Introduction
Evidence concerning the interactions between human health and planetary health has grown extensively in recent years. In turn, the perceived importance of environmental sustainability within higher education is growing at a rapid rate. This paper provides a summary of key elements as they apply to dentistry, and provides an introduction to the reader of an early consensus of how sustainability could be included as part of the dental curriculum.
Methods
The consensus opinion within this paper largely centres around discussion at the ADEE sustainability workshop at the annual conference in Berlin (August 2019). In order to help inform discussions at the workshop, a brief scoping questionnaire was circulated to potential participants regarding their understanding and current teaching practices in sustainability. An infographic was designed to help delegates remember the important elements of sustainable dentistry. Delegates discussed the concept of sustainability alongside the infographic, and how they could link these with the Graduating European Dentist (GED) curriculum.
Results
The discussions within the workshop largely centred around 4 main themes: Disease prevention and health promotion, Patient education and empowerment, Lean service delivery and Preferential use of strategies with lower environmental impact.
Discussion
It is apparent that there is a widespread need for teaching materials relating to environmental sustainability; this includes specific learning outcomes relating to the 4 educational domains of the Graduating European Dentist curriculum, and methods for teaching and assessing these outcomes.
Conclusion
This paper reports consensus on the first phase of a pan‐European working group on Sustainability in dental education.
Background/Aims: Podocytes are critical in maintaining the filtration barrier of the glomerulus and are dependent on the slit diaphragm. We hypothesized that disturbances of podocyte biology contribute to proteinuria in women with preeclampsia (PE). Methods: A human podocyte cell line was stimulated with serum from women with PE (patients) and healthy pregnant women (controls); the main changes in 3 important podocyte proteins: podocin, CD2AP and actin were established by immunofluorescence and Western blot; we also searched for changes in cell plasticity by measuring the resistance of cultured podocytes. Results: Different distributions of CD2AP, podocin and actin were observed in the podocytes stimulated with patient sera compared to podocytes stimulated with control sera. We also found that the mean resistance value of podocytes cultured with serum from women with PE was significantly lower than podocytes cultured with serum from controls. There was no difference in the protein expression level of podocin and CD2AP between patients and controls. Conclusions: We present evidence that there are differences in podocytes when stimulated with sera from women with PE compared to those stimulated with healthy pregnancy sera. This is the first time that podocyte alterations have been directly related to PE; these descriptive findings could be considered as an interesting beginning for further studies relating podocytes and PE.
Preeclampsia is a frequent cause of maternal and fetal morbidity and mortality worldwide. The underlying causes of this hypertensive complication have remained elusive. The placenta seems to be at the origin of the disease, as its removal appears to be the only effective treatment available. Many organs can potentially be affected. Nonetheless, kidney alterations are always present: proteinuria is one of the hallmarks for a preeclampsia diagnosis. VEGF is pivotal for maintaining glomerular filtration barrier function; hence, the elevated concentrations of placental-derived VEGF inhibitors, such as sFlt-1, may largely explain the renal alterations observed. Classically, glomerular endothelial injury was considered responsible for the renal impairment present in preeclampsia. Recent findings, however, have shown that podocytes are crucial in explaining the loss of filtration capacity of the preeclamptic kidney. The aims of this manuscript are to detail the main findings that associate podocyte injury with proteinuria in preeclampsia, and discuss the eventual applications of podocyte damage biomarkers in clinical practice.
VEGF deficiency within the glomerulus in women with PE leads to the disruption of podocyte and glomerular endothelium symbiosis. The evidence demonstrating that exogenous VEGF administration in a rat model of PE could alleviate hypertension and proteinuria in these animals are encouraging in view of looking for therapeutic approaches in this direction, nonetheless further evidence should be provided in humans to directly demonstrate that VEGF supplementation could mitigate the symptoms of PE.
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