Diabetes mellitus is one of the most frequent co-morbidities of ulcerative colitis patients.The epidemiological association of these diseases suggested a genetic sharing and has challenged gene identification.Diabetes...Diabetes mellitus is one of the most frequent co-morbidities of ulcerative colitis patients.The epidemiological association of these diseases suggested a genetic sharing and has challenged gene identification.Diabetes co-morbidity in ulcerative colitis has also relevant clinical and therapeutic implications,with potential clinical impact on the follow up and outcome of patients.These diseases share specific complications,such as neuropathy,hepatic steatosis,osteoporosis and venous thrombosis.It is still unknown whether the coexistence of these diseases may increase their occurrence.Diabetes and hyperglycaemia represent relevant risk factors for postoperative complications and pouch failure in ulcerative colitis.Medical treatment of ulcerative colitis in patients with diabetes mellitus may be particularly challenging.Corticosteroids are the treatment of choice of active ulcerative colitis.Their use may be associated with the onset of glucose intolerance and diabetes,with difficult control of glucose levels andwith complications in diabetic patients.Epidemiologic and genetic evidences about diabetes co-morbidity in ulcerative colitis patients and shared complications and treatment of patients with these diseases have been discussed in the present review.展开更多
Despite tremendous strides in modern medicine stringent control over insulin resistance or restoration of normoglycemia has not yet been achieved.With the growth of molecular biology,omics technologies,docking studies...Despite tremendous strides in modern medicine stringent control over insulin resistance or restoration of normoglycemia has not yet been achieved.With the growth of molecular biology,omics technologies,docking studies,and in silico pharmacology,modulators of enzymes and receptors affecting the molecular pathogenesis of the disease are being considered as the latest targets for anti-diabetic therapy.Therapeutic molecular targets are now being developed basing on the up or down regulation of different signaling pathways affecting the disease.Phytosynergistic antidiabetic therapy is in vogue both with classical and non-classical medicinal systems.However its chemoprofiling,structural and pharmacokinetic validation awaits providing recognition to such formulations for international acceptance.Translational health research with its focus on benchside product development and its sequential transition to patient bedside puts the pharma RDs to a challenge to develop bio-waiver protocols.Pharmacokinetic simulation models and establishment of in vitro-in vivo correlation can help to replace in vivo bioavailability studies and provide means of quality control for scale up and post approval modification.Thisreview attempts to bring different shades highlighting phyto-synergy,molecular targeting of antidiabetic agents via different signaling pathways and bio-waiver studies under a single umbrella.展开更多
Background:Overexpression of inducible nitric oxide synthase(iNOS)has been reported in diabetic retinopathy(DR).The kinin B1 receptor(B1R)is also overexpressed in DR,and can stimulate iNOS via Gαi/ERK/MAPK pathway.We...Background:Overexpression of inducible nitric oxide synthase(iNOS)has been reported in diabetic retinopathy(DR).The kinin B1 receptor(B1R)is also overexpressed in DR,and can stimulate iNOS via Gαi/ERK/MAPK pathway.We previously showed that the topical administration of a B1R antagonist,LF22-0542,significantly reduces leukocyte infiltration,increased vascular permeability and overexpression of several inflammatory mediators,including iNOS in DR.Thus,the aim of this study was to determine whether the pro-inflammatory effects of B1R are attributed to oxidative stress caused by the activation of iNOS pathway in order to identify new therapeutic targets for the treatment of DR.iNOS and B1R being absent in the normal retina,their inhibition is unlikely to result in undesirable side effects.The approach will be no invasive by eye application of drops.Methods:Diabetes was induced in male Wistar rats(200-230 g)by a single intraperitoneal injection of streptozotocin(STZ,65 mg/kg b.w).One week later,rats were randomly divided into four groups(N=5)and treated for one week as follows:Gr 1:control rats treated with the selective iNOS inhibitor(1,400 W,0.06μM twice a day by eye-drops×7 days),Gr 2,STZ-diabetic rats treated with 1,400 W,Gr 3:control rats received a selective B1R agonist[Sar(D-Phe8)-des-Arg9-BK,100μg twice a week]by intravitreal injections(itrv)and treated with 1,400 W,Gr 4:STZ-diabetic rats+B1R agonist+1,400 W.At the end of treatment and two weeks post-STZ,three series of experiments were carried out to measure vascular permeability(by Evans blue dye method)and the expression of vasoactive and inflammatory mediators,including iNOS,VEGF-A,VEGF-R2,IL-1β,Cox-2,TNF-α,bradykinin 1 and 2 receptors and carboxypeptidase M/kininase 1(by Western Blotting and qRT-PCR).The nitrosative stress(nitrosylation of proteins)was also assessed by Western Blotting.One-way Anova test with Bonferroni post hoc was used for statistical analysis.Results:STZ-diabetic rats showed a significant increase in retinal vascular permeability(22.8μg/g Evans blue dye per g of fresh retinas,P=0.016)compared with control rats and control treated rats(17.2 and 16.8μg/g respectively).The injections of B1R agonist amplified the increase of vascular permeability which was normalized by the 1,400 W.The overexpression of inflammatory markers was also normalized by the 1,400 W in STZ-diabetic rats received or not the B1R agonist.Conclusions:These results support a contribution of iNOS in the deleterious effects of B1R in this model of diabetic retinopathy.Hence,iNOS inhibition by ocular application of 1,400 W may represent a promising and non-invasive therapeutic approach in the treatment of diabetic retinopathy.展开更多
Objective: to study the effect of valsartan combined with amlodipine in the treatment of three high diseases. Methods: a total of 100 patients in our hospital from 2019 to date were randomly divided into two groups. T...Objective: to study the effect of valsartan combined with amlodipine in the treatment of three high diseases. Methods: a total of 100 patients in our hospital from 2019 to date were randomly divided into two groups. The patients in the first group were treated with valsartan, and the patients in the second group were treated with amlodipine while valsartan. After the treatment was completed, the physical conditions of the two groups were compared, including whether there was any adverse reaction. Results: the physical condition of patients in the second group after treatment was lower than that in the first group (P < 0.05). No obvious adverse reactions were observed in the two groups during the treatment, and the treatment effects were relatively good. P > 0.05. Conclusion: valsartan combined with amlodipine in the treatment of hypertension can obtain better effect, which is very good for improving patients' physical condition, improving patients' life quality and ensuring the safety in the treatment process.展开更多
玻璃体切除术(pars plana vitrectomy,PPV)为增殖性糖尿病视网膜病变(proliferative diabeticretinopathy,PDR)常用治疗手段,但手术难度大、出血量多,难以有效控制,会延长手术时间、增加手术失败风险。采取有效措施优化治疗,降低手术风...玻璃体切除术(pars plana vitrectomy,PPV)为增殖性糖尿病视网膜病变(proliferative diabeticretinopathy,PDR)常用治疗手段,但手术难度大、出血量多,难以有效控制,会延长手术时间、增加手术失败风险。采取有效措施优化治疗,降低手术风险是近年来的研究热点。展开更多
目的探讨大黄游离蒽醌(free anthraquinone from rhubarb,FAR)对糖尿病大鼠心肌CTGF和collagen表达及间质纤维化的影响。方法健康♂SD大鼠一次性腹腔注射STZ制备糖尿病大鼠模型,2周后随机分为模型对照组(DCM组)和大黄游离蒽醌干预组(FAR...目的探讨大黄游离蒽醌(free anthraquinone from rhubarb,FAR)对糖尿病大鼠心肌CTGF和collagen表达及间质纤维化的影响。方法健康♂SD大鼠一次性腹腔注射STZ制备糖尿病大鼠模型,2周后随机分为模型对照组(DCM组)和大黄游离蒽醌干预组(FAR组),同时设立正常对照组(CON组);干预8周后检测大鼠空腹血糖;心脏质量指数;Masson染色观察心肌纤维化程度;RT-PCR法检测CTGF、procollagenⅠ和collagenⅢmRNA表达;免疫组化法检测CTGF蛋白含量;ELISA法检测collagenⅠ和collagenⅢ胶原含量。结果与CON组相比,DCM组大鼠空腹血糖、心脏质量指数、心肌纤维化程度以及CTGF、collagen I和collagenⅢ表达均明显升高;与DCM相比,FAR组心脏质量指数、心肌纤维化程度以及CTGF、collagenⅠ和collagenⅢ表达均明显下降。结论大黄游离蒽醌可通过调低糖尿病大鼠心肌组织CTGF的表达,减少心肌间质中collagen I和Ⅲ合成及沉积。展开更多
目的研究海地瓜岩藻糖基化海参硫酸软骨素(fucosylated chondroitin sulfate from the sea cucumber Acaudina molpadioides,Am-CHS)对Ⅱ型糖尿病小鼠胰岛素抵抗的改善作用。方法以高脂高糖饲料饲喂法建立Ⅱ型糖尿病小鼠模型。雄性C57B...目的研究海地瓜岩藻糖基化海参硫酸软骨素(fucosylated chondroitin sulfate from the sea cucumber Acaudina molpadioides,Am-CHS)对Ⅱ型糖尿病小鼠胰岛素抵抗的改善作用。方法以高脂高糖饲料饲喂法建立Ⅱ型糖尿病小鼠模型。雄性C57BL/6小鼠随机分为正常对照组、模型对照组、阳性对照组、实验A、B、C组。正常对照组饲喂标准饲料,其它组饲喂高脂饲料。阳性对照组、实验A、B、C组分别在饲料中添加罗格列酮(rosiglitazone,RSG,1mg·kg-1·d-1)、高剂量Am-CHS(80mg·kg-1·d-1)、低剂量Am-CHS+RSG(20+1mg·kg-1·d-1)、高剂量Am-CHS+RSG(80+1mg·kg-1·d-1)。各组小鼠自由摄食摄水19周。实验结束后,称重小鼠白色脂肪重量,检测空腹血糖、空腹血清胰岛素及血清脂联素、抵抗素、瘦素、肿瘤坏死因子-α(TNF-α)水平。结果 Am-CHS可显著降低Ⅱ型糖尿病小鼠的脂肪积累,降低血糖和胰岛素水平,改善胰岛素抵抗,提高血清脂联素含量,降低抵抗素、瘦素和TNF-α含量。Am-CHS与RSG复配使用,效果更显著。结论 Am-CHS能显著改善Ⅱ型糖尿病小鼠的胰岛素抵抗程度,其作用机制可能与改善肥胖引起的脂肪细胞因子的分泌紊乱有关。展开更多
Hepatocyte nuclear factor 1-β(HNF1B)defects cause renal cysts and diabetes syndrome(RCAD),or HNF1B-maturity-onset diabetes of the young.However,the hepatic phenotype of HNF1B variants is not well studied.We present a...Hepatocyte nuclear factor 1-β(HNF1B)defects cause renal cysts and diabetes syndrome(RCAD),or HNF1B-maturity-onset diabetes of the young.However,the hepatic phenotype of HNF1B variants is not well studied.We present a female neonate born small for her gestational age[birth weight 2360 g;-2.02standard deviations(SD)and birth length 45 cm;-2.40 SD at the 38th gestational week].She developed neonatal cholestasis due to biliary atresia and required surgical intervention(portoenterostomy)when 32-d old.Following the operation,icterus resolved,but laboratory signs of liver dysfunction persisted.She had hyperechogenic kidneys prenatally with bilateral renal cysts and pancreatic hypoplasia postnatally that led to the diagnosis of an HNF1B deletion.This represents the most severe hepatic phenotype of an HNF1B variant recognized thus far.A review of 12 published cases with hepatic phenotypes of HNF1B defects allowed us to distinguish three severity levels,ranging from neonatal cholestasis through adult-onset cholestasis to noncholestatic liver impairment,all of these are associated with congenital renal cysts and mostly with diabetes later in life.We conclude that to detect HNF1B variants,neonates with cholestasis should be checked for the presence of renal cysts,with special focus on those who are born small for their gestational age.Additionally,patients with diabetes and renal cysts at any age who develop cholestasis and/or exocrine pancreatic insufficiency should be tested for HNF1B variants as the true etiological factor of all disease components.Further observations are needed to confirm the potential reversibility of cholestasis in infancy in HNF1B mutation/deletion carriers.展开更多
文摘Diabetes mellitus is one of the most frequent co-morbidities of ulcerative colitis patients.The epidemiological association of these diseases suggested a genetic sharing and has challenged gene identification.Diabetes co-morbidity in ulcerative colitis has also relevant clinical and therapeutic implications,with potential clinical impact on the follow up and outcome of patients.These diseases share specific complications,such as neuropathy,hepatic steatosis,osteoporosis and venous thrombosis.It is still unknown whether the coexistence of these diseases may increase their occurrence.Diabetes and hyperglycaemia represent relevant risk factors for postoperative complications and pouch failure in ulcerative colitis.Medical treatment of ulcerative colitis in patients with diabetes mellitus may be particularly challenging.Corticosteroids are the treatment of choice of active ulcerative colitis.Their use may be associated with the onset of glucose intolerance and diabetes,with difficult control of glucose levels andwith complications in diabetic patients.Epidemiologic and genetic evidences about diabetes co-morbidity in ulcerative colitis patients and shared complications and treatment of patients with these diseases have been discussed in the present review.
文摘Despite tremendous strides in modern medicine stringent control over insulin resistance or restoration of normoglycemia has not yet been achieved.With the growth of molecular biology,omics technologies,docking studies,and in silico pharmacology,modulators of enzymes and receptors affecting the molecular pathogenesis of the disease are being considered as the latest targets for anti-diabetic therapy.Therapeutic molecular targets are now being developed basing on the up or down regulation of different signaling pathways affecting the disease.Phytosynergistic antidiabetic therapy is in vogue both with classical and non-classical medicinal systems.However its chemoprofiling,structural and pharmacokinetic validation awaits providing recognition to such formulations for international acceptance.Translational health research with its focus on benchside product development and its sequential transition to patient bedside puts the pharma RDs to a challenge to develop bio-waiver protocols.Pharmacokinetic simulation models and establishment of in vitro-in vivo correlation can help to replace in vivo bioavailability studies and provide means of quality control for scale up and post approval modification.Thisreview attempts to bring different shades highlighting phyto-synergy,molecular targeting of antidiabetic agents via different signaling pathways and bio-waiver studies under a single umbrella.
文摘Background:Overexpression of inducible nitric oxide synthase(iNOS)has been reported in diabetic retinopathy(DR).The kinin B1 receptor(B1R)is also overexpressed in DR,and can stimulate iNOS via Gαi/ERK/MAPK pathway.We previously showed that the topical administration of a B1R antagonist,LF22-0542,significantly reduces leukocyte infiltration,increased vascular permeability and overexpression of several inflammatory mediators,including iNOS in DR.Thus,the aim of this study was to determine whether the pro-inflammatory effects of B1R are attributed to oxidative stress caused by the activation of iNOS pathway in order to identify new therapeutic targets for the treatment of DR.iNOS and B1R being absent in the normal retina,their inhibition is unlikely to result in undesirable side effects.The approach will be no invasive by eye application of drops.Methods:Diabetes was induced in male Wistar rats(200-230 g)by a single intraperitoneal injection of streptozotocin(STZ,65 mg/kg b.w).One week later,rats were randomly divided into four groups(N=5)and treated for one week as follows:Gr 1:control rats treated with the selective iNOS inhibitor(1,400 W,0.06μM twice a day by eye-drops×7 days),Gr 2,STZ-diabetic rats treated with 1,400 W,Gr 3:control rats received a selective B1R agonist[Sar(D-Phe8)-des-Arg9-BK,100μg twice a week]by intravitreal injections(itrv)and treated with 1,400 W,Gr 4:STZ-diabetic rats+B1R agonist+1,400 W.At the end of treatment and two weeks post-STZ,three series of experiments were carried out to measure vascular permeability(by Evans blue dye method)and the expression of vasoactive and inflammatory mediators,including iNOS,VEGF-A,VEGF-R2,IL-1β,Cox-2,TNF-α,bradykinin 1 and 2 receptors and carboxypeptidase M/kininase 1(by Western Blotting and qRT-PCR).The nitrosative stress(nitrosylation of proteins)was also assessed by Western Blotting.One-way Anova test with Bonferroni post hoc was used for statistical analysis.Results:STZ-diabetic rats showed a significant increase in retinal vascular permeability(22.8μg/g Evans blue dye per g of fresh retinas,P=0.016)compared with control rats and control treated rats(17.2 and 16.8μg/g respectively).The injections of B1R agonist amplified the increase of vascular permeability which was normalized by the 1,400 W.The overexpression of inflammatory markers was also normalized by the 1,400 W in STZ-diabetic rats received or not the B1R agonist.Conclusions:These results support a contribution of iNOS in the deleterious effects of B1R in this model of diabetic retinopathy.Hence,iNOS inhibition by ocular application of 1,400 W may represent a promising and non-invasive therapeutic approach in the treatment of diabetic retinopathy.
文摘Objective: to study the effect of valsartan combined with amlodipine in the treatment of three high diseases. Methods: a total of 100 patients in our hospital from 2019 to date were randomly divided into two groups. The patients in the first group were treated with valsartan, and the patients in the second group were treated with amlodipine while valsartan. After the treatment was completed, the physical conditions of the two groups were compared, including whether there was any adverse reaction. Results: the physical condition of patients in the second group after treatment was lower than that in the first group (P < 0.05). No obvious adverse reactions were observed in the two groups during the treatment, and the treatment effects were relatively good. P > 0.05. Conclusion: valsartan combined with amlodipine in the treatment of hypertension can obtain better effect, which is very good for improving patients' physical condition, improving patients' life quality and ensuring the safety in the treatment process.
文摘玻璃体切除术(pars plana vitrectomy,PPV)为增殖性糖尿病视网膜病变(proliferative diabeticretinopathy,PDR)常用治疗手段,但手术难度大、出血量多,难以有效控制,会延长手术时间、增加手术失败风险。采取有效措施优化治疗,降低手术风险是近年来的研究热点。
基金Supported by Grants No.NT11457 and No.NT11402(to IGA MZ CR)grant from Research project(Ministry of Health Care,Czech Republic)of the conceptual development of research organization,No.00064203(to FN Motol)
文摘Hepatocyte nuclear factor 1-β(HNF1B)defects cause renal cysts and diabetes syndrome(RCAD),or HNF1B-maturity-onset diabetes of the young.However,the hepatic phenotype of HNF1B variants is not well studied.We present a female neonate born small for her gestational age[birth weight 2360 g;-2.02standard deviations(SD)and birth length 45 cm;-2.40 SD at the 38th gestational week].She developed neonatal cholestasis due to biliary atresia and required surgical intervention(portoenterostomy)when 32-d old.Following the operation,icterus resolved,but laboratory signs of liver dysfunction persisted.She had hyperechogenic kidneys prenatally with bilateral renal cysts and pancreatic hypoplasia postnatally that led to the diagnosis of an HNF1B deletion.This represents the most severe hepatic phenotype of an HNF1B variant recognized thus far.A review of 12 published cases with hepatic phenotypes of HNF1B defects allowed us to distinguish three severity levels,ranging from neonatal cholestasis through adult-onset cholestasis to noncholestatic liver impairment,all of these are associated with congenital renal cysts and mostly with diabetes later in life.We conclude that to detect HNF1B variants,neonates with cholestasis should be checked for the presence of renal cysts,with special focus on those who are born small for their gestational age.Additionally,patients with diabetes and renal cysts at any age who develop cholestasis and/or exocrine pancreatic insufficiency should be tested for HNF1B variants as the true etiological factor of all disease components.Further observations are needed to confirm the potential reversibility of cholestasis in infancy in HNF1B mutation/deletion carriers.
