06-01 00:00:00