zahra hoseini-tavassol

The higher health education system in the Islamic Republic of Iran is an integrated system with multiple stakeholders responsible for training human resources in the health sector at different levels. The Academy of Medical Sciences of the Islamic Republic of Iran is one of the effective institutional factors in this system. This study aimed to explain the position of the Academy of Medical Sciences in the country’s medical sciences education system and outline its major directions in this field. In this study, the knowledge-to-action framework was implemented in four steps. Effective institutional factors in system development were explained, and the role of the various stakeholders of the country’s medical sciences education system was compared with them. Then, the functions of the academy as a main beneficiary based on the degree of connection with the stages of the knowledge-to-action framework were weighted, and finally, these functions were classified into different categories. According to this model, although the academy plays a role in many stages of the development of the country’s medical sciences education system, it primarily functions as a think tank and observatory and to a lesser extent as a knowledge implementation unit. The model presented in this study will help the trustees of the Academy of Medical Sciences to play the largest and most effective role in the development of the country’s medical sciences education system, with optimal resource management and principled development of human capacities, thereby laying the groundwork for the improvement of the integrated health system.

Nowadays, metabolomics studies are performed with different approaches to identify biomarkers, clarify the underlying mechanisms of diseases and achieve novel treatment strategies. In this context, gut microbiota-derived metabolites are known as one of the most important mediators of gut microbiota effects on human health and various diseases. Due to the inefficiency of conventional therapies in some cases, personalized medicine is of great clinical importance. Recent studies have shown that alterations in gut microbiota metabolites like short-chain fatty acids (SCFAs), amino acids, bile acid metabolites, and choline metabolites can link gut microbiota to numerous chronic non-communicable diseases including obesity, diabetes, inflammatory bowel diseases, psychological disorders, cardiovascular diseases and cancers. Understanding the composition of gut microbiota and the relationship between its derived-metabolites and the occurrence of various diseases is necessary to achieve new clinical applications. Furthermore, potential therapeutic agents such as prebiotic supplements and next-generation probiotics, dietary interventions, antibiotics, and fecal microbiota transplantation (FMT) could be among the leading strategies for personalized medicine in prognosis, diagnosis and treatment of various diseases, via modulating the diversity and composition of gut microbiota and its metabolites.

Diabetes and obesity are among the most important metabolic disorders which are of worldwide concern. Today, it has been proven that the diversity and composition of the intestinal microbiota play a key role in the incidence and control of metabolic diseases via regulating the metabolism and immune responses of the host. Previous studies reported links between Akkermansia muciniphila, a commensal bacterium in the gut microbiota, and obesity and diabetes. Human and animal studies have shown that this mucin-degrading bacterium is effective in preventing obesity and diabetes by reducing intestinal wall permeability and preventing metabolic endotoxemia and inflammation, as well as modulating energy and fat metabolism. New evidence shows that both forms of the A. muciniphila (live bacterium or its pasteurized form) can control the disease. Considering the difficulties of the survival and cultivation of this anaerobic bacterium and in order to help optimal use of A. muciniphila in clinical treatments of metabolic diseases, in this study we compared the effect of live and pasteurized A. muciniphila. Besides, we investigated the effects of this bacterium as the next generation of probiotics on obesity and management of diabetes.

Increasing prevalence of obesity over the past few decades constitutes a global health challenge. Recent evidence suggests that gut microbiota may contribute to weight control. So, the present study aimed at comparing the frequency of different bacteria in gut microbiota between obese and normal weight people in Iran.

Thirty normal weight (BMI of 18.5- 25 kg/m²) and 27 obese adults (BMI of 30 kg/m² or higher) were included in this case-control study. Dietary intake was assessed using food frequency questionnaire (FFQ). Anthropometric measurements and collection of blood and faecal samples were also done. Then, gut microbiota composition was assessed using quantitative real-time PCR.

The mean age of participants and concentrations of fasting blood glucose and insulin, insulin resistance index, triglyceride concentration and hsCRP were higher in obese group than the normal group (P<0.05). The frequency of Akkermansia was significantly higher in individuals with normal weight than obese individuals (P=0.003). On the other hand, the frequencies of Prevotella and Lactobacillus genera were higher in obese individuals (P>0.05).

In this study, the frequencies of some bacterial genera of intestinal microbiota were significantly different between obese and normal weight individuals. Therefore, population-based studies are needed to confirm current findings. Moreover, in order to achieve personalized medicine goals, information on gut microbiota composition could be helpful.

Extracellular vesicles, naturally released from all cell types including bacteria, are of great importance in medical microbiology due to transporting a variety of biomaterials, enzymes, and virulence factors, regulating immunity, and having roles in colonization and initiation of signaling pathways. These vesicles are also secreted from microbiota in the gastrointestinal tract and affect the host through various mechanisms by causing many systematic, metabolic, and physiological changes. Nowadays, the role of these vesicles is proven in maintaining gastrointestinal homeostasis, the pathogenesis, and diagnosis of related diseases such as obesity, diabetes, cancer, inflammatory bowel disease, mental disorders, and infectious diseases. Effective use of these characteristics could be possible by modulating the microbiota and its metabolites and using extracellular vesicles derived from probiotics. Therefore, the study of these vesicles as microbiota-derived products and next generation probiotics offers a new approach in clinical studies. The present study investigates how the microbiota-derived extracellular vesicles affect the hostchr('39')s health and play underlying roles in various diseases.