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[center][b][size=large]The natural healing force within is the greatest force in getting well. Let food be thy medicine.[/size][/b] [b]Hippocrates, circa 400 BC[/b][/center] [b]Preventing and Reversing Osteoporosis[/b] [1994] by Alan R. Gaby MD, MSc (biochem) provides insight into preventing and reversing atrial fibrotic remodeling, thus reversing, or avoiding, AF. In this important book Dr Gaby explains that [i]“bone is active, living tissue, continuously remodeling itself and constantly participating in a wide range of biochemical reactions. Bone tissue consists of both cells and an intercellular matrix. [b]Osteoblasts[/b] are the cells within bone involved in laying down new bone tissue. [b]Osteoclasts[/b], on the other hand, participate in breaking down of old or damaged bone (a process called [b]resorption[/b])”.[/i] If osteoclasts' resorption exceeds osteoblasts' building, bone quality will lessen (osteoporosis) [Dr. Alan R. Gaby biography, publications, more: http://www.doctorgaby.com/foreword.html ] Similar to bone, cardiac intercellular matrix, comprised largely of collagen fibers, is active, living tissue, continuously remodeling itself. [b]Fibroblasts[/b] are the cells within the intercellular matrix involved in laying down new collagen, while f[b]ibroclasts[/b] resorb collagen. If fibroblasts' collagen deposition exceeds fibroclasts' resorption, excessive collagen (fibrosis) may result, potentiating AF. All [b]-blast[/b] and [b]-clast[/b] cells perform their function via energy and [b]magnesium dependent enzymes[/b]. Chapter 5 of Dr. Gaby’s book is titled [b]Magnesium: The Mineral That “Does It All”[/b] and has this: [i]“As a cofactor in the production of ATP, the body’s basic unit of stored energy, magnesium participates in all energy dependent processes that take place in the body”[/i]. From [b]The Magnesium Factor[/b] (2003) by Mildred S. Seelig MD MPH and Andrea Rosanoff PhD [i]“Among the [b]enzymes[/b] that have been studied intensively, over 350 need [b]magnesium[/b], directly, to do their jobs. . .it is indirectly required for thousands of others”[/i]. [Drs. Seelig and Rosanoff bigraphys, more: http://www.magnesiumeducation.com/about-us ] It has long been understood that magnesium deficiency produces cardiac fibrosis, e.g. http://www.ncbi.nlm.nih.gov/pubmed/11585706 Free Radic Biol Med. [b]2001[/b] Oct 1;31(7):882-6. [b]Superoxide-mediated activation of cardiac fibroblasts by serum factors in hypomagnesemia[/b] Kumaran C, Shivakumar K. [b]Abstract[/b] [i]Magnesium deficiency is known to produce myocardial fibrosis in different animal models.[/i] (continue) An important related article by EP John Mandrola MD was presented to the forum on 4-19-'15 (thank you Jerry!): [b]Atrial Fibrillation Care: Put the Catheter (and Rx Pad) down[/b] http://www.afibbers.org/forum/read.php?9,150516 The last post in the thread links to four presentations at the 2011 European Society of Cardiology Congress in Paris, France. http://spo.escardio.org/SessionDetails.aspx?id=382825#.VWqAt1JGTkN Together they show clearly that atrial fibrosis, defined as excessive interstitial collagen, is the prime cause of AF. The second presentation is a good summary: [b]Proarrhythmic potential of fibrosis[/b] [b]-- What do we call fibrosis?[/b] Excessive collagen deposition. [b]-- The collagen network of the normal heart:[/b] - provides support. - maintains myocardial structure. - sustains the transmission of force. [b]-- Figure 1[/b] [depicts factors that stimulate fibroblast cells to deposit excessive collagen resulting in AF] [b]-- Etiology of fibrosis:[/b] - Reactive fibrosis: Secondary to overload, stretching. (potential reversibility) - Reparative fibrosis Induced by myocyte necrosis, apoptosis (no reversibility) - Multiple etiologies create different substrates and produce different pictures at the myocardium, and may coexist in the same heart. [b]-- Permanent arrhythmia creates fibrosis by itself, as in permanent AF.[/b] ================== [b]Related science:[/b] http://www.ncbi.nlm.nih.gov/pubmed/165801 Arkh Patol. [b]1975[/b];37(3):13-9. [b]Fibroblast-fibroclast: The ultrastructural mechanisms of resorption of collagen fibers in involution of the connective tissue[/b]. Article in Russian Shekhter AB, Milovanova ZP. [b]Abstract[/b] [i]Using various experimental models (postpartum involution of the uterus, resolution of a subcutaneous scar which replaced the collagen implant and connective-tissue capsule following the removal of a foreign body) and electron-microscopy and histochemical methods of investigation, intra- and extracellular resorption of the collagenous fibres was established. The main role in this process was played by fibroblasts which under these conditions could function as fibroclasts phagocyting and digesting in its cytoplasma collagenous fibrillas with the help of lysosomal [b]enzymes[/b]. Desintegration of fibroclasts, enriching the medium with these [b]enzymes[/b], stimulated the extracellular lysis of the collagenous fibrillas. This lysis was particularly intensive in the presence of an inflammatory process, and even could take place before the intracellular resorption. In macrophages no intracellular lysis was observed, however, they could phagocyte denaturated collagen, deprived of structural organization.[/i] http://www.ncbi.nlm.nih.gov/pubmed/490689 J Trauma. [b]1979[/b] Oct;19(10):744-56. [b]Ultrastructural evidence for the presence of "fibroclasts" and "myofibroclasts" in wound healing tissues.[/b] Baur PS Jr, Barratt GF, Brown GM, Parks DH. [b]Abstract[/b] [i]We have observed, by light and electron microscopy, fibroblast-like cells which appear to be involved in collagen fiber and filament degradation. These cells are most prominent in the dermis of mature hypertrophic scars which were clinically observed to be in the remodeling phase of wound repair. Total incorporation of collagen filaments within cellular vacuoles, as seen by TEM, appears to precede the [b]enzymatic degradation of the collagen[/b]. Cytoplasmic contractile bundles and/or collagen filament remnants found within residual lysosomes were also seen in many of these cells. Evidence of structural reorganization within the tissue was observed by means of SEM. These cells appear to be similar to osteoclasts in function: thus we propose to name them "fibroclasts" and "myofibroclasts."[/i] http://drsvenkatesan.wordpress.com/2009/09/06/lesser-known-areas-of-heart-the-cardiac-interstitium/ Expressions in Cardiology [b]Less Charted Areas of The Heart: The Cardiac Interstitium. Cardiac interstitial fibrosis. Amyloidosis[/b] September 6, 2009 by Dr S Venkatesan [i]Human body is made up of trillions of cells. Some of these cells are specialised and connected together to form various organs.The cells that connect each other provides the structural support and maintain the organ shape and function. Traditionally these supporting cells were thought to have little functional role. Now it is well recognised these cells could be as important as the myocytes or hepatocyte. God has never created any of the human cells without any purpose. They may have important paracrine function. Healthiness of these interstitial cells are vital for the intercellular communication, cell nutrition, and it’s proper function. These cells are called by various names, the old terminology could be the connective tissue -- the tissue that connects cells. Many times [b]fibroblasts[/b] is the common name given to all interstitial cells. Interstitium is not only filled with some bizarre mesenchymal cells, it is also a depot of sticky molecules. Now we have deeper knowledge about these, and identified various intercellular adhesion molecules, matrix metallo proteins, vitronectins, etc.. It is a great medical paradox: The specialised myocytes, hepatocytes, axonal cells are given due respect, while the role of cells and molecules that bind them together is least appreciated. In fact, in any given organ the functional cells constitute only one third of it’s weight. In the heart, myocytes form only 30% of it’s weight. It is a clear cut case of discriminating the majority ![/i] [continue to pictures, text, website http://drsvenkatesan.wordpress.com/2009/09/06/lesser-known-areas-of-heart-the-cardiac-interstitium/

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