Vitamin D₃ plays a pivotal role not only in bone health but also in the functioning of the nervous system, particularly in the context of age-related neurodegenerative diseases such as Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease. Vitamin D₃ deficiency has been associated with cognitive decline, heightened inflammation, and shortened leukocyte telomere length, which may contribute to accelerated cellular aging. Therapeutic interventions involving vitamin D₃ have been reported in selected clinical studies and meta-analyses to potentially enhance cognitive function, decrease amyloid β biomarkers, and prolong telomere length, although heterogeneity remains across study designs and populations. Furthermore, vitamin D₃ has been shown to influence the expression of genes implicated in DNA repair and oxidative stress response, including NRF2, OGG1, MYH, and MTH1. This narrative review synthesizes current knowledge on the molecular mechanisms of vitamin D₃ action in the context of neuroprotection and discusses potential directions for future research, including its possible therapeutic applications in neurodegenerative diseases.

ATTR amyloidosis is a rare disease associated with abnormal folding of the transthyretin (TTR) protein, leading to the deposition of amyloid fibrils in the heart and nervous system. Treatment to date has focused primarily on alleviating symptoms such as heart failure and neuropathy. Currently available disease-modifying therapies include TTR stabilizers (tafamidis, acoramidis), which prevent TTR tetramer dissociation, and gene silencers (siRNA and ASO), which reduce TTR production and slow the progression of polyneuropathy. Modern experimental strategies, including CRISPR-Cas9 gene editing and anti-ATTR monoclonal antibodies, offer the potential for one-time treatment and removal of existing amyloid deposits. The choice of therapy should be tailored to the patient's phenotype, disease stage, and clinical capabilities, and ongoing research will better determine the long-term efficacy and safety of new drugs. The aim of this paper is to present contemporary therapeutic strategies in the treatment of transthyretin amyloidosis (ATTR), with particular emphasis on disease-modifying drugs such as TTR stabilizers, gene silencers, CRISPR-Cas9 gene editing therapies, and anti-ATTR monoclonal antibodies. The paper aims to evaluate the efficacy and safety of available therapies, discuss their clinical indications depending on the patient's phenotype (polyneuropathy, cardiomyopathy), and present directions for the development of new therapeutic strategies based on current clinical trials.

Introduction and purpose: Smoking remains one of the leading preventable causes of premature mortality worldwide. A structured search of PubMed and Google Scholar databases was performed to identify clinical, epidemiological and experimental evidence, including original studies, systematic reviews and meta-analyses, on the impact of active and passive smoking. This narrative review summarises current evidence on the health effects of tobacco smoking and secondhand smoke exposure, with a particular focus on cardiovascular, respiratory and neoplastic diseases. Description of the state of knowledge: Tobacco smoke contains numerous toxic and carcinogenic compounds that promote endothelial dysfunction, oxidative stress and chronic inflammation, thereby accelerating atherosclerosis and increasing the risk of myocardial infarction, stroke and other vascular events. Long-term exposure damages the airways and lung parenchyma, leading to chronic obstructive pulmonary disease (COPD), worse asthma control and increased susceptibility to respiratory infections. Smoking is also a major driver of cancer, accounting for most lung cancer cases and contributing substantially to malignancies of the upper aerodigestive tract, pancreas and bladder. Secondhand smoke, although involving lower levels of exposure, is associated with higher risks of cardiovascular disease, respiratory illness, type 2 diabetes and adverse outcomes in children and older adults. Conclusion: The available evidence clearly shows that there is no safe level of exposure to tobacco smoke. Smoking cessation and effective protection from secondhand smoke are essential components of strategies to prevent cardiovascular, respiratory and neoplastic diseases and should remain central priorities in public health policy and clinical practice.

Introduction: Alcohol use disorder (AUD) drives preventable illness and death worldwide, causing medical, mental health, and social harms that strain individuals and health systems. Cognitive behavioral therapy (CBT) targets maladaptive cognitions, conditioned cues, and high risk situations using functional analysis, coping skills training, and relapse prevention grounded in learning and cognitive theory. Relapse prevention frameworks emphasize high risk situations, coping responses, outcome expectancies, abstinence violation effects, and covert antecedents (e.g., urges) to enhance self efficacy and reduce relapse, with meta analyses showing benefits over minimal or non specific controls. Effects versus non specific therapies are small but significant early and generally attenuate over time, while head to head comparisons show comparable efficacy, highlighting maintenance care, treatment matching, and mechanism focused augmentation. Technology delivered CBT expands access and can reduce consumption and increase abstinence, with early trials suggesting noninferiority or advantages over clinician delivered CBT, warranting larger, longer evaluations and careful integration with pharmacotherapy in stepped care. Study overview and methodology: This review examined randomized controlled trials evaluating CBT efficacy for substance use disorders, primarily alcohol. Studies compared CBT against three types of controls: minimal treatment, non-specific therapy, and specific evidence-based therapy. Effect sizes were pooled using inverse-variance weighting under random effects assumptions, with outcomes assessed at both early and late follow-up periods for frequency and quantity measures. Conclusion: Cognitive behavioral therapy is a reliable, evidence-based option for alcohol use disorder that achieves meaningful reductions in drinking and supports maintenance of gains, performing on par with other established therapies; its emphasis on relapse prevention skills and flexible delivery, including effective digital formats, makes it well suited for integration into comprehensive, stepped-care models tailored to individual needs.

Introduction: Type 1 diabetes is a chronic autoimmune disease that leads to permanent lack of insulin. In recent years, advances in insulin formulations and delivery methods have improved the ability to mimic natural insulin secretion and support better diabetes management. Aim: The aim of this article is to review the most commonly used forms of insulin therapy and modern technologies supporting the treatment of type 1 diabetes, with attention to their effectiveness, safety, and impact on patients’ quality of life. Methods: A search of PubMed and ScienceDirect was performed for publications from January 2008 to June 2025. The review included clinical trials and review articles about insulin therapy in type 1 diabetes. Titles and abstracts were screened, full texts were analysed, and reference lists of key papers were checked. Results: Modern insulin therapy is based on insulin analogues with different action profiles and on delivery systems such as insulin pens, pumps, and hybrid closed-loop devices. New basal and prandial analogues help improve glycaemic control and reduce complications. Automated Insulin Delivery systems increase time in range and improve daily functioning. However, problems such as variability of insulin absorption, lipodystrophy, and high costs still remain. Conclusions: Although progress in insulin therapy has improved diabetes care, further research, better access to modern technologies, and further patient education is essential.