However, emerging research suggests that its unique mechanism of action may extend to various other physiological processes. This article explores the speculative implications of Bremelanotide in research domains such as neuroprotection, inflammation modulation, energy homeostasis, and pigmentation regulation, aiming to provide a comprehensive overview of its potential beyond traditional research scope.

Bremelanotide is a cyclic heptapeptide derived from \u03b1-MSH, functioning as a non-selective agonist of melanocortin receptors, excluding MC2R. Its primary interaction with MC3R and MC4R has been linked to central nervous system activities, including pathways involved in sexual arousal. While its possible role in modulating sexual desire has been a focal point, there is a growing interest in understanding how its receptor interactions might influence other physiological functions.

The melanocortin system is considered to play a key role in various biological pathways, including energy balance, immune response, pigmentation, and neuroprotection. Bremelanotide’s potential to bind to multiple melanocortin receptors suggests that its relevance in research may extend far beyond its originally intended scope. By investigating its potential impact on various physiological systems, researchers may uncover novel roles for this peptide in the field of science.

Neuroprotective Potential

The involvement of the melanocortin system in neuroprotection has been a subject of interest. The activations of MC4R and MC3R in the central nervous system are associated with anti-inflammatory and neuroprotective responses. Bremelanotide’s proposed affinity for these receptors suggests that it might have the potential to mitigate neurodegenerative processes. It has been hypothesised that Bremelanotide might modulate microglial activation, thereby reducing neuroinflammation and promoting neuronal survival.

Neurodegenerative disorders such as Alzheimer’s and Parkinson’s diseases are characterised by chronic inflammation and oxidative stress. Given that the melanocortin system has been implicated in cellular protection, Bremelanotide may serve as a research candidate in exploring novel research related to these conditions. Furthermore, its influence on synaptic plasticity and neurotransmitter release warrants further investigation to determine whether it might contribute to cognitive function enhancement or neuroregeneration.

Inflammation and Immune Response Research

Beyond the nervous system, melanocortin receptors are expressed in various immune cells, suggesting that they play a role in regulating inflammatory responses. Research indicates that melanocortin agonists may suppress pro-inflammatory cytokine production and support anti-inflammatory cytokine release. Bremelanotide’s interaction with these receptors suggests a potential to modulate immune responses, which could be relevant for exploration in conditions characterised by excessive inflammation, such as autoimmune diseases.

Several autoimmune and inflammatory disorders, including rheumatoid arthritis, multiple sclerosis, and inflammatory bowel disease, are characterised by dysregulated immune responses. It has been theorised that Bremelanotide might influence immune cell signalling pathways that contribute to the resolution of inflammation. Additionally, its potential involvement in reducing oxidative stress further supports the idea that melanocortin receptor modulation may play a role in immune system regulation.

Research in Energy Homeostasis and Weight

The central melanocortin system plays a crucial role in regulating energy balance and appetite. MC4R, in particular, is considered to be crucial in mediating signals related to food intake and energy expenditure. Bremelanotide’s agonistic action on MC4R suggests that it might influence feeding behaviours and metabolic processes. Studies suggest that Bremelanotide may suppress appetite and promote energy expenditure, indicating potential applications in the context of obesity and metabolic syndrome.

The hypothalamic melanocortin system regulates energy homeostasis through complex interactions with leptin, insulin, and ghrelin. It has been suggested that Bremelanotide might influence hypothalamic signalling, leading to alterations in appetite control and thermogenesis. Research into its potential to affect glucose metabolism and lipid oxidation may further clarify its role in metabolic disorders.

Pigmentation and Dermatological Research

Bremelanotide’s origin as a derivative of Melanotan II, initially developed to stimulate melanin production, suggests its potential impact on skin pigmentation. Studies suggest that by activating MC1R on melanocytes, Bremelanotide might stimulate melanin synthesis, leading to tanning or hyperpigmentation on the outermost epidermal layers. This potential can be explored in research related to pigmentation disorders, such as vitiligo, where increasing melanin production is a research goal.

Additionally, its possible impacts on pigmentation could have implications in photoprotection and dermatological studies. It has been theorised that MC1R activation might increase the skin’s resistance to ultraviolet (UV) radiation, potentially offering protective properties against photodamage. Investigating Bremelanotide’s role in melanocyte biology could reveal additional research implications, particularly in pigmentation-related conditions and the prevention of sun damage.

Cardiovascular Research

Melanocortin receptors are also present in cardiovascular tissues, suggesting that Bremelanotide might influence cardiovascular functions. It has been theorised that melanocortin agonists might modulate blood pressure and heart rate through central mechanisms. Bremelanotide’s impact on these parameters warrants investigation, particularly regarding its potential to address conditions such as hypotension or heart failure.

Research indicates that MC4R activation may influence vascular tone and autonomic regulation of blood pressure. Given that the melanocortin system interacts with other regulatory peptides involved in cardiovascular function, Bremelanotide may be studied in the context of circulatory system disorders. However, more comprehensive studies are necessary to determine its precise impact on cardiovascular physiology.

Gastrointestinal Motility

The expression of melanocortin receptors in the gastrointestinal tract indicates that Bremelanotide might affect gastrointestinal motility. Research suggests that melanocortin pathways might influence gastric emptying and intestinal transit times. Bremelanotide’s interaction with these receptors suggests potential relevance in the study of disorders like gastroparesis or irritable bowel syndrome, where motility is disrupted.

The hypothesised role of melanocortin receptors in gut-brain signalling implies that Bremelanotide might impact both central and peripheral mechanisms of digestive function. Further research into its potential impact on smooth muscle contraction and enteric nervous system activity could provide valuable insights into its gastrointestinal applications.

Pain Perception

The melanocortin system has been implicated in pain modulation, with MC4R playing a role in nociceptive processing. Bremelanotide’s activation of central melanocortin receptors suggests that it might influence pain perception. It has been hypothesised that Bremelanotide might have analgesic potential, offering a novel approach to pain management. Investigating its impact on pain pathways could lead to new insights into analgesic approaches.

Pain disorders involving central sensitisation, such as fibromyalgia and neuropathic pain, may be influenced by melanocortin receptor activity. Further studies exploring its role in nociceptive processing, as well as its interaction with opioid and cannabinoid systems, may offer new directions in pain research.

Conclusion

Bremelanotide’s interactions with melanocortin receptors are thought to extend beyond its proposed role in modulating sexual function. Its potential relevance for novel studies in neuroprotection, immune modulation, energy homeostasis, pigmentation, cardiovascular regulation, gastrointestinal motility, and pain perception presents exciting avenues for research. While current data is preliminary, these speculative applications highlight the need for comprehensive studies to fully understand Bremelanotide’s multifaceted properties and its potential implications across various physiological systems. Researchers may check this study for more peptide data. 

References

[i] Bolognese, A., & Corsi, M. (2019). Melanocortin peptides: From structure to function in neuroprotection and immune modulation. Current Medicinal Chemistry, 26(30), 5513-5532. https://doi.org/10.2174/0929867326666181106121059

[ii] Dorrance, A. M., & Fagundes, R. (2017). Melanocortin receptor agonists in the regulation of cardiovascular function. Frontiers in Physiology, 8, 789. https://doi.org/10.3389/fphys.2017.00789

[iii] Gantz, I., & Tashiro, T. (2020). The melanocortin receptor system in metabolic regulation. Trends in Endocrinology & Metabolism, 31(4), 250-264. https://doi.org/10.1016/j.tem.2020.01.006

[iv] Smith, D. M., & McElroy, S. L. (2021). Bremelanotide and neuroprotection: Implications for Alzheimer’s and Parkinson’s disease. Neuropharmacology, 181, 108336. https://doi.org/10.1016/j.neuropharm.2020.108336

[v] Seppälä, M., & Hooper, D. C. (2018). The role of melanocortins in immune modulation and inflammatory diseases. Journal of Immunology Research, 2018, 1409162. https://doi.org/10.1155/2018/1409162

This article is intended solely for informational and research discussion purposes. Bremelanotide (PT-141) is not approved for therapeutic use in the European Union or Romania. The content provided does not constitute medical advice, diagnosis, or treatment recommendations. Any mention of physiological effects or potential applications refers to preclinical or experimental research findings. Bremelanotide should not be used outside of authorised clinical research settings. Always consult a licensed healthcare professional before considering any investigational substance.

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Medical Tourism in Romania: What medical services are sought by the foreign tourists

Most foreign tourists come for dental surgery, which is famous for its quality-pricing ratio. Romanian dental clinics receive substantial requests from patients abroad, which adds to their annual revenue.

Also, Romania is famous for cosmetic and plastic surgery clinics, and from this perspective, a good percentage of foreign tourists come for plastic surgery procedures.

Orthopedic surgery and oncology are other fields for which international patients seek Romania.

Of the total money spent in Romania, about EUR 14 million went on medical treatment, and another EUR 6 million was paid for accommodation. This means that not only the clinics but also the hotels and restaurants profit from this influx of medical tourists in Romania.

Medical tourism in Romania compared to that in the neighbouring countries

The situation in the neighbouring countries is quite different, though. Why is Romania, a big country with reputable specialists, behind the neighbouring countries?

Hungary attracts about 2 million medical tourists annually, 100 times more than Romania. Hungary is mainly known for its excellence in dental care, cosmetic surgery, orthopedic treatments and eye services.

On the other hand, the other two neighbouring countries, Serbia and Bulgaria, are included in the statistics, and each of them attracts almost 50,000 medical tourists yearly. This is two times more than Romania, and if Bulgaria is also a famous summer destination for Western tourists, one could ask himself why Serbia, a country three times smaller than Romania, accommodates two times more tourists for medical treatments.

Romania has plenty of potential in this field, and thousands of medical tourists search for our recommendations for local clinics in Romania. The quality of the services, the pricing, and the leisure opportunities make Romania a country that could take advantage of the medical staff’s skills and the latest medical developments.

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MCRO, one of the most reputable software development companies in Cluj Napoca, launched Docviser, the first oncology healthcare application in Romania, dedicated to improving the collaboration between doctors and the care of cancer patients.

DOCVISER is a product that incorporates Artificial Intelligence to extract relevant data and provide the best results to improve medical decisions for those who use it. And the numbers so far are highly encouraging.

Since the launch of this application, it has been used by 99 doctors, nurses and pharmacists from 29 clinics registered in the application.

Artificial Intelligence helped all these specialists to prescribe 5106 drugs and treatment schemes and monitor treatment progress for the benefit of 1876 patients. During all this time, the platform supported establishing remote medical commissions to analyze 67 complex cases requiring multidisciplinary decision-making, with specialists located in different locations.

Docviser involves intelligently prescribing treatment through the continuous development of an artificial intelligence model. It recommends the optimal treatment in each case, taking into account both the active substance through the treatment protocol and the dose prescribed based on the one calculated and adjusted according to comorbidities, creatinine level and other relevant indicators that will appear in the future.

The product was developed with the direct involvement of oncologists, adapted to their needs and streamlines the flow of information from the patient to doctors, medical staff and pharmacists, offering real-time progress on the status of the treatment protocol.

The process of using DOCVISER involves oncologists but also assistants and pharmacists:

• Clinic doctors upload all patient data and initial diagnosis.
• For each case, a treatment protocol is assigned with the drug and dose recommended by the platform, or the doctor can decide to prescribe a new treatment.
• Once the treatment protocol is validated, it is sent to the pharmacy for preparation.
• As soon as the treatment is prepared, it is sent to the nurse to be administered to the patient.

Throughout the process, all the medical personnel involved in the patient’s treatment receive, depending on the level of access, live notifications about the status of the treatment protocol. Doctors can communicate through the web application through messages, comments or video calls, which made it possible to streamline the meetings of tumor boards.

DOCVISER helps me make better treatment decisions by leveraging the power of state-of-the-art technology and Artificial Intelligence. But even if we think about the current activities, such as meeting multidisciplinary committees – the application allows the oncologist to talk in real-time with other doctors from other specialties (pathological anatomy, radiotherapy, cardiology and others) or simply to ask for a second opinion, and this makes these decisions much easier to make in a very organized environment. Before Docviser, it was much more difficult to set up these commissions, and doctors had to send the documents from one to another to be analyzed and signed. It was harder to meet, we communicated in writing, and working remotely was impossible. Docviser offers us all the support we need to make decisions much easier and securely. Now I can focus on what matters most – taking care of my patients.

Alexandru Iliescu, Medical Director and head of the Oncology Department of Zalău County Hospital.

DOCVISER unifies technology with the oncology patient care process. Within this application, medical records and health history exist securely in one place for physicians and licensed medical personnel to gain a fast, in-depth, data-driven understanding of each patient’s needs.

„Working with professionals in the field and having on our side medical expertise provided by oncology experts, we have created an intuitive and easy-to-use platform so that doctors and the entire medical staff can collaborate much more effectively within the clinics. DOCVISER perfectly combines scientific research and experience accumulated over the years with artificial intelligence and the latest generation of technological advances. I believe these fields are closely related, and there is an extraordinary potential in validating scientific research with real-life data; therefore, the application contributes to saving patients’ lives by making medical decisions easier”.

Alex Lazăr, CEO MCRO.

At the end of last year, Alex Lazar offered an exclusive interview to our news platform, and he talked more about the advantages of using DOCVISER in oncology.

Docviser is an intelligent application for rapid care management of cancer patients and offers:

• Improving the collection of health data and the evolution of prescribed treatments;
• More accurate diagnosis, based on the medical experience of oncology professionals, transposed into the modules used by Artificial Intelligence;
• Personalized treatment protocols for each patient;
• The ability to communicate more quickly and efficiently between oncologists and the medical staff who help in oncological treatment;
• Cost and time management;
• Traceability of the medical document

DOCVISER is designed to become the online hub for cancer treatment services in the healthcare industry. This platform will become an indispensable tool for medical centers and open new cancer treatment and research horizons. The platform has the potential to revolutionize healthcare systems as we know them, using machine learning, artificial intelligence, big data and other intelligent technologies.

About MCRO

MCRO is a software development company focused on building innovative digital products. With over ten years of application development experience, MCRO’s software developers maximize the use of Artificial Intelligence from product creativity and design to development and scaling to provide companies with a maximized return on investment.

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As we published earlier, MCRO, one of the region’s most reputable software development companies dedicated to improving doctor collaboration and cancer patient care, launched Docviser, the first intelligent oncology healthcare app developer in Romania.

 Here’s the full interview with the Docviser App co-founder.

Interview with Alexandru Lazar

Hello, everyone! We are continuing our interview series with a special guest. His name is Alexandru Lazar, and he is the co-founder of Docviser. A platform that enables doctors to connect with medical peers and discuss challenging cases in a secure environment.

In the interview, we will discuss more on the app, and the challenges faced. Hi Alex, thanks for accepting my invitation and welcome to our interview series for entrepreneurs. How are you?

Alexandru Lazar: Hi Maria, I’m good, thanks. Thanks for inviting me.

To get to know more about Docviser app we would like to know your definition of it, what is Docviser, and what it represents in terms of innovation.

Alexandru Lazar: Docviser is a medical software platform dedicated to oncology centers that are meant to help clinics optimize the oncology practice and improve their performance overall. What it brings is actually clinics will have a flow that allows doctors to use a shared database or treatment protocols that are global, prescribe treatments, set the proper doses based on the calculated warrants and then validate the treatment and then send it to the actual pharmacy of the hospital if there is a pharmacy if there is not, directly to the nurse that would further administer it.

The entire process happens in real-time for everyone, in full transparency. Doctors will be able to oversee everything, the entire flow from prescription to administering the treatment in real-time. That’s the main feature of Docviser.

Other features will include the Tumour Board for the doctors to make the best decision for their patients. They have the option to join offline and meet in the same room and online in a Google meet-like conference room adapted for them to be able to discuss specific case studies, work on a resolution and add anything relevant to them that would make everyone take the best decision. Besides that, we also offer powerful clinic reports that help clinics logistically organize their staff better and be able to determine the exact quantity of drugs to be administered in the following months based on the previous month’s records.

What can you tell us about the beneficiaries of this platform?

Alexandru Lazar: In my opinion pretty much everyone involved in the process will benefit tremendously, starting with patients who are the main actors and the platform is dedicated to making their lives easier, to doctors, clinics, and ultimately to research teams, I think everyone would benefit big time! As I mentioned earlier, the clinic flow will shorten the time for patients to stay in the hospitals, doctors will be able to collaborate more accessible and use the clinic flow to handle even more patients, and clinics will benefit logistically because using the report system they would be able to assess what quantity of certain drugs will be administered based on previous months records, and other statistics like the performance of the medical staff. Because you have an activity at the clinic where you can see who is performing what, and you can assess that as well. Of course, the research part, with its medical data stored securely and efficiently, will enable research to be done properly with solid data with real patients treated at the specific hospitals, compared to fake data on paper and the fact that we require the doctor to send a status, we finalize treatment they have to choose between several statues like ‘’progressive disease, a stationary disease, a partial or a complete response’’, this will further enable us to build a proper milling list on the prescription and use data for research purposes to check if the treatment was weather more efficient than the others and later on why not, build an AI around it to make some sorts of forecasting or treatments where we can get some % on the surviving chances based on several factors. Right now, we don’t have a lot of information collected from doctors other than the level of cretin and the body mass and a few other associated diseases, but later we want to introduce the genetic markers that are probably gonna be very relevant, my co-founder is a doctor he would be able to tell you more about it […]

So would you say this platform is a personal medical assistant for cancer patients?

Alexandru Lazar: Well, I would say it’s much in the future, but it’s not something impossible, so we’re gonna have to work a lot with doctors to analyze data and make sure it’s not biased and make sure we gather the correct results cause it can be very tricky.

Are there any similar apps?

Alexandru Lazar: I don’t think there is an app to contain the full set of features that we offer to close the loop with the clinic needs in terms of patient management, marked prescriptions, tumour boards and everything. I know some other applications that only offer a tool for tumour boards, for instance, that’s not even live conferences as we do. Offer the possibility to collaborate remotely, in a smart secure environment, not WhatsApp, Zoom, or Google Meet that’s not contained by a clinic or a single platform, and it’s definitely not a safe way to handle tumour boards, for instance, and other applications that I know asks doctors to enter their patient data for the sake of research, no, I strongly believe that Docviser has literally no competition out there at the moment.

What were the challenges of creating and developing this platform?

Alexandru Lazar: There were very many challenges, from securing the funds to deliver cause you need money, and money is an important resource, and to convincing clinics to use it. So these are all challenges, we went to several congresses, we’ve been discussing with doctors, we’ve been gathering feedback and all that. I believe the biggest challenge was to transpose what doctors had in their minds into the actual user experience. It’s very difficult to handle this with a non-technical person without distorting the actual need of the hospital, the actual reality. I believe here myself and Alex, my co-founder, together with my UX designer, played a very important role in determining the best way to handle the specific user experience in the application flow. That was the most difficult challenge.

I mean, that’s what we do at MCRO, we are a software company behind this product, and a pretty powerful software company and that was a good starting point which made our lives a lot easier to kick this off, so there were not many technical challenges, I would say more product and user experience challenges.

You mentioned something about money costs and resources at this moment, are we talking about any costs involved in this app, for those who use it?

Alexandru Lazar: Yes and no. It is fully free at the moment, and it will stay free for patients’ management and clinics’ prescriptions meaning the entire clinic flow, we will never charge for that. But we may charge for something like tumour boards as we make it more and more complex, and probably treatment forecasting once we have an efficient A.I. in place, and maybe clinic reports because logistically, that would help them a lot. We may charge for that in the future, but not right now.

How come the government didn’t finance your project?

Alexandru Lazar: We didn’t get any funds from the government, MCRO funded this project, and MCRO is the product development studio that stands behind the initiative, and that was an important factor in terms of receiving the funds. When Alex, my co-founder, a respected oncologist, came to me a year back and asked me if we could build software for him, he was ready to pay from his own pocket. I told him I don’t know if you have the money to pay for it because software costs a lot of money, especially if the developers are really expensive, but we’re probably gonna find a way in which to monetize on this one way or another. The government, I’m sure, has the best interests in digitalization, and the best thing they’ve done so far without needing any money is not to cast any stones in our way.

How do you see the future of this platform in Romania?

Alexandru Lazar: I think it has a very bright future, the plan for Docviser is to onboard all the public hospitals in Romania and the private ones, so why not. It would enable doctors to collaborate efficiently based on a globally shared database of treatment protocols, that would be ideal, right? The plan is to have everyone on the platform for the next years to come and make sure they use it successfully, giving us more courage to explore other markets cause we’re not gonna be limited only to Romania, we want to explore other European markets like Spain, the Netherlands and why not the UK, who is no longer part of Europe anymore but that’s a good market as well and possibly the US.

Thank you very much for accepting our invitation, and we hope that Docviser will be a real game changer in the medical system, and I wish you good luck with your entrepreneurial journey. See you soon.

Alexandru Lazar: Thank you for inviting me, I appreciate it!

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The Senate of the George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Romania (UMFST) decided, on October 1, the establishment of a clinical hub for interdisciplinary research and education.

UMFST has a rich history and actual achievements in the field of neurosciences, and cardiovascular and cerebrovascular research, so the establishment of this Institute will allow the innovation of university and postgraduate education, of research and clinical activity in the field of neurosciences in an autonomous academic institute.

professor Doctor Leonard Azamfirei, Rector of UMFST Targu Mures

The organization of courses in the form of summer postgraduate schools, Master of Science, for international students, offering subjects like neuroanatomy, neurogenetics, human and evolutionary biology, and medical radiology-imaging, will be made possible by an interdisciplinary education and research center connected to the George Emil Palade University Clinical Hospital that unites basic neurosciences with clinical ones.

Another benefit is the improvement in the calibre of interdisciplinary research, which has led to outside funding and Q1 publications, the training of highly qualified staff, guided to establish a culture of research and education, but also the conduct of basic and clinical research in neuroimaging, new effective and sensitive diagnostic and prognostic biomarkers, new therapies, including genetic therapies.

Romania’s medical universities are among the most prestigious in the country. Many foreign students come to Romania to study medicine because of the meagre costs. Outstanding doctors emerge from the benches of the country’s medical facilities, and through this implementation of a neurosurgery research clinic, students can perform incredibly in the neuroscience field.

Photo source: UMFST Facebook

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Romanians’ chase for pills

The reason for this chase began after the pandemic of the COVID-19 started in 2020; patients with other conditions were denied access to hospitals and doctors, particularly during periods of restriction. In this case, the Romanians coped with the situation crossing the thresholds of pharmacies and leaving a significant amount of money to get their treatment; the more expensive, the better.

However, at the level of consumption, the market grew at a slower rate. According to ZF, the market has registered a 5% increase in the number of boxes sent to Romanian patients. As a result, 658 million packages of drugs were delivered last year.

What pills do Romanians buy?

Digestive system drugs are among the most purchased in 2021, with over 152 million drugs reaching patients in this segment. Cardiovascular drugs come second, with 148 million boxes sold last year. As Ziarul Financiar reported, regarding pharmaceutical companies, the most prominent companies by value in 2021 were Sanofi, Novartis and Zentiva. In volume, two companies with local factories are in the first two positions – Zentiva and Sun Pharma.

But not only pills do Romanians buy. Also, supplements are more and more requested. The CEO of an important Romanian producer of supplements for diabetes confirms this.

The supplements market is growing. We offer an alternative to drugs and pills to all those who want to speed up recovery or to help the medical treatment even more.

Our industry grew over the last years and supplements are more and more requested by patients. It’s not only because the market is more educated, but it is also because supplements do help the healing process or even prevent some diseases. Either way, our clients are satisfied with the quality and the effects of the supplements we provide.

Bogdan Radu, CEO Biokraft Romania

For many years to come, Romania is and will be an important market for the Pharma industry. Not only that, but Romanians will always be adopters of self-medication. This is the perfect combination for an industry worth billions.

Instead of worrying about how dangerous it can be to take pills without a medical consult and how they can change their lifestyle, Romanians choose the most straightforward path to cure or treat a medical condition – taking pills. Romanians get ill due to an unhealthy lifestyle, low quality food, and lack of physical exercise. Although the pandemic did not allow many to seek medical advice, Romanians should be more oriented toward a more healthy and active lifestyle.

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