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Archived Comments for: Vasa vasorum in plaque angiogenesis, metabolic syndrome, type 2 diabetes mellitus, and atheroscleropathy: a malignant transformation

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  1. Pre-metabolic syndrome: the real initial stage of metabolic-syndrome, type 2 diabetes and arteroscleropathy.

    Sergio Stagnaro, Private

    17 February 2004

    I agree completely with this exciting article authors who state that MS, PD, and T2DM are associated with endothelial dysfunction and carry an elevated risk for both micro and macrovascular disease that are often present at the time of diagnosis of overt T2DM. Postnatal vascularization in a response to injury mechanism to the endothelium and the arterial vessel wall as well as the capillary bed result in most of the complications associated with these disorders. I demonstrated, since 30 years, in early papers that all individuals with Campbell de Morgan spots (cutaneous microangiomas) are involved by a particular mitochondrial cytopathology, termed Congenital Acidosic Enzyme –Metabolic Hystangiopathy-a (CAEMH-a) (1, 2, 3, 4), conditio sine qua non of diabetic, dyslipidemic, arteriosclerotic, hypertensive, a.s.o., constitutions (See HONCode web site 233736,

    Really, we must consider the importance of bed side recognizing all these inherited conditions, which play a paramount role in primary prevention of MS, PD, and T2DM, among other common human diseases, including malignancy.

    In fact, from the healthy stage, white zone, slowly, very slowly one can reach the disease onset, black zone – DM, ATS, AI, dyslipidaemia, gout, malignancies, a.s.o., going through the pre-morbid, pre-metabolic stage, or grey zone, that can last years or decades, without any clinical symptomatology, which is the topic of my comment, as far as arteriosclerosis (arterioscleropathy) and type 2 DM are concerned.

    Metabolic syndrome, X syndrome, or Reaven’s syndrome, classic or “variant”, I described years ago (5), represent the possible end of grey zone. Due to this reason, we term the grew zone as pre-morbid or pre-metabolic syndrome (Oncological Terrain, in above-cited site).

    Interestingly, both grey zone and metabolic syndrome, classic or “variant”, are based on Congenital Acidosic Enzyme-Metabolic Histangiopathy-a (CAEMH-a) (1,2,3,4 and the above-cited site), observable since birth-day obviously in individual CAEMH-a positive. It is a functional mitochondrial cytopathology, inheredited, as a general rule, from the mother, mainly asymptomatic in initial stages, as well as for long time, before ending in poly-metabolic syndrome.

    The main problem, we have to face and hopefully resolve, is, therefore, to recognize and define “clinically” underlying molecular-biological events, characteristic of grey zone by means of efficacious method, rapid to perform at the bed-side, as Biophysical Semeiotics, meaning it as conceptual and operative tool.

    In the method are implicit all future knowledges, and, thus, we ask this method – but not only to logic-deductive method, according to our philosophy (4) to allow us to recognize “clinically” pre-morbid syndrome, which represents the locus of primary prevention of most severe human diseases (1-5). Therefore, as starting point of our reasoning, it is to be found a biophysical semeiotic reading key, really different from that, based on “classic” signs and symptoms, which are, on the other hand, completely absent in pre-morbid stage or grey zone, which permits us to correctly diagnose in a “quantitative” manner the pre-metabolic syndrome, in easy and rapid way, during common physical examination, even performed for whatever other reason.


    1) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre, Bellagio 1983

    2) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, Siena 1981

    3) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Una Patologia Mitocondriale Ignorata. Gazz Med. It. – Arch. Sci. Med. 144, 423 (Infotrieve) 1985

    4) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeitica Biofisica. Il Terreno Oncologico. Travel Factory Ed., Roma, (in press).

    5) Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617 (Pub-Med indexed for Medline) 1993

    Competing interests

    None declared