17. Equality derives from the cure of the short circuit between the heart and the brain.

 (a) From Roman racism to Orthodox equality.

All humans suffer from this short-circuit “since all have sinned and fall short of the glory of God.” (Rom. 3:23) The difference among humans is not equality or inequality of race, but whether one is being cured or not. Within this context we have a complete reversal of the above foundation of the Hellenic paganism of the Roman Empire. The great struggle between paganism and Christianity in the time of Emperor Constantine the Great (306-337) is reflected in the difference between Roman Greeks (meaning Pagans) and Roman Christians. All Pagan Romans were defending their aristocratic ancient Hellenic identity and traditions which was being torn apart by the aristocratic identity of the cure of glorification which was open to all Romans, both gentis and non-gentis, and to all non-Romans.[ 66 ] The “Aristocracy” of Glorification is no respector of the aristocracy of birth.

(b) Examples of racism even in the theology of Pan-Germanism and Pan-Slavism.

Having conquered the West Romans the Franco-Latins called themselves the “gentis” and their Roman slaves “serfs” and “villains”. Pan-German ideology was clearly expressed to an extreme degree by the followers of Hitler who were out to enslave at least the Slavs. But a theological expression of this Germanic racism is found in Albert Schweitzer’s book, “The Quest Of The Historical Jesus.” For example, on the first page of Chapter I he claims that,

“When, at some future day, our civilization shall lie, closed and completed, before the eyes of later generations, German theology will stand out as a great, a unique phenomenon in the mental and spiritual life of our time. For nowhere save in the German temperament can there be found in the same perfection in the living complex of conditions and factors — of philosophic thought, critical acumen, historic insight, and religious feeling — without which no deep theology is possible.”

“And the greatest achievement of German theology is the critical investigation of the life of Jesus. What it has accomplished here has laid down the conditions and determined the course of the religious thinking of the future..”

“In the history of doctrine its work has been negative; it so to speak, cleared the site for the new edifice of religious thought. In describing how the ideas of Jesus were taken possession of by the Greek spirit, it was tracing the growth of what must necessarily become strange to us, and, as a matter of fact, has become strange to us.”[ 67 ]

All this has been done without the slightest knowledge of what glorification in the Lord (Yahweh) of Glory is (in both Old and New Testaments). This is ignored equally by both Germans and their Protestant and or ‘Catholic’ colleagues. Because of Augustine’s Neo-Platonism, both Protestants and Latins have always imagined that the Fathers of the Ecumenical Councils accepted both the analogia entis between God and His creation and analogia fidei between God and the Bible. This created not only their Biblical fundamentalism, but also made Greek philosophy the foundation of their understanding of the History of Dogma which is certainly not that of the reality of the Roman Ecumenical Councils. The reason for this is that Western Biblical and doctrinal scholars are ignorant of the Four Patristic Keys to the Bible and the Dogmas of the Roman Ecumenical Councils explained earlier. But even many “Orthodox” scholars follow either the Protestant or ‘Catholic’ scholars by “sniffing.”

Albert Schweitzer and his students saw clearly where their quest for the “historical Jesus” was leading, i.e. to the dissolution of the doctrinal fabric of what passes off as Christian Tradition in the Franco-Latin West. One typical Orthodox reaction has been to become proud that the Fathers of the Church had supposedly Hellenized Christianity thereby making it acceptable to the Hellenic mind of the Roman Empire.

The Slavophil branch of Pan-Slavism also believed that the Slavs understood the Bible better than other races. But the supposed reason for this is that among the Orthodox the Greco-Roman Fathers of the Church belong to the historical manifestation of the Kouchite movement in history, whereas the Slavs belong to the Iranian movement in history.[ 68 ] In other words the Slavic Orthodox are a superior brand of Christians than the Roman Fathers of the Church, not because they may have reached glorification, but simply because they are Slavs.[ 69 ]


18. Why Charlemagne wanted to believe that real Romans are Latins and Latin-speaking.

It is a fact that the Carolingian Franks wanted and decided to believe that the Romans were an Italo-Latin speaking race. Latin was beginning to be made the official language of the Franks. Their own language was a Teutonic Dialect. The tradition that the Romans were Latin and Latin speaking was invented within the Carolingian circles and became manifest in the year 794. In the Libri Carolini the Franks were still calling the Empire of New Rome the Imperium Romanum. But since 794 this same Empire begins to be called “Imperium Grecorum.” It must be emphasized that when this change took place the Franks were ignorant barbarians. Since Charlemagne himself was illiterate it is probable that the Saxon Alcuin, the director of his Palatine School, perhaps did some kind of research which convinced him that the Romans were a people who spoke Latin only. This would mean that the Greek language became a Roman language only because so many Greeks had become Romans in the course of Roman conquests. The Franks knew very well that the Romans in Southern Spain, Southern Gaul, Southern Italy were Greek-speaking. Even Rome itself had been a Greek-speaking city until Constantine moved the Roman Capital to Constantinople-New Rome. The void left by the so many Romans who moved to New Rome was filled mostly by Latin-speaking Romans. This obliged Pope Damasus to introduce Latin into the services of Rome. Italy had two Synods of bishops: the Northern Synod centered in Milan and the Synod of Rome whose members were all the bishops not only of the rest of Italy but the whole of the Balkans excepting Thrace which had been transferred to the Patriarchate of Constantinople.

The reason for this falsification was the Frankish need to convince their West Romans serfs and villains that their Emperor and fellow Romans in the East were nothing but a bunch of “Greeks” and “heretics.” The purpose was to cut off the West Romans from the East Romans who were still trying to help their fellow-Romans in the West enslaved to the Franco-Latins. But what about modern historians today? Why are they not better historians of Rome than their barbarian ancestors of the Dark Ages?

The last group of Latins of Roman history were created as part of the settlement between Rome and those Italians who revolted between 91-83 BC demanding Roman citizenship. A second group of Italians also revolted at the same time and fought for their complete independence from Rome. The first group was not given the Roman franchise, but the “Latin name.” The second group was simply defeated. This distinction between Roman and Latin citizens of Rome which resulted from this war was abolished by Emperor Caracala in 212 AD when he gave these Italian Latins the “Roman name.”

It is possible that the Merovingian Franks may have been given the “Latin name” as indicated by the fact that their gold coins bore the effigy of the Roman Emperors of Constantinople-New Rome from Anastasius I (491-518) through the reign of Heraclius (610-641). The latter’s rule coincided with his ally the Frankish King Dagobert I (d. 639). Together they fought the Bulgarians and Slavs.

The title of the Merovingian kings was “King of the Franks.” Dagobert’s reign was followed by the “do nothing kings,” evidently made that way by their Carolingian Mayors of the Palace who after the reign of Dagobert become the real rulers of the Roman Province of Gaul. It is significant that the name Francia is not once mentioned in Gregory of Tours’ “History of the Franks” since it remained the Roman Province named Gallia. In other words the Frankish King was the King of the Franks not the King of the Romans. The ruler of the West Romans was still the Emperor of the Romans in Constantinople-New Rome, especially after the West Roman Emperor disappeared in 476.

It is also possible that the Carolingian Franks may have been given the “Latin” name in conjunction with Pope Leo III’s (795-816) crowning Charlemagne “Emperor of the Romans” in 800. In any case we call the Teutonic Latins of the Middle Ages Franco-Latins in order to distinguish them from the Greek Latins who were Romans and the Italian Latins who became Romans in 212 AD. The Franks never became Romans, but rulers of the Romans. In sharp contrast to the Merovingian Franks, who were allies of New Rome, the Carolingian Franks literally hated the Romans. This is clear from the Libri Carolini, the Carolingian preface to Salic Law and Otto I’s Ambassador to New Rome Luitbrand of Cremona who revealed this same reality in his tirade against the very name “Roman,” which, according to him, all Franco-Latins use to insult their enemies.[ 70 ]Frankish hatred for Romans, and not dogma, was the basis of Charlemagne’s condemnation of Romans as “heretics” and “Greeks” at his Councils of Frankfurt in 794 and Aachen in 809. The main purpose of these titles, “heretic” and “Greek” was to teach the enslaved West Romans that the only Romania left was Papal Romania and their prayers for Romania and its Emperor should stop there.[ 71 ] The Franks began brainwashing their now subjected Roman revolutionaries into believing that this Romania of their Pope is all that exists since the rest of the Empire was a “heretical Grecia” somewhere in the East.

The second reason we use the term Franco-Latins is because the mostly Teutons in question looked upon Charlemagne as the founder of their Latin Empire and Civilization which its leaders believed was destined to rule the world. They call Charlemagne’s Empire the First Reich, Emperor Otto I’s (912-973) “Roman” Empire the Second Reich, while some of the Franco-Latin royalty and nobility considered Hitler’s (1889-1945) candidate Empire the “Third Reich.” In any case Charlemagne is considered the primary Father of today’s United Europe whose real purpose is to compete with the United States dollar for control of the world’s wealth.

One Orthodox nation, Greece, is part of today’s United Europe and a second one, Cyprus, is a candidate. Others want to follow. This means that United Europe is indeed becoming not only the real “Third Reich,” but also a Third Imperium Romanum, both combined into one. In such a case this State should be named “Franco-Romania” and its citizens Franco-Romans. This is a historical reality since almost all Europeans are descendants of either Franco-Latins or Romans. But this can become a reality only by the recognition of religion as a neurobiological sickness which divides people, according to the figments of their religious imaginations, into fanatic enclaves. This sickness is exactly what divides Europeans in the sphere of religion and to a certain degree in culture also.

It is also a reality that the prophets of the Old Testament and their students had been one of the sources of this tradition whereby religion was considered a sickness of man’s spirit in the heart and which is cured by the purification and illumination of the heart, as we shall see. This prophetic tradition was preserved by the Hasidim through the Hellenistic and Roman periods of Jewish history and preserved, as it seems, by them even up to our time.[ 72 ]

The very cure of the sickness of religion is what had been incorporated into the foundation of Constantine the Great’s New Rome in 330 AD However, this sickness and its cure has been forgotten by many Orthodox because of Peter the Great’s (1672-1725) Westernization of his Russian Orthodox Church. This was imposed as policy by Britain, France and Russian upon those nations which were created by Balkanization of the European part of the Ottoman Empire. This is why both the Vatican and most Protestants continue to believe dogmatically indeed, that the only key to relations with the Orthodox is the “way” of Tsar Peter. Both the Anglican and the Vatican Churches have specialists who follow Orthodox theological developments and carefully pick out those Orthodox “specialists” who follow such lines of convergence with the Augustinian tradition in order to promote them to key dialogue positions.[ 73 ]

In sharp contrast to Peter the Great’s policies, the Merovingian Franks, who ruled Gallo-Roman Christians were part of this tradition of the cure of the sickness of religion. Even the few Christian Lombards at the time belonged to this tradition.[ 74 ] However, this was never understood by the Carolingian Franks who made Augustine’s Neo-Platonism their religion (and sickness) in sharp contrast to the Merovingian Franks who witnessed and supported the condemnation of Augustine’s teaching about grace and original sin at the Council of Orange (529). The Carolingian doctrinal tradition began with this Platonism of Augustine which they never abandoned and which still dominates both Vaticanism and Protestantism. In other words both Western and Eastern Europeans must return to the unity they had in this cure of the sickness of religion under New Rome and the Merovingians in order to complete the current effort for European union. What is of interest is that many Jews still belong to this tradition of the cure. To speak of a separation between East and West is nonsense. In reality the separation is one between those who do not know that religion is a sickness and those who know that religion is a sickness and know its cure. Since one is speaking about a common disease of all humans one can not confine its cure only to a United Europe.

There are two keys to this study which may be distinguished but in reality are two faces of the same coin. For this reason we will deal with them together.

One key to this study is that religion is a neurobiological sickness. It stems from a short-circuit between the heart and the brain. The “spirit of man in the heart” should be spinning in a circle praying when in its normal state of communion with the uncreated glory (shekina), i.e. the uncreated “reign (basilea) of God.” This uncreated glory or reigning power of God is everywhere present saturating all of creation. Like the rest of creation all humans are already in communion with this glory’s creating, providential, ruling and even purifying energy at various levels. However, few go on to participating in the “illuminating” and “glorifying” energy of the “glory” of God. The reason for this is that “all have sinned and fall short of the glory of God. (Rom. 3:23)” The reason for this is that the “spirit” or the noetic faculty of each one usually begins to unfold itself out of its natural circular state during infancy into a straight line and sticks itself to the brain causing a short-circuit. In this way this “spirit” in infants, while always anchored in the heart, becomes enslaved by means of the brain to the shortcomings of its parents and its general environment since all thoughts in the brain originate thence.

It seems that the reason why neurologists have not yet found a center for religion in the brain, as far as I know, is that it resides in this short-circuit between the heart and the brain and not in the brain itself. It is this short-circuit which creates the fantasies of religious convictions, as well as other signs of a disorded mind, from mild to serious, including acute criminality and barbarism.

The second key to this study is the phenomenon of deliberate falsification of history as part of the enslavement of others. It is generally agreed, even by the Franco-Latin nobility, that the civilization of the Roman Empire was Hellenic in its inception. But this same nobility claims that this Romano-Hellenic Civilization changed into a Western Civilization in the 8-9th centuries in Western Europe and into a Byzantine Civilization in the East at about the same time. But what had really happened was that the Franco-Latins had reverted to a period of sheer barbarity under the leadership of the Carolingian Franks which up until recently was still being called the “Dark Ages.” How else can one describe France, for example, in 1789 when 85% of her population were still serfs and villains guarded from escape by 40,000 castles.[ 75 ] How can such a France be better described than part of the Dark Ages. It can, of course, be made to look like a civilized society only when history is controlled by the aristocracy and the middle class of 13% which still keep this so-called “free” 85% in abject slavery to history as written by themselves.[ 76 ]

So that we may not be accused of exaggerations we quote a description of the condition of the serfs of France before the French Revolution written by Germaine de Stael, the daughter of Jacques Necker (1732-1804) the finance minister of Louis XVI. She writes, “Young people and strangers who had not known France before the revolution, and today see the people enriched by the division of properties and the suppression of the tithe and the feudal regime, can have no idea of the condition of this country, when the nation was carrying the weight of all the privileges. The supporters of slavery in the colonies have often said that a peasant in France was more unfortunate than an Negro. This was an argument to comfort the whites, but not to harden them against the blacks.”[ 77 ]

From this viewpoint the real beginning of Western Civilization is the American Revolution of 1775-81 which was completed by the abolition of slavery in 1865. The French Revolution of 1789 was also a beginning of Western Civilization since it immediately liberated the serfs and villains from their captivity to the 40,000 castles which the peasants enjoyed burning together with their castellani inhabitants. But democracy itself was squelched by Napoleon in 1800. After he fell from power the rest of the nobility returned from mostly self-imposed exile. Both the Napoleonists and the other royalists got down to work and re-enslaved the 85% of Gallo-Romans. Of course they were no longer called serfs and villains. However, they are still called “peasants” (paysan) which had been the collective name for the “serfs” and “villains” before the revolution. Now all Gallo-Roman children are being brainwashed by the comic figure “Asterix” into believing that they are the “Celts” who were enslaved to the Romans as though they were not Gallo-Roman citizens during Imperial and Merovingian times. It was the ancestors of these children now being brainwashed by “Asterix” who are the descendants of the 85% of Gallo-Roman serfs and villains liberated in 1789.

The leaders of the falsification of history today are the nobilities of France, England and Russia. What these nobilities had been losing in battle and politics has been gradually recouped by their progressive re-writing of history. One of their greatest successes has been creating a partnership between the Encyclopaedia Britannica and naïve Chicago University in order to put it into every American home. It has been transforming the way Americans think about so many aspects of historical reality into conformity with the interests of European nobility. The basic reason for their success is that it is easier for Americans doing historical research to copy English scholars rather than learn the sources themselves which are in a wide range of languages. Americans in general could never suspect that scholars of such prestigious Universities as Oxford and Cambridge and British professors teaching in American Universities are capable of deliberately shading or even falsifying historical reality in support of their class interests. After all isn’t Charlemagne still their Great Father?

Being misled, as it seems, by their first teacher, the Anglo-Saxon Alcuin, the Carolingians came to believe that the ancient Romans spoke Latin and were therefore Latins. As we already saw it was the Latins who were absorbed into the Roman nation. Also the first language of the Romans was Greek because they were simply Greeks who came to Italy as a result of the War between Trojan Greeks and the Achaean Greeks. What is even more interesting is that the basic reason the Latins refused to become Romans before they were conquered by King Ancus Marcius is that the Latins considered the Romans impure Greeks because they had intermarried with the Sabines who were also Greeks, but not pure Greeks. The Latin General Mettius Fufetius argues with the Roman King Tullus Hostius that “…if we should yield the command to you, the base born will rule over the true born, the barbarians over Greeks, and immigrants over the native born.”[ 78 ]

In sharp contrast to this historical reality the Franks believed that the Roman Emperor Constantine the Great (306-337) had abandoned the Latin language and tradition in favor of the Greek language and tradition when he moved his capital from Rome to New Rome officially in 330. This nonsense was clearly argued by Emperor Louis II (855-875) against Emperor Basil I (867-886) in 871.[ 79 ] The falsification of Roman history in question has become the power base of the Franco-Latin nobility’s ability of ruling so many millions of Romans by means of their ignorance of their true identity and why they are not really members of the ruling class.

Since religion had been one of the determining factors in this change we shall concentrate a bit here. Under the weight of Augustine Franco-Latin Christianity became one of the barbaric forms of religion and one of the clearest manifestations of the sickness of religion. At the very same time the Roman Empire in the East had continued to promote this cure of the sickness of religion. The very foundation of the Dark Ages was the cultivation of the short-circuit between the brain and the heart which is the basis of the sickness of religion. At this very same time the Roman Empire in the East was still concentrating on the cure of this short circuit between the brain and the heart among its citizens, being guided by monasticism which had become the center of this cure. In sharp contrast Franco-Latin monasticism was mere Augustinian Neo-Platonic mysticism in Christian dress. This is exactly what much of Protestantism rejected during the Reformation. A basic reason why many Orthodox do not see this any more is that they follow the Franco-Latin translation of the Patristic term Secret Theology by Mystical Theology. Secret Theology simply means that the uncreated glory of God seen in glorification has no similarity whatsoever to anything created and therefore cannot be described or expressed in words or concepts. Mystical Theology means union with the so-called archetypes of creation in God which is an “invention of demons” according to the Orthodox Fathers, as we shall see. Words and concepts may lead to glorification in which one sees in not seeing since it is the uncreated glory which sees itself by means of the glorified. There is here no liberation of a soul from a body since the individual, body and soul, and everything in sight is saturated by uncreated glory of God dividing itself without division and is everywhere present.

In order to make the function of this short-circuited “spirit” in the heart more intelligible to the Hellenic mind the Fathers of the early Church called it also by the Greek termnoera energeia which we translate noetic energy or noetic faculty. Of the three Greek terms for rational activity, i.e. nous, dianoiaand logos, the Fathers used nous to designate the “spirit” of man which prays in the heart without ceasing when restored to normal. In this way they accorded this spirit in the heart a reality equal to the brain. The original use of this praying spirit is to be found in St. Paul. “I will pray with the spirit, but I will also pray with the intellect. I will recite psalms with the spirit, but I will also recite psalms with the intellect (nous)” 1 Cor. 14:14. These are the Old Testament psalms being recited quietly in the heart and not the strange sounds being passed off today as “speaking in tongues” by the aid of a translator.

The cure of this short-circuit which causes the sickness of religion is the key to both the Old and New Testaments. Within this context such titles as Christian, Jew, Moslem, heretic, Orthodox, Catholic, Protestant, atheist, infallible Pope, etc., are in reality meaningless when this sickness of religion and its cure is ignored and sometimes accompanied with phenomenal pretensions and even with barbaric conduct. The center stage in the cure of this sickness is held by the prophets of both the Old and the New Testaments and their successors, who having been cured themselves guide others in this same process of cure. If one does not know this cure, yet fancies himself, or is fancied by others, to be inspired by God, he is indeed inspired, but only by his own short-circuit.

That quite a few religions have been historically dangerous to the liberty of the individual and to the proper functioning of society is obvious enough and must be handled accordingly. More recently the communists had handled religion as a psychological and social problem and tried to uproot it by means not very democratic. In contrast to such approaches the prophets of the Old and New Testaments practiced a concrete cure of the sickness of religion which the Roman Empire espoused in order to produce normal citizens who would put the common good and neighbor over self at the center of individual efforts. Most Jews and Christians are no longer aware of this short-circuit let alone its cure. In contrast the leaders of the Roman Empire had become very much aware of this sickness and cure and incorporated it into its administration, exactly as modern medicine is being supported by governments today.


by ©John S. Romanides


[ 66 ] See my “Romanity, Romania, Rumeli.” (in Greek), Thessaloniki 1975.

[ 67 ] Albert Schweitzer, “The Quest of the Historical Jesus”, New York; A. and C. Black, 1910. Pg. 1.

[ 68 ] John S. Romanides, “Orthodox Ecclesiology According to Alexis Khomiakov (1804-1860), The Greek Orthodox Theological Review, vol.11, no. 1, 1956, pp. 58 ff.

[ 69 ] This is why Father Georges Florovsky attacked the theology of the Slavophiles whose modern supporters finally retaliated by getting him fired as dean of St. Vladimir’s Seminary.

[ 70 ] John S. Romanides, “Franks, Romans, Feudalism and Doctrine, an interplay between Theology and Society,” Holy Cross Orthodox Press 1981, p. 27.

[ 71 ] All Orthodox Christians, including the Irish, were praying for their Imperium Romanum. G. Every, “The Byzantine Patriarchate, 451-1204,” London 1947, p.114.

[ 72 ] This was discovered during a dialogue meeting between Orthodox Christians and Jews in Bucharest, October 1979.

[ 73 ] This is how the first General Secretary of the World Council of Churches, a Dutch Calvinist, dumped Father G. Florovsky as the natural leader of the Orthodox in dialogue in favor of Prof. N. Nissiotis. The latter had promised “to perform a marriage between John Calvin and the Orthodox Fathers” as the key to the union of the Churches.

[ 74 ] John S. Romanides, Ibid., pp. 53-57.

[ 75 ] Louis Madelin, La Revolution, Deuxieme Edition, Paris 1912, p. 74.

[ 76 ] For these population figures see the edition of Germaine de Stael’s book, Considerations Sur La Revolution Fancaise, par Tallandier, Paris 1881, p. 610. Jacques Godechot who prepared the reedition of this book cites J. Dupaquiers, La population francais aux XVII et XVIII siecles, Paris (Que sais-Je?) 1979.

[ 77 ] Ibid, p. 96.

[ 78 ] Dionysius of Halicarnassus, Roman Antiquities, III, 10, 3-5.

[ 79 ] Ibid, pp. 17-18.

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[1] Περὶ μὲν τῆς ἱερῆς νούσου καλεομένης ὧδʹ ἔχει· οὐδέν τί μοι δοκέει τῶν ἄλλων θειοτέρη εἶναι νούσων οὐδὲ ἱερωτέρη, ἀλλὰ φύσιν μὲν ἔχει ἣν καὶ τὰ λοιπὰ νουσήματα, ὅθεν γίνεται. Φύσιν δὲ αὐτῇ καὶ πρόφασιν οἱ ἄνθρωποι ἐνόμισαν θεῖόν τι πρῆγμα εἶναι ὑπὸ ἀπειρίης καὶ θαυμασιότητος, ὅτι οὐδὲν ἔοικεν ἑτέρῃσι νούσοισιν· καὶ κατὰ μὲν τὴν ἀπορίην αὐτοῖσι τοῦ μὴ γινώσκειν τὸ θεῖον αὐτῇ διασώζεται, κατὰ δὲ τὴν εὐπορίην τοῦ τρόπου τῆς ἰήσιος ᾧ ἰῶνται, ἀπόλλυται, ὅτι καθαρμοῖσί τε ἰῶνται καὶ ἐπαοιδῇσιν. Εἰ δὲ διὰ τὸ θαυ‐ μάσιον θεῖον νομιεῖται, πολλὰ τὰ ἱερὰ νουσήματα ἔσται καὶ οὐχὶ ἓν, ὡς ἐγὼ ἀποδείξω ἕτερα οὐδὲν ἧσσον ἐόντα θαυμάσια οὐδὲ τερατώδεα, ἃ οὐδεὶς νομίζει ἱερὰ εἶναι. Τοῦτο μὲν γὰρ οἱ πυρετοὶ οἱ ἀμφημερινοὶ καὶ οἱ τριταῖοι καὶ οἱ τεταρταῖοι οὐδὲν ἧσσόν μοι δοκέουσιν ἱεροὶ εἶναι καὶ ὑπὸ θεοῦ γίνεσθαι ταύτης τῆς νούσου, ὧν οὐ θαυμασίως γʹ ἔχουσιν· τοῦτο δὲ ὁρέω μαινομένους ἀνθρώπους καὶ παρα‐ φρονέοντας ἀπὸ μηδεμιῆς προφάσιος ἐμφανέος, καὶ πολλά τε καὶ ἄκαιρα ποιέοντας, ἔν τε τῷ ὕπνῳ οἶδα πολλοὺς οἰμώζοντας καὶ βοῶντας, τοὺς δὲ πνιγομένους, τοὺς δὲ καὶ ἀναΐσσοντάς τε καὶ φεύγοντας ἔξω καὶ παραφρονέοντας μέχρις ἂν ἐπέγρωνται, ἔπειτα δὲ ὑγιέας ἐόντας καὶ φρονέοντας ὥσπερ καὶ πρότερον, ἐόντας τʹ αὐτέους ὠχρούς τε καὶ ἀσθενέας, καὶ ταῦτα οὐχ ἅπαξ, ἀλλὰ πολλάκις, ἄλλα τε πολλά ἐστι καὶ παντοδαπὰ ὧν περὶ ἑκάστου λέγειν πουλὺς ἂν εἴη λόγος. Ἐμοὶ δὲ δοκέουσιν οἱ πρῶτοι τοῦτο τὸ νόσημα ἀφιερώσαντες τοιοῦτοι εἶναι ἄνθρωποι οἷοι καὶ νῦν εἰσι μάγοι τε καὶ καθάρται καὶ ἀγύρται καὶ ἀλαζόνες, ὁκόσοι δὴ προσποιέονται σφόδρα θεοσεβέες εἶναι καὶ πλέον τι εἰδέναι.

Οὗτοι τοίνυν παραμπεχόμενοι καὶ προβαλλόμενοι τὸ θεῖον τῆς ἀμηχανίης τοῦ μὴ ἴσχειν ὅ τι προσενέγκαντες ὠφελήσουσιν, ὡς μὴ κατάδηλοι ἔωσιν οὐδὲν ἐπιστάμενοι, ἱερὸν ἐνόμισαν τοῦτο τὸ πάθος εἶναι, καὶ λόγους ἐπιλέξαντες ἐπιτηδείους τὴν ἴησιν κατεστήσαντο ἐς τὸ ἀσφαλὲς σφίσιν αὐτοῖσι, καθαρμοὺς προσφέροντες καὶ ἐπαοιδὰς, λουτρῶν τε ἀπέχεσθαι κελεύοντες καὶ ἐδεσμάτων πολλῶν καὶ ἀνεπιτηδείων ἀνθρώποισι νοσέουσιν ἐσθίειν, θαλασσίων μὲν τρίγλης, μελανούρου, κεστρέος, ἐγχέλυος (οὗτοι γὰρ οἱ ἰχθύες εἰσὶν ἐπικαιρότατοι), κρεῶν δὲ αἰγείου καὶ ἐλάφων καὶ χοιρίων καὶ κυνὸς (ταῦτα γὰρ κρεῶν ταρακτικώτατά ἐστι τῆς κοιλίης), ὀρνίθων δὲ ἀλεκτρυόνος καὶ τρυγόνος καὶ ὠτίδος, ἔτι δὲ ὅσα νομίζεται ἰσχυρότατα εἶναι, λαχάνων δὲ μίνθης, σκορόδου καὶ κρομύου (δριμὺ γὰρ ἀσθενέοντι οὐδὲν ξυμφέρει), ἱμάτιον δὲ μέλαν μὴ ἔχειν (θανατῶδες γὰρ τὸ μέλαν), μηδὲ ἐν αἰγείῳ κατακέεσθαι δέρματι μηδὲ φορέειν, μηδὲ πόδα ἐπὶ ποδὶ ἔχειν, μηδὲ χεῖρα ἐπὶ χειρὶ (ταῦτα γὰρ πάντα κωλύματα εἶναι). Ταῦτα δὲ πάντα τοῦ θείου εἵνεκεν προστιθέασιν, ὡς πλέον τι εἰδότες καὶ ἄλλα; προφάσιας λέγοντες, ὅκως, εἰ μὲν ὑγιὴς γένοιτο, αὐτῶν ἡ δόξα εἴη καὶ ἡ δεξιότης, εἰ δὲ ἀποθάνοι, ἐν ἀσφαλεῖ καθισταῖντο αὐτῶν αἱ ἀπολογίαι καὶ ἔχοιεν πρόφασιν ὡς οὐκ αἴτιοί εἰσιν αὐτοὶ, ἀλλʹ οἱ θεοί· οὔτε γὰρ φαγέειν οὔτε πιέειν ἔδοσαν φάρμακον οὐδὲν, οὔτε λουτροῖσι καθήψησαν, ὥστε δοκέειν αἴτιον εἶναι. Ἐγὼ δὲ δοκέω Λιβύων τῶν τὴν μεσόγειον οἰκεόντων οὐδένα ὑγιαίνειν, ὅτι ἐν αἰγείοισι δέρμασι κατακέονται καὶ κρέασιν αἰγείοισι χρῶνται, ἐπεὶ οὐκ ἔχουσιν οὔτε στρῶμα οὔτε ἱμάτιον οὔτε ὑπόδημα ὅ τι μὴ αἴγειόν ἐστιν· οὐ γάρ ἐστιν αὐτοῖς ἄλλο προβάτιον οὐδὲν ἢ αἶγες καὶ βόες.

Εἰ δὲ ταῦτα προσφερό [1.51] μενα καὶ ἐσθιόμενα τὴν νοῦσον τίκτει τε καὶ αὔξει καὶ μὴ ἐσθιόμενα ἰῆται, οὐκ ἐστὶν ἄρα ὁ θεὸς αἴτιος οὐδενὸς, οὐδὲ οἱ καθαρμοὶ ὠφελέουσιν, ἀλλὰ τὰ ἐδέσματα τὰ ἰώμενά ἐστι καὶ τὰ βλάπτοντα, τοῦ δὲ θείου ἀφανίζεται ἡ δύναμις. Οὕτως οὖν ἔμοιγε δοκέουσιν οἵτινες τούτῳ τῷ τρόπῳ ἐγχειρέουσιν ἰῆσθαι ταῦτα τὰ νοσήματα, οὔτε ἱερὰ νομίζειν εἶναι οὔτε θεῖα· ὅκου γὰρ ὑπὸ καθαρμῶν τοιούτων μετάστατα γίνεται καὶ ὑπὸ θεραπείης τοιῆσδε, τί κωλύει καὶ ὑφʹ ἑτέρων τεχνημάτων ὁμοίων τούτοισιν ἐπιγίνεσθαι τοῖσιν ἀνθρώποισι καὶ προσπίπτειν; ὥστε μηκέτι τὸ θεῖον αἴτιον εἶναι, ἀλλά τι ἀνθρώπινον. Ὅστις γὰρ οἷός τε περικαθαίρων ἐστὶ καὶ μαγεύων ἀπάγειν τοιοῦτον πάθος, οὗτος κἂν ἐπάγοι ἕτερα τεχνησάμενος, καὶ ἐν τούτῳ τῷ λόγῳ τὸ θεῖον ἀπόλλυται. Τοιαῦτα λέγοντες καὶ μηχανεύμενοι προσποιέονται πλέον τι εἰδέναι, καὶ ἀνθρώπους ἐξαπατέουσι προστιθέμενοι τούτοισιν ἁγνείας τε καὶ καθαρότητας, ὅ τε πουλὺς αὐτοῖσι τοῦ λόγου ἐς τὸ θεῖον ἀφήκει καὶ τὸ δαιμόνιον.

Καίτοι ἔμοιγε οὐ περὶ εὐ‐ σεβείης δοκέουσι τοὺς λόγους ποιέεσθαι, ὡς οἴονται, ἀλλὰ περὶ δυσσεβείης μᾶλλον, καὶ ὡς οἱ θεοὶ οὐκ εἰσὶ, τό τε εὐσεβὲς καὶ θεῖον αὐτῶν ἀσεβὲς καὶ ἀνόσιόν ἐστιν, ὡς ἐγὼ διδάξω. Εἰ γὰρ σελήνην τε καθαιρέειν καὶ ἥλιον ἀφανίζειν καὶ χειμῶνά τε καὶ εὐδίην ποιέειν καὶ ὄμβρους καὶ αὐχμοὺς καὶ θάλασσαν ἄφορον καὶ γῆν καὶ τἄλλα τὰ τοιουτότροπα πάντα ὑποδέχονται ἐπίστασθαι, εἴτε καὶ ἐκ τελετέων εἴτε καὶ ἐξ ἄλλης τινὸς γνώμης ἢ μελέτης φασὶν ταῦτα οἷόν τʹ εἶναι γενέσθαι οἱ ταῦτʹ ἐπιτηδεύοντες, δυσσεβέειν ἔμοιγε δοκέουσι καὶ θεοὺς οὔτε εἶναι νομίζειν οὔτʹ ἐόντας ἰσχύειν οὐδὲν οὔτε εἴργε σθαι ἂν οὐδενὸς τῶν ἐσχάτων, ὧν ποιέοντες πῶς οὐ δεινοὶ αὐτοῖσίν εἰσιν; εἰ γὰρ ἄνθρωπος μαγεύων τε καὶ θύων σελήνην τε καθαιρήσει καὶ ἥλιον ἀφανιεῖ καὶ χειμῶνα καὶ εὐδίην ποιήσει, οὐκ ἂν ἔγωγέ τι θεῖον νομίσαιμι τούτων εἶναι, ἀλλʹ ἀνθρώπινον, εἰ δὴ τοῦ θείου ἡ δύναμις ὑπὸ ἀνθρώπου γνώμης κρατέεται καὶ δεδούλωται. Ἴσως δὲ οὐχ οὕτως ἔχει ταῦτα, ἀλλʹ ἄνθρωποι βίου δεόμενοι πολλὰ καὶ παντοῖα τεχνέονται καὶ ποικίλλουσιν ἔς τε τἄλλα πάντα καὶ ἐς τὴν νοῦσον ταύτην, ἑκάστῳ εἴδει τοῦ πάθεος θεῷ τὴν αἰτίην προστιθέντες. Οὐ γὰρ καθάπαξ, ἀλλὰ πλεονάκις ταῦτα μέμνηνται· κἢν μὲν γὰρ αἶγα μιμῶνται, κἢν βρύχωνται, κἢν τὰ δεξιὰ σπῶνται, μητέρα θεῶν φασὶν αἰτίην εἶναι.

Ἢν δὲ ὀξύτερον καὶ εὐτονώτερον φθέγγηται, ἵππῳ εἰκάζουσι, καὶ φασὶ Ποσειδῶνα αἴτιον εἶναι. Ἢν δὲ καὶ τῆς κόπρου τι παρέῃ, ὃ πολλάκις γίνεται ὑπὸ τῆς νούσου βιαζομένοισιν, Ἐνοδίου πρόσκειται ἡ προσωνυμίη· ἢν δὲ λεπτότερον καὶ πυκνότερον, οἷον ὄρνιθες, Ἀπόλλων νόμιος. Ἢν δὲ ἀφρὸν ἐκ τοῦ στόματος ἀφίῃ καὶ τοῖσι ποσὶ λακτίζῃ, Ἄρης τὴν αἰτίην ἔχει. Ὁκόσα δὲ δείματα νυκτὸς παρίσταται καὶ φόβοι καὶ παράνοιαι καὶ ἀναπηδήσιες ἐκ τῆς κλίνης καὶ φόβητρα καὶ φεύξιες ἔξω, Ἑκάτης φασὶν εἶναι ἐπιβολὰς καὶ ἡρώων ἐφόδους. Καθαρμοῖσί τε χρέονται καὶ ἐπαοιδῇσι, καὶ ἀνοσιώτατόν γε καὶ ἀθεώτατον ποιέουσιν, ὡς ἔμοιγε δοκέει, τὸ θεῖον· καθαίρουσι γὰρ τοὺς ἐχομένους τῇ νούσῳ αἵματί τε καὶ ἄλλοισι τοιούτοισιν ὥσπερ μίασμά τι ἔχοντας, ἢ ἀλάστορας, ἢ πεφαρμαγμέ‐ νους ὑπὸ ἀνθρώπων, ἤ τι ἔργον ἀνόσιον εἰργασμένους, οὓς ἐχρῆν τἀναντία τούτοισι ποιέειν, θύειν τε καὶ εὔχεσθαι καὶ ἐς τὰ ἱερὰ φέροντας ἱκετεύειν τοὺς θεούς· νῦν δὲ τούτων μὲν ποιέουσιν οὐδὲν, καθαίρουσι δέ. Καὶ τὰ μὲν τῶν καθαρμῶν γῇ κρύπτουσι, τὰ δὲ ἐς θάλασσαν ἐμβάλλουσι, τὰ δὲ ἐς τὰ οὔρεα ἀποφέρουσιν, ὅπη μηδεὶς ἅψεται μηδὲ ἐπιβήσεται· τὰ δʹ ἐχρῆν ἐς τὰ ἱερὰ φέροντας τῷ θεῷ ἀποδοῦναι, εἰ δὴ θεός γέ ἐστιν αἴτιος. Οὐ μέντοι ἔγωγε ἀξιῶ ὑπὸ θεοῦ ἀνθρώπου σῶμα μιαίνεσθαι, τὸ ἐπικηρότατον ὑπὸ τοῦ ἁγνοτάτου· ἀλλὰ κἢν τυγχάνῃ ὑπὸ ἑτέρου μεμιασμένον ἤ τι πεπονθὸς, ἐθέλοι ἂν ὑπὸ τοῦ θεοῦ καθαίρεσθαι καὶ ἁγνίζεσθαι μᾶλλον ἢ μιαίνεσθαι.

Τὰ γοῦν μέγιστα τῶν ἁμαρτημάτων καὶ ἀνοσιώτατα τὸ θεῖόν ἐστι τὸ καθαῖρον καὶ ἁγνίζον καὶ ῥύμμα γινόμενον ἡμῖν, αὐτοί τε ὅρους τοῖσι θεοῖσι τῶν ἱερῶν καὶ τῶν τεμενέων ἀποδεικνύμενοι, ὡς ἂν μηδεὶς ὑπερβαίνῃ ἢν μὴ ἁγνεύῃ, εἰσιόντες τε ἡμεῖς περιῤῥαινόμεθα οὐχ ὡς μιαινόμενοι, ἀλλʹ εἴ τι καὶ πρότερον ἔχομεν μύσος, τοῦτο ἀφαγνιούμενοι. Καὶ περὶ μὲν τῶν καθαρμῶν οὕτω μοι δοκέει ἔχειν. [2] Τὸ δὲ νούσημα τοῦτο οὐδέν τί μοι δοκέει θειότερον εἶναι τῶν λοιπῶν, ἀλλὰ φύσιν μὲν ἔχει ἣν καὶ τὰ ἄλλα νουσήματα, καὶ πρόφασιν ὅθεν ἕκαστα γίνεται· φύσιν δὲ τοῦτο καὶ πρόφασιν ἀπὸ ταὐτοῦ τὸ θεῖον γίνεσθαι ἀφʹ ὅτου καὶ τἄλλα πάντα, καὶ ἰητὸν εἶναι, καὶ οὐδὲν ἧσσον ἑτέρων, ὅ τι ἂν μὴ ἤδη ὑπὸ χρόνου πολλοῦ καταβεβιασμένον ἔῃ, ὥστε ἤδη εἶναι ἰσχυρότερον τῶν φαρμάκων τῶν προσφερομένων. Ἄρχεται δὲ ὥσπερ καὶ τἄλλα νουσήματα κατὰ γένος· εἰ γὰρ ἐκ φλεγματώδεος φλεγματώδης, καὶ ἐκ χολώδεος χολώδης γίνεται, καὶ ἐκ φθινώδεος φθινώδης, καὶ ἐκ σπληνώδεος σπληνώδης, τί κωλύει ὅτῳ πατὴρ καὶ μήτηρ εἴχετο, τούτῳ τῷ νοσήματι καὶ τῶν ἐκγόνων ἔχεσθαί τινα; ὡς ὁ γόνος ἔρχεται πάντοθεν τοῦ σώματος, ἀπό τε τῶν ὑγιηρῶν ὑγιηρὸς, ἀπό τε τῶν νοσερῶν νοσερός. Ἕτερον δὲ μέγα τεκμήριον ὅτι οὐδὲν θειότερόν ἐστι τῶν λοιπῶν νουσημάτων· τοῖσι γὰρ φλεγματώδεσι φύσει γίνεται· τοῖσι δὲ χολώδεσιν οὐ προσπίπτει· καίτοι εἰ θειότερόν ἐστι τῶν ἄλλων, τοῖσιν ἅπασιν ὁμοίως ἔδει γίνεσθαι τὴν νοῦσον ταύτην, καὶ μὴ διακρίνειν μήτε χολώδεα μήτε φλεγματώδεα.



(ed. E. Littre, Paris 1849)

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Brothels, Baths and Babes  Prostitution in the Byzantine Holy Land

Graeco-Roman domestic sexuality rested on a triad: the wife, the concubine and the courtesan. The fourth century BC Athenian orator Apollodoros made it very clear in his speech Against Neaira quoted by Demosthenes (59.122) that ‘we have courtesans for pleasure, and concubines for the daily service of our bodies, but wives for the production of legitimate offspring and to have reliable guardians of our household property’. Whatever the reality of this domestic set-up in daily life in ancient Greece,[2] this peculiar type of ‘ménage à trois’ pursued its course unhindered into the Roman period: monogamy de jure appears to have been very much a façade for polygamy de facto.[3] The advent of Christianity upset this delicate equilibrium. By forbidding married men to have concubines on pain of corporal punishment, canon law elaborated at Church councils took away from this triangular system one of its three components.[4] Henceforth, there remained only the wife and the courtesan.

If we are to believe the Lives of the holy monks of Byzantine Palestine, the Holy Land (in particular the Holy City of Jerusalem, the aim of pilgrimages at the very heart of Christianity) was replete with ‘abodes of lust’ and prostitutes tracked down the monks in their secluded caves near the River Jordan. Thus, we are faced with a paradox: the coexistence of holiness and debauchery, of Christian asceticism and lust. Lest we forget that virtue is meaningless without vice, that holiness cannot exist without lewdness, a fifth century AD Gnostic hymn from Nag-Hammadi in Middle Egypt proclaimed: ‘I am She whom one honours and disdains. / I am the Saint and the prostitute. / I am the virgin and the wife. / I am knowledge and I am ignorance. / I am strength and I am fear. / I am Godless and I am the Greatness of God’.

In the Old Testament, Jerusalem appeared as a Prostitute in dire need of purification through divine punishment (Ez. 16 and 23). Her degradation contrasted with her original faithfulness: ‘How the faithful city has become a harlot, she that was full of justice!’, the prophet Isaiah (1:21) lamented. St John applied the epithet Prostitute ‘clothed in fine linen, in purple and scarlet, bedecked with gold, with jewels, and with pearls!’ (Rev. 18.16-17) to the idol-worshipping Great City, Babylon, Rome and ultimately to any great urban concentration. A similar opinion was held by the rabbis of the Babylonian Talmud in the fifth century AD who considered that a bachelor who succeeded in remaining chaste in a large city was without any doubt an excessively pious man. Likewise, the monks of Nitria (modern Wadi Natrun), of the Kellia and of Scetis in Egypt and those of the Judaean Desert in Palestine, considered that the city was par excellence a den of iniquity, of temptation and of sin. Harbours with international maritime trade links such as Alexandria and Beirut, and the universal Christian capital Jerusalem, both provided their innkeepers and harlots with a cosmopolitan clientèle of residents, travellers and pilgrims.

Free prostitution

In the streets

Byzantine erotic epigrams, notably those of Agathias Scholasticus in the sixth century, generally describe encounters with prostitutes in the street.[5] The winding, dark alleyways of the Old City of Jerusalem were particularly appropriate for soliciting by scortae erraticae or ambulatrices. These lurked under the high arches which bridged the streets of the Holy City and walked up and down the cardo maximus. In the small towns of Roman and Byzantine Palestine, however, it seems that the squares (not the streets) were the favourite hunting-grounds of prostitutes. Rabbi Judah observed: “‘How fine are the works of this people [the Romans] ! They have made streets, they have built bridges, they have erected baths !’. Rabbi Yose was silent. Rabbi Simeon ben Yohai answered and said, ‘All what they made, they made for themselves; they built market-places, to set harlots in them; baths to rejuvenate themselves; bridges to levy tolls for them'” (Babylonian Talmud, Shabbat 33b).

At home

Some harlots worked at home, either on their own account, such as Mary the Egyptian whose Life was written down in the sixth century by Sophronios, the last Patriarch of Jerusalem before the Arab Conquest, or for a pimp. On the evidence of the legislation of Emperor Justinian in the mid-sixth century, in particular Novella 14 of 535, it is clear that providing housing was part of the deal which the pimps of Constantinople struck with the fathers of the young peasant girls whom they bought in the capital’s hinterland. Housing did not necessarily mean a house, and was frequently only a shack, hut or room. Byzantine prostitutes were relegated to ‘red light districts’ in the same way that the prostitutes of Rome lived and worked predominantly in Subura and near the Circus Maximus, thus to the north and south of the Forum. In the late sixth-century Life of John the Almsgiver, Patriarch of Alexandria, Leontios of Neapolis describes a monk coming to Tyre on some errand. As he passed through ‘the place’, he was accosted by a prostitute who cried out: ‘Save me, Father, like Christ saved the harlot’, this referring to Luke 7:37. These districts were generally the most destitute areas in town. The Babylonian Talmud (Pesahim 113b) relates how Rabbi Hanina and Rabbi Hoshaia, both poor cobblers in the Land of Israel, dwelt in a street of harlots for whom they made shoes. The prostitutes were so impressed by these rabbis’ chastity (for they would not even lift their eyes to look at the girls) that they took to swearing ‘by the life of the holy rabbis of Eretz Yisrael’!

In tavernae

In city inns (tavernae) as well as in the staging posts for change of mounts (mutationes) or overnight stay (mansiones) along the official Roman road network (the cursus publicus), all the needs of travellers were catered for by the barmaids. They served them wine, danced for them and often led them upstairs to the rooms on the upper floor. In fact, according to the Codex Justinianus, a barmaid could not be prosecuted for adultery, since it was presumed that she was anyway a prostitute (CJ 9.9.28). In order to prevent Christian travellers from falling prey to sexual dangers of this sort, ecclesiastical canons forbade the clergy to enter those establishments. Soon, therefore, ecclesiastical resthouses (xenodochia) and inns specifically for pilgrims (pandocheia) run by members of the clergy, sprang up along the main pilgrim routes.

Institutionalised prostitution


Prostitution was also institutionalised under the form of brothels which Juvenal called lupanaria (Sat. 11.172-173) and Horace fornices (Ep. 1.14.21). These, John Moschus described in his sixth-century Spiritual Meadow as a ‘house of prostitution’ in Jericho or even more vaguely ‘an abode of lust’ in Jerusalem (Prat. Spir. 17). The prostitutes who were employed in these establishments were slaves and the property of a pimp (leno) or of a ‘Madam’ (lena). The very name of the prostitute in Tyre who called out to a monk to save her – Kyria Porphyria – is telling. She was so used as a ‘Madam’ to boss other women, that once she had been reformed and had convinced other harlots (presumably her former ‘girls’) to give up prostitution, she organised them into a community of nuns of which she became the abbess – the mirror image of her brothel.

A Byzantine brothel has recently been unearthed in the course of excavations at Bet She’an, ancient Scythopolis, capital of Palaestina Prima.[6] At the heart of this thriving metropolis, a Roman odeon founded in the second half of the second century was partly destroyed in the sixth century. Byzantine Baths adjoined it to the west. To the south-west, the second row of shops of the western portico of the impressive Street of Palladius was also dismantled to make way for a semi-circular exedra (13x15m). Each half of the exedra comprised six trapezoidal rooms with front doors. Some of these rooms also opened onto a corridor or a hall at the back of the building. In one room, a staircase led to an upper storey. Some rooms had niches with grooves for wooden shelves. The apses at both ends of the exedra and in the centre of the semi-circle, as well as the façades of the rooms were revetted with marble plaques, most of which are now lost, there only remaining holes for the nails which held these plaques in position. The inner faces of the walls of these rooms exhibited two coats of crude white plaster.

The floor of most of these rooms was paved with mosaics depicting geometric motifs enclosing poems in Greek, animals and plants, and lastly, in an emblema, a magnificent Tyche crowned by the walls of Scythopolis and holding a cornucopia. The mosaic pavements of some rooms had been subsequently replaced by bricks or a layer of crushed lime. Traces of crude repairs in the mosaics and the insertion of benches in other rooms indicated that the building had undergone various stages of construction. A semi-circular courtyard (21x30m) stretched in front of the twelve rooms. Towards the street, it was closed off by a set of rooms which incorporated the shops previously at the northern end of the portico of the Street of Palladius, whilst putting them to a different use. This row of rooms which was probably interrupted by the main entrance into the complex, opened onto a portico with an opus sectile floor of black and white marble. Two steps running for the entire length of the portico enabled access from the street. The portico and the rooms had a tiled roof. The exedra was demolished at the end of the sixth century or in the early seventh century.

The cabins of the Bet She’an exedra are reminiscent of the cells of the Pompeii lupanarium which consisted of ground floor rooms, each equipped with a stone bed and a bolster. An external staircase provided access to the first floor balcony onto which opened five more spacious rooms. At Bet She’an, the back doors of some rooms on the ground floor enabled clients who were keen to remain anonymous, to enter an abode of lust without being seen from the main street and thus to surreptitiously satisfy their sexual fantasies.

The portico where the girls strolled in the hope of attracting passers-by from the Street of Palladius, as well as the neighbouring Byzantine Baths were part of a fascinating network: soliciting at the Baths, in the portico and in the exedra courtyard, followed by sex in the cabins; and at the back of the building, an entrance-and-exit system for supposedly ‘respectable clients’.

Hierarchy and regulations in prostitution

There were two categories of Byzantine harlots: on the one hand, actresses and courtesans (scenicae), on the other, poor prostitutes (pornai) who fled from rural poverty and flocked to the great urban centres such as Constantinople and Jerusalem. There, even greater destitution pushed them straight into the rapacious hooks of crooks and pimps.

Actresses and courtesans

The scenicae were involved in a craft aimed primarily at theatre-goers. It has been described as a ‘closed craft’, since daughters took over from their mothers. The classic example is that of the mother of the future Empress Theodora who put her three young daughters to work on the stage of licentious plays. The poet Horace described in his Satires (1.2.1) Syrian girls (whose name ambubaiae probably derived from the Syrian word for flute, abbut orambut) livening up banquets by dancing lasciviously with castanets and accompanied by the sound of flutes. Suetonius simply equated these with prostitutes (Ner. 27). That is why Jacob, Bishop of Serûgh (451-521) in Mesopotamia warned in his Third Homily on the Spectacles of the Theatre against dancing, ‘mother of all lasciviousness’ which ‘incites by licentious gestures to commit odious acts’. A sixth-century mosaic in Madaba in Transjordan depicts a castanet-snapping dancer dressed in transparent muslin next to a satyr who is clearly sexually-roused.[7]

According to Bishop John of Ephesus’ fifth-century Lives of the Eastern Saints, Emperor Justinian’s consort was known to Syrian monks as ‘Theodora who came from the brothel’. Her career proves that Byzantine courtesans like the Ancient Greek hetairai could aspire to influential roles in high political spheres. Long before her puberty, Theodora worked in a Constantinopolitan brothel where, according to the court-historian Procopius of Caesarea’sSecret History, she was hired at a cheap rate by slaves as all she could do then was to act the part of a ‘male prostitute’. As soon as she became sexually mature, she went on stage, but as she could play neither flute nor harp, nor even dance, she became a common courtesan. Once she had been promoted to the rank of actress, she stripped in front of the audience and lay down on the stage. Slaves emptied buckets of grain into her private parts which geese would peck at. She frequented banquets assiduously, offering herself to all and sundry, including servants. She followed to Libya a lover who had been appointed Governor of Pentapolis. Soon, however, he threw her out, and she applied her talents in Alexandria and subsequently all over the East. Upon her return to Constantinople, she bewitched Justinian who was then still only the heir to the imperial throne. He elevated his mistress to Patrician rank. Upon the death of the Empress, his aunt and the wife of Justin II (who would never have allowed a courtesan at court), Justinian forced his uncle Justin II to abrogate the law which forbade senators to marry courtesans. Soon, he became co-emperor with his uncle and at the latter’s death, as sole emperor, immediately associated his wife to the throne (Anecd. 9.1-10).

Centre National de la Recherche Scientifique


Claudine Dauphin


[1]This article is based on a paper given at the Dublin Classics Seminar in the Department of Classics of University College Dublin on 25 April 1995 at the invitation of its organiser, Dr A. Erskine, whom we wish to thank warmly.

[2]In particular, see the discussion in M. Lloyd, Euripides Andromache (Warminster, 1995), pp. 6 ff.

[3]P. Salmon, Population et dépopulation dans l’empire romain (Bruxelles, 1974), p. 45.

[4]In particular Canon 87 of the Council in Trullo of 692. See C.J. Héfélé and H. Leclercq, Histoire des Conciles, T. III.[1] (Paris, 1909), p. 573.

[5]Palatine Anthology (A.P.) 5.46; 5.101; 5.302 and 5.308. See also, R.C. McCail, ‘The Erotic and Ascetic Poetry of Agathias Scholasticus’, Byzantion 41 (1971), p. 215. We are grateful to Dr R.C. McCail of the Department of Classics, University of Edinburgh, for introducing us to Agathias’ erotic poetry connected with prostitution.

[6]G. Mazor, ‘City Center of Ancient Bet Shean – South’, Excavations and Surveys in Israel 1987/88, Vol. 6 (1987), pp. 18 ff.; R. Bar-Nathan and G. Mazor, ‘City Center (South) and Tel Iztabba Area. Excavations of the Antiquities Authority Expedition, The Bet She’an Excavation Project (1989-1991)’, Excavations and Surveys in Israel, Vol. 11 (1993), pp. 43 ff.

[7]M. Piccirillo, Madaba le chiese e is mosaici (Milano, 1989), pp. 134 ff.

SOURCE  , © Classical Association of Ireland

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A)Επαναστατική θεραπεία των αθλητικών κακώσεων με βλαστοκύτταρα

Τα βλαστοκύτταρα έχουν κάνει τα τελευταία χρόνια την ιατρική πιο αποτελεσματική. Δεν είναι τυχαίο που οι επιστήμονες ερευνούν συνέχεια νέες πτυχές εκμετάλλευσης τους για καλύτερη θεραπεία περισσότερων ασθενειών. Τελευταία δεδομένα μας έρχονται από τους αθλητιάτρους καθώς η χρήση βλαστοκυττάρων στις αθλητικές κακώσεις μειώνουν σημαντικά το χρόνο επιστροφής του αθλητή στην ενεργό δράση.

Συγκεκριμένα τα πρώτα εντυπωσιακά αποτελέσματα μας έρχονται από τη δοκιμή βλαστοκυττάρων στη ρήξη του προσθίου χιαστού συνδέσμου, της πιο συχνής αθλητικής κάκωσης και τα οποία παρουσιάστηκαν στο διεθνές Συνέδριο «International Cartilage Repair Society- StemCells and Scaffolds», το οποίο διεξήχθη στη Μπολόνια της Ιταλίας 5-6 Δεκεμβρίου 2014, υπό την αιγίδα της ICRS.

Σύμφωνα με τους επιστήμονες, οι αθλητές επιστρέφουν στην ενεργό δράση μέσα  σε μόλις δύο μήνες μετά το χειρουργείο. Η νέα μέθοδος  χαρακτηρίστηκε ως επανάσταση στη χειρουργική των χιαστών συνδέσμων, καθώς μέχρι σήμερα  εφαρμόζονται πάνω  από  540  τεχνικές αποκατάστασης,  ωστόσο το μεγάλο πρόβλημα ήταν ο χρόνος επιστροφής  στην ενεργό δράση, που κυμαίνεται από 6-12 μήνες, ανάλογα με το σπορ  του αθλητή.

Η χρήση βλαστοκυττάρων από το μυελό των οστών, βοηθά  στην ταχύτερη κυτταρική αφομοίωση- νεοαγγειογένεση των μοσχευμάτων (χιαστού) και  ενισχύει τη διαδικασία επούλωσης. Η έκκριση κυτοκινών και νεο-αγγειογεννετικών παραγόντων, επιταχύνουν τη κυτταρική ανάπτυξη και την εν γένει αναγέννηση του χιαστού συνδέσμου, ενώ συνεχίζουν την αναγεννητική τους δράση για πολλούς μήνες.  

Στα πλεονεκτήματα της νέας μεθόδου προσμετρούνται επίσης, η γρήγορη αναγέννηση του μοσχεύματος και η σταθερότητα του γόνατος, η μείωση του κινδύνου μόλυνσης και αποτυχίας, η αποφυγή μετεγχειρητικής δυσκαμψίας και ο πόνος και φυσικά το μεγαλύτερο εύρος κίνησης της άρθρωσης.

Αξίζει να τονιστεί ότι η  χρήση βλαστοκυττάρων στην αναγέννηση του χιαστού δεν είναι μια απλή διαδικασία. Απαιτεί έμπειρη και εξειδικευμένη ιατρική ομάδα, ειδικά πρωτόκολλα λήψης, προετοιμασίας και εφαρμογής, καθώς κρίσιμοι παράγοντες, μπορούν να επηρεάσουν την ποιότητά τους.

Η χρήση παροχέτευσης μετά το χειρουργείο απαγορεύεται και ειδικά πρωτόκολλα αιμόστασης απαιτούνται. Επίσης απαιτείται ειδικό πρωτόκολλο αποθεραπείας που ξεκινά από μερικές ώρες μετά το χειρουργείο και ολοκληρώνεται με την επανένταξη του αθλητή στην ομάδα του. Η διενέργεια μαγνητικής τομογραφίας έξι  εβδομάδες μετεγχειρητικά, αποτελεί οδηγό σημείο για την περαιτέρω  αποθεραπεία του.

Ο πρόσθιος χιαστός σύνδεσμος είναι ο σύνδεσμος που τραυματίζεται πιο συχνά από τις αθλητικές δραστηριότητες μας, πιθανές πτώσεις ή και τροχαία ατυχήματα. Μάλιστα, οι ειδικοί εκτιμούν ότι οι γυναίκες τραυματίζουν το χιαστό δύο με οκτώ φορές περισσότερο σε σχέση με τους άντρες ενώ, οι Ευρωπαίοι και Αμερικανοί έχουν μεγαλύτερη συχνότητα τέτοιων τραυματισμών σε σχέση με τους Αφρο-αμερικάνους τους Ασιάτες και τους Ισπανόφωνες. Στις ΗΠA  mάλιστα περίπου 250.000 άτομα τραυματίζουν το χιαστό τους σε ετήσια βάση, ενώ στην Ελλάδα ξεπερνάμε τις 4.000 άτομα το χρόνο. Οι ηλικίες κυμαίνονται από 15 ετών μέχρι 45 ετών.

Οι συχνότεροι αθλητικοί τραυματισμοί γίνονται στο μπάσκετ, στο χόκεϊ, το ποδόσφαιρο και τη γυμναστική, ενώ ακολουθούν σε συχνότητα αυτοί του σκι και του βόλεϊ. Να σημειωθεί όμως, ότι μόνο στο 30% των περιπτώσεων ο τραυματισμός είναι από άμεση επαφή με αντίπαλο.

Τέλος, αναφορικά με το κόστος για την αντιμετώπιση των κακώσεων του χιαστού συνδέσμου στις ΗΠΑ για παράδειγμα όπου υπάρχει καταγραφή, αυτό φτάνει στα 2-3 δισ. δολάρια το χρόνο, γεγονός που δείχνει το τεράστιο κοινωνικοοικονομικό κόστος των τραυματισμών αυτών.

PEEGEE  naftemboriki

B)Η Κυτταρική Ιατρική προλαμβάνει και καταπολεμά τις ασθένειες

Η ημερήσια πρόσληψη μικροθρεπτικών συστατικών όπως η βιταμίνη C, τα αμινοξέα λυσίνη και προλίνη και οι πολυφαινόλες από το πράσινο τσάι είναι το κλειδί για την πρόληψη και καταπολέμηση ασθενειών όπως ο καρκίνος και οι καρδιοπάθειες, υποστηρίζει η Κυτταρική Ιατρική.

«Η βιταμίνη C διαδραματίζει σημαντικό ρόλο στην πρόληψη και αντιμετώπιση της αρτηριοσκλήρυνσης, του σακχαρώδους διαβήτη αλλά και του καρκίνου», επισημαίνει ο κύπριος γιατρός, ειδικευμένος στην κυτταρική ιατρική, Γιώργος Κατσώνης, με αφορμή την ομιλία του στο Βαφοπούλειο Πνευματικό Κέντρο, στη Θεσσαλονίκη.
«Η κυτταρική ιατρική μελετά τις μικρότερες ομάδες του σώματος, τα κύτταρα. Η υγεία του σώματός μας, καθορίζεται στο επίπεδο των εκατομμυρίων κυττάρων, που συναποτελούν τον οργανισμό μας και όχι στο επίπεδο των οργάνων. Τα κύτταρα σχηματίζουν τα όργανα και χρειάζονται συγκεκριμένες ουσίες για όλες τις βιοχημικές αντιδράσεις. Η χρόνια έλλειψη σε μικροθρεπτικά στοιχεία οδηγεί σε ελλιπείς κυτταρικές λειτουργίες και άρα σε ασθένειες», εξηγεί ο κ. Κατσώνης
Σύμφωνα με τον ίδιο ακόμη και οι υγιείς άνθρωποι δεν προσλαμβάνουν επαρκείς ποσότητες μικροθρεπτικών ουσιών, ενώ οι ανάγκες τους είναι αυξημένες λόγω του φυσικού και ψυχολογικού στρες.
«Η κύρια αιτία ανάπτυξης της αρτηριοσκλήρυνσης δεν είναι η χοληστερίνη αλλά η χρόνια ανεπάρκεια σε βιταμίνη C και σε άλλα μικροθρεπτικά, στα εκατομμύρια κύτταρα του τοιχώματος των στεφανιαίων αρτηριών, με αποτέλεσμα να αποδυναμώνεται η σταθερότητα τους και να δημιουργούνται ρωγμές. Η χοληστερίνη και οι άλλες εναποθέσεις αποτελούν ένα πρόχειρο μηχανισμό του οργανισμού για επιδιόρθωση και σταθεροποίηση των αποδυναμωμένων αιμοφόρων αγγείων. Η βέλτιστη παροχή βιταμίνης C προάγει την παραγωγή κολλαγόνου και οδηγεί στην απομάκρυνση των διορθωτικών παραγόντων, δηλαδή των αθηρωματικών πλακών, καθώς και στη ρύθμιση της χοληστερίνης. Εξάλλου η βιταμίνη C συνεισφέρει στην αποκατάσταση της ισορροπίας μεταξύ του μεταβολισμού βιταμινών-σακχάρων και διαδραματίζει κεντρικό ρόλο στη πρόληψη και αντιμετώπιση των επιπλοκών του διαβήτη. Επιπλέον η τακτική πρόσληψη κυτταρικών θρεπτικών ουσιών είναι απαραίτητη για τη βέλτιστη τροφοδότηση των καρδιομυοκυττάρων με βιοενέργεια και άρα για την πρόληψη και αντιμετώπιση των αρρυθμιών», υποστηρίζει ο κ. Κατσώνης.
Όσον αφορά τον καρκίνο, η κυτταρική ιατρική στοχεύει στον έλεγχο των μηχανισμών που προκαλούν τη νόσο. Οι μηχανισμοί αυτοί είναι: η εισβολή των καρκινικών κυττάρων και η μετάσταση, ο πολλαπλασιασμός των καρκινικών κυττάρων και η ανάπτυξη όγκου, η ανάπτυξη νέων αιμοφόρων αγγείων στον όγκο και η ενεργοποίηση της διαδικασίας θανάτου των καρκινικών κυττάρων. Όπως εξηγεί ο κ Κατσώνης υπάρχει μηχανισμός φυσικού ελέγχου του καρκίνου.
«Για τον έλεγχο του καρκίνου κεντρικό ρόλο παίζει η αναστολή των ενζύμων αποδόμησης του κολλαγόνου. Καθοριστικό ρόλο προς αυτό τον σκοπό παίζουν: η βιταμίνη C με αναστολή αποδόμησης και προαγωγή της οικοδόμησης του συνδετικού ιστού, τα αμινοξέα λυσίνη-προπολίνη που προάγουν την οικοδόμηση του συνδετικού ιστού και οι πολυφαινόλες από το πράσινο τσάι, που είναι αντιοξειδωτικές και προστατεύουν τα κύτταρα. Η βέλτιστη πρόσληψη βιταμίνης C και άλλων μικροθρεπτικών είναι ένας επιστημονικά τεκμηριωμένος τρόπος βιολογικής αντιμετώπισης του καρκίνου. Με αυτόν τον τρόπο είναι πλέον εφικτός ο έλεγχος της μετάστασης, που είναι η κυριότερη αιτία θανάτου καρκινοπαθών», προσθέτει ο κ Κατσώνης.


C)Υαλουρονικό νάτριο

Από τη Βικιπαίδεια, την ελεύθερη εγκυκλοπαίδεια

Το Υαλουρονικό Νάτριο (Sodium hyaluronate) είναι το μετά νατρίου άλας της Υαλουρονάνης (Ηyaluronan), δηλαδή του Υαλουρονικού οξέος (Hyaluronic Acid). Το όνομα Υαλουρονικό οξύ προέρχεται ετυμολογικά από την Ελληνική λέξη «ύαλος» (και «ύελος»), που σημαίνει γυαλί, διαφανής υαλοπίνακας, τζάμι (cam= τουρκικό), και «ουρονικό οξύ» επειδή απομονώθηκε πρώτα στο υαλοειδές υγρό του οφθαλμού (vitreous houmor) και απέδιδε ένα μεγάλο ποσό ουρονικού οξέος. Ο όρος Υαλουρονικός αναφέρεται στη συζευγμένη βάση του Υαλουρονικού οξέος. Επειδή το μόριο της ουσίας τυπικά υφίσταται in vivo στην πολυανιονική μορφή, γι αυτό συχνά αναφέρεται και ως Υαλουρονάνη (Hyaluronan).[1].

Το Υαλουρονικό Νάτριο χρησιμοποιείται τα τελευταία χρόνια από σε τρεις ιατρικές ειδικότητες, την οφθαλμολογία, την ορθοπεδική – τραυματολογία και την πλαστική χειρουργική.

Η Χημεία του Υαλουρονικού Νατρίου

Sodium Hyaluronate

Χημικά, το Υαλουρονικό Οξύ είναι ένα βιοπολυμερές (biopolymer) φυσιολογικό σύμπλεγμα σακχάρου της οικογένειας Γλυκοζαμινογλυκάνης (Glucosaminoglycan) και αποτελεί ένα πολυμερές μακράς αλυσίδας, που περιέχει επαναλαμβανόμενες μονάδες Na-γλυκουρονικο-N-ακετυλογλυκοζαμίνης. Η Χημική ονομασία του Υαλουρονικού Νατρίου είναι: Νάτριο (2S,3S,4R,5R,6R) -3- [(2S,3R,4R,5S,6R) -3- ακεταμιδο -4- [(2R,3R,4S,5S,6S) -6- καρβοξυ-3,4,5-τριυδροξυοξαν2-υλ] οξυ -5- υδροξυ -6- (υδροξυμεθυλ) οξαν -2- υλ] οξυ -6- [(2R,3R,4R,5S,6R) -3- ακεταμιδο -2,5- διυδροξυ -6- (υδροξυμεθυλ) οξαν -4- υλ] οξυ-4,5 – διυδροξυοξανο -2- καρβοξυλικό οξύ. Ο συντακτικός τύπος της ουσίας διατίθεται στην  ιστοσελίδα[1].

  • Ο μοριακός χημικός τύπος της είναι = [C14H20NO11Na]n.
  • Ονομασία INCI = Sodium Hyaluronate
  • Ονομασία EINECS = 232-678-0 (Hyaluronic acid)
  • Αριθμός CAS = 9067-32-7

Παραγωγή Υαλουρονικού Νατρίου

Γενιές Υαλουρονικών

Το Υαλουρονικό Οξύ είναι ένα ελαστικό και κολλώδες (viscoelastic) πολυμερές, το οποίο όπως προαναφέρθηκε, φυσιολογικά υπάρχει στο υαλοειδές υγρό του οφθαλμού αλλά στις αρθρώσεις. Το Υαλουρονικό νάτριο που φυσιολογικά απαντάται στο επιθήλιο του κερατοειδούς χιτώνος συνδεδεμένο με ειδικούς υποδοχείς, έχει μια ισχυρή συγγένεια και έλξη με τους υποδοχείς αυτούς. Πιθανώς να υπάρχει και στο ελυτρικό υγρό των τενόντων, όπως και στις κύστεις γαγγλίων, όπως φαίνεται τουλάχιστον μακροσκοπικά. Το σύνηθες υαλουρονικό νάτριο είναι ένα κολλώδες διάλυμα αποτελούμενο από ένα κλάσμα μεγάλου μοριακού βάρους, περίπου 500.000-730.000 daltons, εντός εξευγενισμένου υδατικού διαλύματος χλωριούχου νατρίου.[2].

Η αρχική παραγωγή σκευασμάτων Υαλουρονικού Νατρίου πρώτης γενιάς, γινόταν από ιστούς ζωικής προέλευσης, και ιδίως από ακρολοφίες πουλερικών (λειρί κόκκορα). Η διαδικασία παραγωγής ήταν πλύση με απορρυπαντικά και αλκοόλη, θέρμανση, πολτοποίηση, κονιορτοποίηση, εκχύλιση με αλκοόλη και έτσι είχαμε τα Υαλουρονικά πρώτης γενιάς βραχείας και διασταυρούμενης αλύσου ζωϊκής προέλευσης. Τα Υαλουρονικά αυτά είχαν Μοριακό Βάρος 500-730 kDaltons (Hylan A) και ορισμένα εξακολουθούν να χρησιμοποιούνται και σήμερα (πχ HYALART®).[3]. Τα Υαλουρονικά δεύτερης γενιάς παράγονταν από Hylan A, και με επεξεργασία με φορμαλδεΰδη, παραγόταν το Hylan B (παχύρευστη γέλη). Στη συνέχεια ένα μίγμα αποτελούμενο από 20% Hylan Β και 80% Hylan A επεξεργάζονταν με σουλφοξείδιο του βινυλίου και παραγόταν το Hylan GF-20 (SYNVISC® και EUFLEXXA®).[3] Οι Γάλλοι Chevalier X, Jerosch J, Goupille P et al. δημοσίευσαν το έτος 2010 διπλή τυφλή πολυκεντρική μελέτη – εργασία περί επιτυχούς χρήσης Hylan G-F 20 σε ασθενείς με οστεοαρθρίτιδα του γόνατος.[4].

Για τα αρχικά αυτά σκευάσματα Υαλουρονικού Νατρίου πρώτης και δεύτερης γενιάς, έχουν γραφεί επικριτικά σχόλια ειδικών. Ο Αμερικανοκινέζος Chen et al έγραψε ότι “Τα αποτελέσματα δείχνουν ότι το διασταυρούμενης αλύσου Υαλουρονικό ήταν η πιο πιθανή αιτία της κοκκιωματώδους φλεγμονής στις αρθρώσεις“. Επίσης οι Γερμανοί Leopold S et al έγραψαν ότι «Τοπικές αντιδράσεις παρατηρήθηκαν σημαντικά συχνότερα στους ασθενείς που έλαβαν πάνω από ένα κύκλο θεραπείας σε σχέση με τους ασθενείς που έλαβαν μόνο ένα κύκλο Hylan GF-20».[3]. Το έτος 2007 οι Γερμανοί Reichenbach S, Blank S, Rutjes A et al. δημοσίευσαν εργασία – μελέτη όπου σύγκριναν τις εγχύσεις Hylan GF 20 με τις εγχύσεις Υαλουρονικού Νατρίου και πραγματοποίησαν μετα-ανάλυση.[5].[1].

Τα τελευταία χρόνια έχουμε την παραγωγή Υαλουρονικών τρίτης γενιάς, ή ορθότερα Υψηλής Καθαρότητας Υαλουρονάνες (Highly Purified Hyaluronan, HPH). Πρόκειται για βιοτεχνολογικά προϊόντα με πλήρη καθαρότητα, που παράγονται από καλλιέργειες κυττάρων. Επιλέγεται η αφαίρεση του εκτός κυτταρικής μεμβράνης Υαλουρονικού, γίνεται αύξηση της κυτταρικής σειράς, ζύμωση σε βιοαντιδραστήρα, παραγωγή μεγάλου αριθμού κυττάρων, διήθηση σε γέλη πυριτίου (Silica Gel), κατακράτηση προσμίξεων, διατήρηση του κυτταρικού τοιχώματος, καθίζηση, περαιτέρω καθαρισμός, έκπλυση (το Υαλουρονικό εκπλένεται από τα κυτταρικά τοιχώματα και συλλέγεται) και τελικά παράγεται καθαρό Υαλουρονικό οξύ, μακράς μη διακλαδούμενης αλύσου. Τα Υαλουρονικά αυτά έχουν μοριακό βάρος είτε 1800-2000 kDaltons είτε 2400 – 3600 kDaltons».[6].[1].

Είδη σκευασμάτων Υαλουρονικού Νατρίου

Πίνακας Υαλουρονικών

Στο εμπόριο σήμερα κυκλοφορούν διεθνώς δεκάδες σκευάσματα Υαλουρονικού Νατρίου, ή Υαλουρονάνης, ενίοτε το ίδιο σκεύασμα με διαφορετικό όνομα σε κάθε χώρα, που πολλές φορές στα έντυπά τους έχουν ανεπαρκείς πληροφορίες ιδιοτήτων. Για παράδειγμα το Ιταλικό Hyalart® της Fidia, στην Ιταλία και στις ΗΠΑ κυκλοφορεί σε συσκευασία των 5 ενέσεων με το όνομα Hyalgan®. Πάντως συγκριτικές μελέτες των διαφόρων Υαλουρονικών δεν είναι διαθέσιμες εκτός σπανίων εξαιρέσεων. Οι Karlsson και συνεργάτες δημοσίευσαν το έτος 1998 συγκριτική μελέτη δύο διαφορετικών Υαλουρονικών και Placebo σε ασθενείς με Οστεοαρθρίτιδα, αλλά δεν βρήκαν στατιστικα σημαντική διαφορά στα Υαλουρονικά.[7] Θα παραθέσουμε κατωτέρω τα κυριότερα σκευάσματα που κυκλοφορούν στην Ελλάδα και την Ευρώπη και ΗΠΑ με τις βασικές ιδιότητές τους, αλφαβητικά: (Πίνακας). Διαφορές: Ορισμένα από αυτά τα Υαλουρονικά είναι συνταγογραφούμενα, και η δαπάνη τους καλύπτεται από τα ασφαλιστικά ταμεία της Ελλάδας (αυτά με MW=1800-2000 kDaltons), ενώ άλλα όχι (αυτά με MW = 2400-3600 kDaltons). Επίσης, όπως βλέπουμε στον πίνακα τα Υαλουρονικά διαφέρουν στην τεχνολογία παρασκευής, στο μοριακό βάρος και φυσικά στο ιξώδες. Ουδέν εξ αυτών κατάφερε να φτάσει το μοριακό βάρος του ανθρώπινου Υαλουρονικού υγιούς αρθρικού υγρού που είναι 4000-7000 kDaltons, ενώ στην Οστεοαρθρίτιδα είναι μόλις 1000 kDaltons. Μια άλλη διαφορά των Υαλουρονικών είναι ο τρόπος χρήσης. Άλλες εταιρείες προτείνουν μία έγχυση Υαλουρονικού 2ml ανά εβδομάδα επί πέντε ενέσεις συνολικά, άλλες εταιρείες μία εφ άπαξ ένεση 4ml (Monovisc®) ή 6ml ετησίως (Synvisc®) και άλλα 3 ενέσεις ετησίως, μία κάθε εβδομάδα (Euflexxa®). Πρόσφατα η εταιρεία Fidia Ιταλίας ανακοίνωσε εργασίες όπου προτείνεται για το Hyalart® σχήμα 3 ενέσεων 2ml εφάπαξ ανά τετράμηνο, δηλαδή 12 ενέσεις 2ml κάθε χρόνο σε κάθε γόνατο.[8] Πάντως ο Ελληνικός ΕΟΦ συνιστά και εγκρίνει μέχρι 5 ενέσεις σε κάθε γόνατο χωρίς να καθορίζει χρόνο επαναληψιμότητας [9]. Σημείωση – Συντομογραφίες:

  • HPA = Highly Purified Hyaluronan = Υαλουρονάνη Υψηλού Εξευγενισμού – Καθαρότητας,
  • MW = Molecular Weight = Μοριακό Βάρος: Μετράται σε kDa= kilo Daltons.
  • Ελαστικότητα (Elasticity, ELΑ): μετράται σε μονάδες Pa.s (2,5 Hz),
  • Ιξώδες (Viscosity, VI): Μετράται σε μονάδες Pa.s (2,5 Hz).
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The art of medicine

The theriac in antiquity In Greek mythology,

Panacea, the goddess of healing was said to have a potion that healed every sickness. The   search for the cure-all remedy would continue throughout antiquity as physicians and healers tried out various cures in the regular care of their patients, especially in desperate situations. In the ancient world, poisonings were fairly common and the pursuit of a compound that was capable of protecting a person against any kind of toxin led to the popularity of what was thought to be a universal antidote: the theriac. The name theriac comes from the Greek term theria, which refers to wild beasts, and it was given to a preparation that served initially as an antidote and later as an all-purpose drug. According to Pliny the Elder (23–79 AD) and Galen of Pergamon (131–201 AD), one of the earliest formulations for a theriac against the bites of venomous animals was inscribed on a stone in the Temple of Asclepios on the island of Kos, and it contained thyme, opoponax (sweet myrrh), aniseed, fennel, and parsley. Another early reference to  theriacs can be found in the didactic poems Theriaca et Alexipharmaca, from the second century BC, by the Greek grammatician, poet, and physician Nicander of Colophon who described a variety of poisons from animal bites and their antidotes. The idea of a theriac seems to have gained greater prominence during the reign of Mithridates VI (132–63 BC), King of Pontus in Asia Minor. Mithridates VI lived in a constant fear of being poisoned and not only tested poisonous substances on criminals and slaves but also regularly ingested poisons and their antidotes himself. His personal physician Crateuas concocted an antidote known as Mithridatum, which contained about 40 ingredients and was thought to be protect against scorpions, vipers, sea-slugs, as well as other toxins. Mithridates appears to have become so accustomed to various poisons that he attempted suicide by self-poisoning when he was captured by Pompey. Yet as Dio Cassius wrote “the poison, although deadly, did not prevail over him, since he had inured his constitution to it, taking precautionary antidotes in large doses every day”. Some histories describe that having failed in this attempt, Mithridates ordered one of his soldiers to kill him with a sword. Among the papers of the defeated king, Pompey found the receipt for Mithridatum and translated it into Latin.


Different kinds of theriacs were subsequently produced in antiquity but the most celebrated was perhaps the one invented by Andromachus, physician to the Roman Emperor Nero, in the first century AD. Andromachus came from the island of Crete where “botanical men” in the service of the Emperor collected herbs and placed them in knitted vases, which were sent not only to Rome but also to other nations. Andromachus’ vast knowledge of botany helped him “to provide the mankind with the necessary medicines”. He claimed that his formula for his Galeni Theriaca (tranquillity theriac) was an improvement on that of Mithridates because it contained 64 ingredients and was enriched with the flesh of viper with a much greater quantity of opium. According to Andromachus, his theriac would not only counteract all poisons and bites of venomous animals, but would also diminish pain, weakness of the stomach, and help treat asthma, colic, dropsy, inflammation, and even the plague. Indeed, Andromachus’ theriac raised him to the dignity of Archiatrus (chief-physician) and the preparation enjoyed a great reputation for centuries. In the next century, the Greek physician Galen formulated a theriac that would, he intended, eclipse all others in its fame and popularity. Moreover, he experimented with his theriac, intent on proving its therapeutic effect. Galen is, of course, Wellcome Library, London one of the leading figures in classical medicine. He wrote a great number of  treatises on medical and philosophical  subjects and his doctrines dominated medical thought  until the 16th century. Born in Pergamum, part of Asia  Minor, Galen’s father Nicon, a wealthy architect, oversaw his education. Initially, Galen studied medicine in his home city, then in Corinth, and finally in Alexandria. Returning  to Pergamum, he was appointed as a city physician to the  School of Gladiators but gained such a reputation that he  soon became the court physician of the Roman Emperors Marcus Aurelius and Lucius Verus.
Following Hippocrates’ humoural theory, Galen believed  that the four humours of the body (phlegm, blood, black  bile, and yellow bile) were responsible for health or illness.
Going further, he classified all personalities into four types:
phlegmatic, sanguine, choleric, and melancholic. Imbalances  in these humours would lead to the disease and could be  corrected not only by adding herbal extracts of similar origin
but also other extracts with opposite properties. Galen  believed more than one medicine has to be administrated  in order to have a therapeutical effect, and favoured mixing
several agents to optimise their absorption. In the royal  court, Galen prepared his theriac and wrote about various  theriac compounds in his books De Antidotis I, De Antidotis II,
and De Theriaca ad Pisonem. The basic formula consisted of  viper’s flesh, opium, honey, wine, cinnamon, and more than  70 ingredients. The final product was supposed to mature for  years and was administrated orally as a potion or topically  in plasters. Galen claimed that his theriac drew out poisons  like a cupping glass and could divide the tissue of an abscess  more quickly than a scalpel. The preparation was taken daily by the Emperor Marcus Aurelius to protect against poisons  and to aid in ensuring good general health.
But Galen did not just administer his theriac, he also writes about experimenting with it on animals. In De theriaca ad  Pisonem he describes how he took roosters and divided
them in two groups: in one group he gave the theriac and  in the other group he did not. Then he brought both groups  into contact with snakes; Galen observed that the roosters
who had not been given the theriac died immediately after  being bitten, whereas those who has been given the theriac  survived. Moreover, he points out that this experiment could  be used in cases where someone wants to make sure whether  a theriac is in its natural form or has been adulterated.
Alongside this work, Galen also wrote about the effect  of his theriac on individual patients. In one passage in De  Theriaca ad Pisonem, his gives an illuminating account of  treating jaundice caused by snake bite with theriac.
One of the slaves of the Emperor whose duty it was to drive  away snakes, having been bitten, took for some time draughts of ordinary medicines, but as his skin changed so as
to assume the colour of a leek, he came to me and narrated  his accident; after having drunk theriac he recovered quickly  his natural colour. Physicians seek to find out if there are  signs peculiar to poisoning, because they often see, without  the administration of any deadly poison, that the body  presents a corruption of the humours similar to that which is  produced by poisons; it is not at all surprising, therefore, that  there sometimes supervenes a change in the humours, so  that the whole body is affected with jaundice.
Galen called his preparation Theriac of Andromachus and  for as long as Galenic medicine held sway, so did the appeal  of the theriac—not just as an antidote for snake bites but
gradually it came to be regarded as a universal cure-all.
Stored in ornate porcelain jars, often illustrated with scenes  from the life of Mithridate, it survived into medieval Europe  in the trade that developed in theriacs, most notably in
Italy, which became known as the Venice Treacle, an official  preparation that carried the republic’s seal. Its legacy is even apparent in French and German pharmacopeias of the 19th  century. Whether as a universal panacea or just an addictive  preparation thanks to opium, the theriac’s history seems to  have lasted more than 2000 years.

Demetrios Karaberopoulos, *Marianna Karamanou,George Androutsos
History of Medicine Department, Medical School, University of  Athens, 145 64 Athens, Greece

Further reading:
1. Galen. De Theriaca ad Pisonem.In: Opera omnia, ed. Kühn CG,XIV, Hildesheim: Olms, 1965
2. Mattern SP. Galen and the  Rhetoric of Healing. Baltimore:
The Johns Hopkins University  Press, 2008
3. Porter R., Teish M. Drugs and  Narcotics in History. Cambridge:
Cambridge University Press, 1995
4. Watson G. Theriac and  Mithridatum: A study in  therapeutics. London: Wellcome
Historical  Medical Library, 1966
5. Thompson CJS. The mystery  and art of the apothecary.
London: John Lane, The Bodley  Hend, Ltd., 1929


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A)Μεταμοσχεύτηκε συνθετικό όργανο


Χειρουργοί στη Σουηδία κατάφεραν να μεταμοσχεύσουν ένα πλήρως συνθετικά κατασκευασμένο όργανο -μια τραχεία- σε έναν άνδρα με καρκίνο στο τελικό στάδιο

Η συνθετική τραχεία δημιουργήθηκε εξ ολοκλήρου στο εργαστήριο, χρησιμοποιώντας ένα αντίγραφο κατασκευασμένο από ένα πορώδες πολυμερές και ιστό από βλαστικά κύτταρα του ίδιου του ασθενή μέσα σ’ έναν βιοαντιδραστήρα σχεδιασμένο ειδικά για την προστασία του οργάνου και την ανάπτυξη κυττάρων.

Η εγχείρηση πραγματοποιήθηκε τον Ιούνιο από τον Πάολο Μακιαρίνι στο Πανεπιστήμιο Καρολίνσκα στη Στοκχόλμη. Ο ασθενής έχει αναρρώσει πλέον πλήρως και έχει γυρίσει στις καθημερινές του δραστηριότητες.

Το αντίγραφο της τραχείας κατασκευάστηκε από μια ομάδα με επικεφαλής τον Αλεξάντερ Σεϊφάλιαν, καθηγητή νανοτεχνολογίας και αναγεννητικής ιατρικής στο UCL του Λονδίνου. Οι ιστοί του οργάνου αναπτύχθηκαν πάνω στο αντίγραφο χρησιμοποιώντας τα βλαστοκύτταρα του ασθενούς μέσα στον βιοαντιδραστήρα. Το αντίγραφο βασίστηκε πάνω σε ένα διάλυμα από βλαστοκύτταρα που πάρθηκε από το μυελό των οστών του ασθενούς και διατηρήθηκε στη σωστή θερμοκρασία καθώς περιστρεφόταν μέσα στον βιοαντιδραστήρα και τα κύτταρα σχημάτιζαν τον ιστό του οργάνου. Η διαδικασία αυτή διήρκεσε περίπου δύο εβδομάδες.

Η μεταμόσχευση αυτή είναι ένα τεράστιο άλμα στο πεδίο της αναγεννητικής ιατρικής, λέει ο Αρνολντ Κρίεγκσταϊν, διευθυντής του Κέντρου Αναγεννητικής Ιατρικής και Ερευνας Βλαστοκυττάρων στο Πανεπιστήμιο της Καλιφόρνιας, στο Σαν Φρανσίσκο. «Το να βρίσκουμε τρόπους να δημιουργούμε μοσχεύματα μέσω των βλαστικών κυττάρων είναι ακριβώς αυτό που υπόσχεται η αναγεννητική ιατρική» λέει ο Κρίεγκσταϊν.

Ωστόσο, ο ίδιος τονίζει πως η τραχεία είναι ένα απλό όργανο που πραγματοποιεί μια κατά βάση μηχανική λειτουργία -λειτουργεί σαν ένας αγωγός αέρα. Η δημιουργία ενός εξαιρετικά περίπλοκου οργάνου, όπως ενός πνεύμονα ή ενός νεφρού θα είναι μια πολύ μεγαλύτερη πρόκληση, εξηγεί.

Τα συνθετικά όργανα είναι ανώτερα των κοινών οργάνων δωρητών από πολλές απόψεις. Μπορούν να είναι διαθέσιμα πολύ πιο γρήγορα από ό,τι ένα όργανο δωρητή. Επίσης, επειδή δημιουργούνται από τα κύτταρα του ίδιου του ασθενούς, δεν απαιτούν τη χορήγηση επικίνδυνων ανοσοκατασταλτικών φαρμάκων για αποφυγή της απόρριψης του μοσχεύματος.

Για να κατασκευάσουν την τραχεία, ο Σεϊφάλιαν και η ομάδα του χρησιμοποίησαν ένα πολυμερές με χιλιάδες μικρές τρυπούλες, οι οποίες επέτρεψαν στα κύτταρα να «ριζώσουν» και να αναπτυχθούν.

Αρχικά δημιούργησαν ένα γυάλινο καλούπι της τραχείας χρησιμοποιώντας αξονικές τομογραφίες του ασθενούς. Επειτα έκοψαν λωρίδες από πολυμερές υλικό και τις τύλιξαν γύρω από το καλούπι για να δημιουργήσουν δακτυλίους χόνδρου, οι οποίοι δυναμώνουν τη δομή του οργάνου. Μετά έβαλαν το μοντέλο σε μια υγρή μορφή του ίδιου πολυμερούς, η οποία είχε αναμειχθεί με αλάτι. Τέλος, το ξέπλυναν ολόκληρο σε ένα διάλυμα, από το οποίο βγήκε ένα σπογγώδες μοντέλο που έμοιαζε με μια οργανική τραχεία.

Οταν το καλούπι ήταν έτοιμο, ο ζωντανός ιστός άρχισε να αναπτύσσεται επάνω του χρησιμοποιώντας τον ειδικό βιοαντιδραστήρα. Ενα διάλυμα βλαστικών κυττάρων από τον μυελό των οστών του ασθενή χύθηκε μέσα στη συνθετική τραχεία η οποία πήρε την τελική της μορφή μέσα στον βιοαντιδραστήρα. Χρειάστηκαν περίπου δύο μέρες για να δημιουργηθούν οι ιστοί.

Η δημιουργία του συνθετικού οργάνου καθυστέρησε, επειδή ήταν η πρώτη εφαρμογή της συγκεκριμένης μεθόδου, εξηγεί ο Σεϊφάλιαν. Στο μέλλον, λέει, θα μπορούμε να φτιάξουμε ένα πλήρες μοντέλο μέσα σε δύο μέρες.

© 2011 Technology Review


B)επιστημονικά θαύματα που άλλαξαν τον κόσμο μας

Με μια διεθνή επικαιρότητα που βρίθει από οικονομική κρίση, ανεργία, διαφθορά και σκάνδαλα κάθε είδους, πολύνεκρα τρομοκρατικά χτυπήματα, εμφυλίους πολέμους και φυσικές καταστροφές, οι «καλές ειδήσεις» της χρονιάς προέρχονται συνήθως από τον χώρο της επιστήμης και της τεχνολογίας.

Η πρώτη μεταμόσχευση τεχνητής καρδιάς μεγάλης διάρκειας παγκοσμίως πραγματοποιήθηκε στις 18 Δεκεμβρίου στο Παρίσι

Η πρώτη μεταμόσχευση τεχνητής καρδιάς μεγάλης διάρκειας παγκοσμίως πραγματοποιήθηκε στις 18 Δεκεμβρίου στο Παρίσι

Οπως κάθε χρόνο έτσι και φέτος, επιστήμονες από όλον τον κόσμο κατάφεραν με τα επιτεύγματά τους να ανοίξουν τον δρόμο για τη θεραπεία ασθενειών, το ξεκλείδωμα μεγάλων μυστηρίων και τη ριζική αλλαγή της καθημερινότητάς μας.

Η έγκριτη επιστημονική επιθεώρηση «Science» επέλεξε ως σημαντικότερο επίτευγμα του 2013 την ανοσοθεραπεία κατά του καρκίνου, που είναι και η μάστιγα του αιώνα μας. Δεν πρόκειται για μία και μόνο μέθοδο αλλά για μια στρατηγική που άλλαξε φέτος «τον τρόπο σκέψης των ερευνητών για το πώς μπορεί να αντιμετωπιστεί ο καρκίνος», δηλαδή μέσω της στρατολόγησης του ανοσοποιητικού συστήματος για την εξουδετέρωση των όγκων.

Μέσα στο 2013 τρεις προσεγγίσεις που βασίστηκαν σε γνώσεις που χρονολογούνται από το 1980 και 1990 απέδειξαν την αποτελεσματικότητά τους στους ασθενείς.

2013... επιστημονικά θαύματα που άλλαξαν τον κόσμο μας

Η πρώτη αφορά την πρωτεΐνη CTLA-4 που υπάρχει στην επιφάνεια των Τ-ανοσοποιητικών κυττάρων και φρενάρει τη δράση τους δίνοντας παράταση ζωής σε ασθενείς με μεταστατικό μελάνωμα και δεύτερη στο μόριο PD-1 που επίσης θεωρείται ότι φρενάρει τη δράση των Τ-κυττάρων συρρικνώνοντας τους όγκους σε διάφορες μορφές καρκίνου.

Η τρίτη ανοσοθεραπεία που αναφέρει η επιθεώρηση έγκειται στην απομόνωση Τ-κυττάρων από τον οργανισμό του καρκινοπαθούς, την προσθήκη επιπλέον γονιδίων σε αυτά και την εκ νέου τοποθέτησή τους στον ασθενή, μια μέθοδος που εξαφανίζει τη λευχαιμία σε μεγάλο ποσοστό των περιπτώσεων.

2013... επιστημονικά θαύματα που άλλαξαν τον κόσμο μας

Ενα ακόμη ιατρικό επίτευγμα, το οποίο αυτόν τον μήνα έγινε πρώτη είδηση στα γαλλικά μέσα ενημέρωσης, είναι η πρώτη μεταμόσχευση τεχνητής καρδιάς μεγάλης διάρκειας παγκοσμίως, η οποία πραγματοποιήθηκε στις 18 Δεκεμβρίου στο Παρίσι. Δημιούργημα της γαλλικής εταιρείας Carmat που έκανε πραγματικότητα την ιδέα που είχε συλλάβει ο Αλέν Καρπεντιέ, η τεχνητή καρδιά αποτελείται από μηχανικά μέρη και από ιστό αγελάδας, μιμείται με επιτυχία τη λειτουργία της ανθρώπινης καρδιάς με έναν συνδυασμό μηχανικών εξαρτημάτων και ηλεκτρονικών αισθητήρων και είναι συμβατή με τον ανθρώπινο οργανισμό για πέντε χρόνια, σε αντίθεση με τα τεχνητά όργανα που υποκαθιστούσαν ή υποβοηθούσαν την καρδιά και είχαν μικρή διάρκεια ζωής. Ο ασθενής που έλαβε το μόσχευμα, το οποίο βέβαια ζυγίζει τρεις φορές περισσότερο από μια ανθρώπινη καρδιά και το κόστος της ανέρχεται σε περίπου 150.000 ευρώ, έχει συνέλθει και έχει κανονική επαφή με το περιβάλλον.

Φυσικά δεν μπορεί κανείς να παραβλέψει και την πρώτη κλωνοποίηση ανθρώπινων βλαστοκυττάρων που επετεύχθη τον περασμένο Μάιο από ερευνητές του Πανεπιστημίου Υγείας και Επιστήμης στο Ορεγκον των Ηνωμένων Πολιτειών ανοίγοντας τον δρόμο για τη θεραπεία ασθενειών και την αναγέννηση ιστών και οργάνων, όπως καρδιάς, μυών και εγκεφάλου.

2013... επιστημονικά θαύματα που άλλαξαν τον κόσμο μας

Μετά από 15 χρόνια αποτυχημένων προσπαθειών, οι επιστήμονες εφάρμοσαν σε ανθρώπινα βλαστικά κύτταρα μια τεχνική κλωνοποίησης παρόμοια με εκείνη που είχαν εφαρμόσει οι Βρετανοί συνάδελφοί τους του Ινστιτούτου Ρόσλιν για να παράγουν το πρώτο κλωνοποιημένο θηλαστικό, το πρόβατο «Ντόλι» το 1996.



C)Αναγεννητική ιατρική με χρήση ομφάλιου λώρου

Το 2005, ο δρ McGuckin και ο δρ Forraz απέδειξαν για πρώτη φορά “την ύπαρξη πολυδύναμων βλαστικών κυττάρων στρ αίμα ομφάλιου λώρου, τα οποία ονομάστηκαν βλαστικά κύτταρα από αίμα ομφάλιου λώρου παρόμοια με τα εμβρυονικά (Cord Blood-derived Embryonic-like Stem Cells, CBE) λόγω των συγγενών χαρακτηριστικών τους με τα εμβρυονικά βλαστοκύτταρα. Τα CBE έχουν την ικανότητα να σχηματίζουν διάφορους τύπους ιστού όπως αίμα, νευρικά κύτταρα, πάγκρεας ή ήπαρ, προσφέροντας ενδιαφέρουσες προοπτικές για Βιοτεχνολογία και κλινικές εφαρμογές.

Το 2005 και το 2006, ο/καθηγητής McGuckin δημοσίευσε τα αποτελέσματα από την πρώτη δημιουργία ηπατικού ιστού σε τρείς διαστάσεις (3D) χρησιμοποιώντας βλαστικά κύτταρα από ανθρώπινο αίμα ομφάλιου λώρου. Για να το επιτύχει αυτό, ή ομάδα του συνεργάστηκε με την Εθνική Υπηρεσία Αεροναυτικής και Διαστήματος (NASA) υπό τη διεύθυνση και χρηματοδότηση του βρετανικού υπουργείου Επιστήμη, και Τεχνολογίας. Η συνεργασία αυτή με τη NASA και με δύο πανεπιστήμια των ΗΠΑ ως εταίρους (Rice University και University of Texas) επέτρεψε την ανάπτυξη του βιοαντιδραστήρα μικροβαρύτητας για μηχανική ιστών. Τα μοντέλα τεχνητού ηπατικού ιστού ενδέχεται να χρησιμοποιηθούν σε κλινικές εφαρμογές τα προσεχή χρόνια. Όσον αφορά τη φαρμακευτική έρευνα, τα μοντέλα αυτά συμβάλλουν ήδη στην ανάπτυξη φαρμάκων για την αντιμετώπιση των τοξικών παρενεργειών στον ανθρώπινο ιστό. Το 2007, η ομάδα του καθηγητή δημοσίευσε ένα άρθρο όπου παρουσιάζονταν οι ανθρώπινοι ιστοί που παράγουν ινσουλίνη. Αυτή η έρευνα είναι ένα σημαντικό βήμα για τη θεραπεία του διαβήτη.

Προάγγελος της ιατρικής του μέλλοντος

Ο δρ Colin McGuckin, πρόεδρος και διευθυντής του Διεθνούς Ινστιτούτου Κυτταρικών θεραπειών στη Λιόν της Γαλλίας και πρόεδρος του μη κερδοσκοπικού οργανισμού Novus Sanguis για την Αναγεννητική Ιατρική, πρόσφατα βρέθηκε στη χώρα μας και κατά τη διάρκεια επιστημονικής εκδήλωσα δήλωσε μεταξύ άλλων:

«Μέσα σε λιγότερα από 20 χρόνια τα Βλαστικά κύτταρα αναδείχθηκαν από μια σχεδόν άγνωστη έννοια σε προάγγελο της ιατρικής του μέλλοντος.»
Τα Μεσεγχυματικά Βλαστικά Κύτταρα, (MSC), είναι ένας τύπος πολυδύναμων ενήλικων Βλαστικών κυττάρων, τα οποία τα βρίσκουμε σε σημαντικά μεγάλες ποσότητες στον ίδιο το ιστό του ομφάλιου λώρου (συγκεκριμένα στη γέλη του Whartοn -ουσία του ομφάλιου λώρου- και στους πλακουντιακούς ιστούς).Ένα από τα Βασικά πλεονεκτήματα της γέλης του Wharton είναι ότι δεν υπάρχει κανένας κίνδυνος κατά τη διαδικασία συλλογής».

Έχει αποδειχθεί, συνέχισε ο καθηγητής, «η δυνατότητα των μεσεγχυματικών βλαστικών κυττάρων να διαφοροποιούνται σε πληθώρα διαφορετικών ιστών, όπως οστικό, χόντρους ,λιπώδη, ηπατικό, νευρικό, παγκρεατικό και μυϊκό, και τα εν λόγω κύτταρα θεωρούνται επίσης ότι έχουν αναγεννητικές δυνατότητες για συγκεκριμένες εκφυλιστικές παθήσεις. Η αποθήκευση αυτών των κυττάρων θεωρείται πλέον εφικτή από τον ομφάλιο λώρο, μέσω των νέων καινοτομιών στην τεχνολογία ψύξης. Η χρησιμότητα των μεσεγχυματικών βλαστοκυττάρων επιβεβαιώνεται από τα θετικά κλινικά αποτελέσματα διαφόρων ερευνητικών κέντρων με τη χορήγηση αυτόλογων MSC (ο ίδιος ασθενής ως δότης) σε ασθενείς που υποφέρουν από παθήσεις όπως έμφραγμα του μυοκαρδίου, οστική νέκρωση, κατάγματα οστών, ρήξη μηνίσκου, διαβήτη τύπου 1, οξεία νέκρωση του εγκεφάλου, αποφρακτική αρτηριοπάθεια και χρόνια τοξική ηπατοπάθεια. Να χρησιμοποιηθούν δηλαδή στην Αναγεννητική Ιατρική.

«Αναγεννητική ιατρική είναι ο όρος με τον οποίο περιγράφεται πλέον αυτό που θεωρείται ως «το τελευταίο οχυρό» της έρευνας: Η αναγέννηση του φθαρμένου ιστού με τρόπο που θα εγγυάται την αποκατάσταση της λειτουργίας όχι μόνο ενός, αλλά πληθώρας εξειδικευμένων ιστών, όπως ήπαρ, πάγκρεας, μυοκάρδιο, προστάτης, οστά, χόντρος, ενδοθήλια, καρδιακές βαλβίδες, κύστη, ακουστικό σύστημα, οπτικό σύστημα, επινεφρίδια, δέρμα και άλλα, μέσω της μεταμόσχευσης κυττάρων, με σκοπό την παροχή νέων θεραπευτικών αγωγών για παθολογίες ή βλάβες, οι οποίες δεν είναι δυνατόν να αντιμετωπισθούν αποτελεσματικά από τις συμβατικές ιατρικές και φαρμακολογικές θεραπείες»


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A New—and Reversible—Cause of Aging

A naturally produced compound rewinds aspects of age-related demise in mice

Mitochondria, organelles on the right, interact with the cell's nucleus to ensure a healthy, functioning cell. Image by Ana Gomes

Mitochondria, organelles on the right, interact with the cell’s nucleus to ensure a healthy, functioning cell. Image by Ana Gomes  Researchers have discovered a cause of aging in mammals that may be reversible.

The essence of this finding is a series of molecular events that enable communication inside cells between the nucleus and mitochondria. As communication breaks down, aging accelerates. By administering a molecule naturally produced by the human body, scientists restored the communication network in older mice. Subsequent tissue samples showed key biological hallmarks that were comparable to those of much younger animals.

“The aging process we discovered is like a married couple—when they are young, they communicate well, but over time, living in close quarters for many years, communication breaks down,” said Harvard Medical School Professor of Genetics David Sinclair, senior author on the study. “And just like with a couple, restoring communication solved the problem.”

This study was a joint project between Harvard Medical School, the National Institute on Aging, and the University of New South Wales, Sydney, Australia, where Sinclair also holds a position.

The findings are published Dec. 19 in Cell.

Communication breakdown

Mitochondria are often referred to as the cell’s “powerhouse,” generating chemical energy to carry out essential biological functions. These self-contained organelles, which live inside our cells and house their own small genomes, have long been identified as key biological players in aging. As they become increasingly dysfunctional overtime, many age-related conditions such as Alzheimer’s disease and diabetes gradually set in.

Researchers have generally been skeptical of the idea that aging can be reversed, due mainly to the prevailing theory that age-related ills are the result of mutations in mitochondrial DNA—and mutations cannot be reversed.

Sinclair and his group have been studying the fundamental science of aging—which is broadly defined as the gradual decline in function with time—for many years, primarily focusing on a group of genes called sirtuins. Previous studies from his lab showed that one of these genes, SIRT1, was activated by the compound resveratrol, which is found in grapes, red wine and certain nuts.

Sirt1 protein, red, circles the cell's chromosomes, blue. Image by Ana Gomes

Sirt1 protein, red, circles the cell’s chromosomes, blue. Image by Ana GomesAna Gomes, a postdoctoral scientist in the Sinclair lab, had been studying mice in which thisSIRT1 gene had been removed. While they accurately predicted that these mice would show signs of aging, including mitochondrial dysfunction, the researchers were surprised to find that most mitochondrial proteins coming from the cell’s nucleus were at normal levels; only those encoded by the mitochondrial genome were reduced.

“This was at odds with what the literature suggested,” said Gomes.

As Gomes and her colleagues investigated potential causes for this, they discovered an intricate cascade of events that begins with a chemical called NAD and concludes with a key molecule that shuttles information and coordinates activities between the cell’s nuclear genome and the mitochondrial genome. Cells stay healthy as long as coordination between the genomes remains fluid. SIRT1’s role is intermediary, akin to a security guard; it assures that a meddlesome molecule called HIF-1 does not interfere with communication.

For reasons still unclear, as we age, levels of the initial chemical NAD decline. Without sufficient NAD, SIRT1 loses its ability to keep tabs on HIF-1. Levels of HIF-1 escalate and begin wreaking havoc on the otherwise smooth cross-genome communication. Over time, the research team found, this loss of communication reduces the cell’s ability to make energy, and signs of aging and disease become apparent.

“This particular component of the aging process had never before been described,” said Gomes.

While the breakdown of this process causes a rapid decline in mitochondrial function, other signs of aging take longer to occur. Gomes found that by administering an endogenous compound that cells transform into NAD, she could repair the broken network and rapidly restore communication and mitochondrial function. If the compound was given early enough—prior to excessive mutation accumulation—within days, some aspects of the aging process could be reversed.

When Sirt1 loses its ability to monitor HIF-1, communication between mitochondria and the nucleus breaks down, and aging accelerates. Image by Ana Gomes

When Sirt1 loses its ability to monitor HIF-1, communication between mitochondria and the nucleus breaks down, and aging accelerates. Image by Ana Gomes

Cancer connection

Examining muscle from two-year-old mice that had been given the NAD-producing compound for just one week, the researchers looked for indicators of insulin resistance, inflammation and muscle wasting. In all three instances, tissue from the mice resembled that of six-month-old mice. In human years, this would be like a 60-year-old converting to a 20-year-old in these specific areas.

One particularly important aspect of this finding involvesHIF-1. More than just an intrusive molecule that foils communication, HIF-1 normally switches on when the body is deprived of oxygen. Otherwise, it remains silent. Cancer, however, is known to activate and hijack HIF-1. Researchers have been investigating the precise role HIF-1 plays in cancer growth.

“It’s certainly significant to find that a molecule that switches on in many cancers also switches on during aging,” said Gomes. “We’re starting to see now that the physiology of cancer is in certain ways similar to the physiology of aging. Perhaps this can explain why the greatest risk of cancer is age.”

“There’s clearly much more work to be done here, but if these results stand, then certain aspects of aging may be reversible if caught early,” said Sinclair.

The researchers are now looking at the longer-term outcomes of the NAD-producing compound in mice and how it affects the mouse as a whole. They are also exploring whether the compound can be used to safely treat rare mitochondrial diseases or more common diseases such as Type 1 and Type 2 diabetes. Longer term, Sinclair plans to test if the compound will give mice a healthier, longer life.

The Sinclair lab is funded by the National Institute on Aging (NIA/NIH), the Glenn Foundation for Medical Research, the Juvenile Diabetes Research Foundation, the United Mitochondrial Disease Foundation and a gift from the Schulak family.

By DAVID CAMERON  19/12/2013



Turning back time: ageing reversed in mice

Imagine if we could turn back time. A team that has identified a new way in which cells age has also reversed the process in old mice whose bodies appear younger in several ways. The discovery has implications for understanding age-related diseases including cancers, neurodegenerative disorders and diabetes.

One way all mammalian cells produce energy is via aerobic respiration, in which large molecules are broken down into smaller ones, releasing energy in the process. This mainly occurs in the mitochondria – the “powerhouses” of cells. Mitochondria carry their own genomes, but some of the cellular components needed for respiration are produced partly by the nucleus, so the two must coordinate their activities.

As we age, mitochondrial function declines, which can lead to conditions such as Alzheimer’s disease and diabetes. To investigate why this decline occurs, Ana Gomes at Harvard Medical School and her colleagues compared the levels of messenger RNA (mRNA) – molecules that convey genetic information around a cell – for the cellular components needed for respiration in the skeletal muscle of 6 and 22-month-old mice.

They found that the level of the mRNA in the nucleus did not change much between the young and old mice, whereas those from the mitochondria appeared to decline with age.

Similar changes were seen in mice that lacked a protein called SIRT1 – high levels of which are associated with calorie restriction and an increased lifespan. These mice also had higher levels of a protein produced by the nucleus called hypoxia inducible factor (HIF-1α).

What was going on? It appears that communication between the nucleus and the mitochondria depends on a cascade of events involving HIF-1α and SIRT1. As long as SIRT1 levels remain high and the two genomes communicate well, ageing is kept at bay. But another molecule called NAD+ keeps SIRT1 on the job; crucially, the amount of NAD+ present in the cell declines with age, though no one knows why, leading to a breakdown in communication.

Turning back time

The team wondered if this aspect of ageing could be reversed by increasing the amount of SIRT1 in the cells. To find out if that was possible, they injected 22-month-old mice twice daily for a week with nicotinamide mono nucleotide (NMN) – a molecule known to increase levels of NAD.

At the end of the week, markers of muscular atrophy and inflammation had dropped and the mice had even developed a different muscle type more common in younger mice. Together, these features were characteristic of 6-month-old mice.

“We found that modulating this pathway can improve mitochondrial function and age-associated pathologies in old mice, and therefore it gives a new pathway to target that can reverse some aspects of ageing,” says Gomes.

“This paper clearly demonstrates that NAD+ production is a sort of ‘Achilles’ heel’, [a lack of which] significantly contributes to ageing, and also that this problem can be ameliorated by boosting NAD+ production with key intermediates, such as NMN,” says Shin-Ichiro Imai, at Washington University School of Medicine in St Louis, Missouri.

Journal reference: Cell, DOI: 10.1016/j.cell.2013.11.037

by Laasya Samhita


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