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Shan S, Alanazi AH, Han Y, Zhang D, Liu Y, Narayanan SP, Somanath PR. Pro-Inflammatory Characteristics of Extracellular Vesicles in the Vitreous of Type 2 Diabetic Patients. Biomedicines 2024; 12:2053. [PMID: 39335566 PMCID: PMC11428929 DOI: 10.3390/biomedicines12092053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 09/06/2024] [Accepted: 09/08/2024] [Indexed: 09/30/2024] Open
Abstract
Diabetic retinopathy (DR) is a leading cause of blindness, yet its molecular mechanisms are unclear. Extracellular vesicles (EVs) contribute to dysfunction in DR, but the characteristics and functions of vitreous EVs are unclear. This study investigated the inflammatory properties of type 2 diabetic (db) vitreous EVs. EVs isolated from the vitreous of db and non-db donors were used for nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), immunogold staining, Western blotting, and proteomic analysis by mass spectrometry. Intracellular uptake of vitreous EVs by differentiated macrophages was evaluated using ExoGlow membrane labeling, and the impact of EVs on macrophage (THP-1) activation was assessed by cytokine levels using RT-qPCR. NTA and TEM analysis of db and non-db vitreous EVs showed non-aggregated EVs with a heterogeneous size range below 200 nm. Western blot detected EV markers (Alix, Annexin V, HSP70, and Flotillin 1) and an upregulation of Cldn5 in db EVs. While the db EVs were incorporated into macrophages, treatment of THP-1 cells with db EVs significantly increased mRNA levels of TNFα and IL-1β compared to non-db EVs. Proteomic and gene enrichment analysis indicated pro-inflammatory characteristics of db EVs. Our results suggest a potential involvement of EC-derived Cldn5+ EVs in triggering inflammation, offering a novel mechanism involved and presenting a possible therapeutic avenue for DR.
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Affiliation(s)
- Shengshuai Shan
- Clinical and Experimental Therapeutics, University of Georgia, Augusta, GA 30912, USA
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA 30912, USA
| | - Abdulaziz H. Alanazi
- Clinical and Experimental Therapeutics, University of Georgia, Augusta, GA 30912, USA
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA 30912, USA
- Department of Clinical Practice, College of Pharmacy, Northern Border University, Rafha 76313, Saudi Arabia
| | - Yohan Han
- Clinical and Experimental Therapeutics, University of Georgia, Augusta, GA 30912, USA
- Department of Microbiology, Wonkwang University School of Medicine, Iksan 54538, Republic of Korea
| | - Duo Zhang
- Clinical and Experimental Therapeutics, University of Georgia, Augusta, GA 30912, USA
| | - Yutao Liu
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA 30912, USA
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA
| | - S. Priya Narayanan
- Clinical and Experimental Therapeutics, University of Georgia, Augusta, GA 30912, USA
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA 30912, USA
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA
| | - Payaningal R. Somanath
- Clinical and Experimental Therapeutics, University of Georgia, Augusta, GA 30912, USA
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA 30912, USA
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Kalahasti KK, Kumar CU, Nagaraju M, Petrash JM, Reddy SS, Reddy GB. Mitigation of lens opacification by a functional food in a diabetic rodent model. Chem Biol Interact 2024; 390:110889. [PMID: 38272248 DOI: 10.1016/j.cbi.2024.110889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024]
Abstract
The current study was designed to test a functional food (FF) mixture containing aldose reductase inhibitors and antiglycation bioactive compounds for suppressing the onset and progression of cataracts in a diabetic rat model. Two-month-old Sprague Dawley rats were grouped as control (C), diabetes untreated (D), and diabetic rats treated with FF at two doses (FF1 = 1.35 g and FF2 = 6.25 g/100g of diet). Diabetes was induced by a single injection of streptozotocin. The FF is a mixture of amla, turmeric, black pepper, cinnamon, ginger, and fenugreek added to the rodent diet. The status of cataracts was monitored weekly by a slit lamp examination for 20 weeks, after which animals were sacrificed to collect eye lenses. Feeding FF1 and FF2 to diabetic rats yielded a significant anti-hyperglycaemic effect and marginally prevented body weight loss. FF delayed cataract progression, and FF2 showed better efficacy than FF1. FF prevented the loss of lens crystallins and their insolubilization in diabetic rats. The antioxidant potential of FF was evident with the lowered protein carbonyls, lipid peroxidation, and prevention of altered antioxidant enzyme activities induced by diabetes. These studies demonstrate the efficacy of plant-derived dietary supplements against the onset and progression of cataracts in a well-established rat model of diabetic eye disease.
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Affiliation(s)
- Krishna K Kalahasti
- Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, 500007, India
| | - Ch Uday Kumar
- Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, 500007, India
| | - Marka Nagaraju
- Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, 500007, India
| | - J Mark Petrash
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - S Sreenivasa Reddy
- Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, 500007, India
| | - G Bhanuprakash Reddy
- Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, 500007, India.
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Mrugacz M, Pony-Uram M, Bryl A, Zorena K. Current Approach to the Pathogenesis of Diabetic Cataracts. Int J Mol Sci 2023; 24:ijms24076317. [PMID: 37047290 PMCID: PMC10094546 DOI: 10.3390/ijms24076317] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/13/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
Cataracts remain the first or second leading cause of blindness in all world regions. In the diabetic population, cataracts not only have a 3–5 times higher incidence than in the healthy population but also affect people at a younger age. In patients with type 1 diabetes, cataracts occur on average 20 years earlier than in the non-diabetic population. In addition, the risk of developing cataracts increases with the duration of diabetes and poor metabolic control. A better understanding of the mechanisms leading to the formation of diabetic cataracts enables more effective treatment and a holistic approach to the patient.
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Emerging therapeutic roles of small heat shock protein-derived mini-chaperones and their delivery strategies. Biochimie 2022; 208:56-65. [PMID: 36521577 DOI: 10.1016/j.biochi.2022.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/28/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
The small heat shock protein (sHsp) family is a group of proteins in which some are induced in response to external stimuli, such as environmental and pathological stresses, while others are constitutively expressed. They show chaperone-like activity, protect cells from apoptosis, and maintain cytoskeletal architecture. Short sequences or fragments ranging from approximately 19-20 residues in sHsps were shown to display chaperone activity in vitro. These sequences are termed sHsp-derived mini-peptides/mini-chaperones. These peptides offer an advantage in providing protective and therapeutic effects over full-length proteins owing to their small molecular weight and easy uptake into the cells. Research on sHsp mini-chaperone therapy has recently received attention and advanced tremendously. sHsp mini-chaperones have shown a wide range of therapeutic effects, such as anti-aggregation of proteins, anti-apoptotic, anti-inflammatory, anti-oxidant, senolytic, and anti-platelet activity. The administration of mini-chaperones into the several disease animal models, including experimental autoimmune encephalomyelitis, cataract, age-related macular degeneration, glaucoma, and thrombosis through various routes reduced symptoms or prevented the progression of the disease. However, it was found that the therapeutic potential of sHsp mini-chaperones is limited by their short turnover and enzymatic degradation in circulation. Nonetheless, carrier molecules approach such as nanoparticles, cell penetration peptides, and extracellular vesicles increased their efficacy by enhancing the uptake, retention time, protection from enzymatic degradation, and site-specific delivery without altering their biological activity. In this context, this review highlights the recent advances in the therapeutic potential of sHsp-derived mini-chaperones, their effect in experimental animal models, and approaches for increasing their efficacy.
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Liu S, Xing L, Zhang J, Wang K, Duan M, Wei M, Zhang B, Chang Z, Zhang H, Shang P. Expression pattern of CRYAB and CTGF genes in two pig breeds at different altitudes. ARQ BRAS MED VET ZOO 2022. [DOI: 10.1590/1678-4162-12403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Tibetan pigs are characterized by significant phenotypic differences relative to lowland pigs. Our previous study demonstrated that the genes CRYAB and CTGF were differentially expressed in heart tissues between Tibetan (highland breed) and Yorkshire (lowland breed) pigs, indicating that they might participate in hypoxia adaptation. CRYAB (ɑB-crystallin) and CTGF (connective tissue growth factor) have also been reported to be associated with lung development. However, the expression patterns of CRYAB and CTGF in lung tissues at different altitudes and their genetic characterization are not well understood. In this study, qRT-PCR and western blot of lung tissue revealed higher CRYAB expression levels in highland and middle-highland Tibetan and Yorkshire pigs than in their lowland counterparts. With an increase in altitude, the expression level of CTGF increased in Tibetan pigs, whereas it decreased in Yorkshire pigs. Furthermore, two novel single-nucleotide polymorphism were identified in the 5′ flanking region of CRYAB (g.39644482C>T and g.39644132T>C) and CTGF (g.31671748A>G and g.31671773T>G). The polymorphism may partially contribute to the differences in expression levels between groups at the same altitude. These findings provide novel insights into the high-altitude hypoxia adaptations of Tibetan pigs.
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Affiliation(s)
- S. Liu
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - L. Xing
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - J. Zhang
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - K. Wang
- Henan Agricultural University, People’s Republic of China
| | - M. Duan
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - M. Wei
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - B. Zhang
- China Agricultural University, People’s Republic of China
| | - Z. Chang
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China
| | - H. Zhang
- China Agricultural University, People’s Republic of China
| | - P. Shang
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
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Kumar CU, Suryavanshi U, Sontake V, Reddy PY, Sankhala RS, Swamy MJ, Reddy GB. Effect of Sorbitol on Alpha-Crystallin Structure and Function. BIOCHEMISTRY. BIOKHIMIIA 2022; 87:131-140. [PMID: 35508910 DOI: 10.1134/s0006297922020055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/13/2022] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
Loss of eye lens transparency due to cataract is the leading cause of blindness all over the world. While aggregation of lens crystallins is the most common endpoint in various types of cataracts, chaperone-like activity (CLA) of α-crystallin preventing protein aggregation is considered to be important for maintaining the eye lens transparency. Osmotic stress due to increased accumulation of sorbitol under hyperglycemic conditions is believed to be one of the mechanisms for diabetic cataract. In addition, compromised CLA of α-crystallin in diabetic cataract has been reported. However, the effect of sorbitol on the structure and function of α-crystallin has not been elucidated yet. Hence, in the present exploratory study, we described the effect of varying concentrations of sorbitol on the structure and function of α-crystallin. Alpha-crystallin purified from the rat lens was incubated with varying concentrations of sorbitol in the dark under sterile conditions for up to 5 days. At the end of incubation, structural properties and CLA were evaluated by spectroscopic methods. Interestingly, different concentrations of sorbitol showed contrasting results: at lower concentrations (5 and 50 mM) there was a decrease in CLA and subtle alterations in secondary and tertiary structure but not at higher concentrations (500 mM). Though, these results shed a light on the effect of sorbitol on α-crystallin structure-function, further studies are required to understand the mechanism of the observed effects and their implication to cataractogenesis.
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Affiliation(s)
- Ch Uday Kumar
- Biochemistry Division, National Institute of Nutrition, Hyderabad, 500007, India.
| | | | - Vishwaraj Sontake
- Biochemistry Division, National Institute of Nutrition, Hyderabad, 500007, India.
| | - P Yadagiri Reddy
- Biochemistry Division, National Institute of Nutrition, Hyderabad, 500007, India.
| | | | - Musti J Swamy
- School of Chemistry, University of Hyderabad, Hyderabad, 500046, India.
| | - G Bhanuprakash Reddy
- Biochemistry Division, National Institute of Nutrition, Hyderabad, 500007, India.
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Marzec E, Olszewski J. Dielectric response to thermal denaturation of lenses in healthy and diabetic rabbits. Bioelectrochemistry 2021; 142:107923. [PMID: 34385118 DOI: 10.1016/j.bioelechem.2021.107923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/14/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022]
Abstract
The relative permittivity and conductivity of healthy and alloxane-induced diabetic rabbits lenses were measured over a frequency range of 500 Hz to 100 kHz in an electric field and at temperatures from 25 to 150 °C. The dielectric spectra for both tissues showed two separate relaxations with a characteristic frequency of around 4 and 25 kHz assigned to the cortical and nuclear zones, respectively. These two dispersions are due to the interfacial polarization at the surface of the α-crystallin molecules. The denaturation temperature for the non-diabetic lens and the diabetic lens is approximately 70 and 80 °C, respectively. Moreover, the relative permittivity and conductivity values are higher in the diabetic lens than in the non-diabetic tissue at the same temperature and frequency. Our dielectric studies provide a better understanding of the thermal stability of crystallin-water complexes in normal and diseased human lenses.
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Affiliation(s)
- E Marzec
- Department of Bionics and Bioimpedance, Poznan University of Medical Sciences, Parkowa 2, 60-775 Poznań, Poland.
| | - J Olszewski
- Department of Bionics and Bioimpedance, Poznan University of Medical Sciences, Parkowa 2, 60-775 Poznań, Poland
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Fundamentals of Diabetic Cataractogenesis and Promising Ways of its Pharmacological Correction. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cataracts in diabetes mellitus lead to decreased visual function and blindness. Cataract surgery for diabetes mellitus has limitations and complications. The search for effective means of conservative cataract therapy continues. The review presents the analysis of data from scientific sources, mainly for 2015–2020 using Internet resources (PubMed, Web of Science, Medline, eLibrary.Ru, Cyberleninka). In the work, diabetic cataractogenesis is presented as a sum of interrelated pathobiochemical processes. The main ones are the polyol pathway of glucose conversion, non-enzymatic glycation and oxidative modification of lens proteins, which are enhanced in diabetes mellitus. The lens has a high protein content. The formation of high molecular weight protein aggregates is of particular importance for the appearance of light scattering zones and a decrease in lens transparency. This review presents data on anti-cataract compounds that affect post-translational crystallin modification, prevent osmotic and oxidative stress in the lens, and exhibit antiglycation properties. This information shows that the search for means of pharmacological correction of cataractogenesis should be carried out among compounds with antioxidant and antiglycation activity.
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Ram L, Mittal C, Harsolia RS, Yadav JK. Trehalose Inhibits the Heat-Induced Formation of the Amyloid-Like Structure of Soluble Proteins Isolated from Human Cataract Lens. Protein J 2020; 39:509-518. [PMID: 33037983 DOI: 10.1007/s10930-020-09919-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 11/25/2022]
Abstract
The age-dependent loss of solubility and aggregation of crystallins constitute the pathological hallmarks of cataract. Several biochemical and biophysical factors are responsible for the reduction of crystallins' solubility and formation of irreversible protein aggregates, which display amyloid-like characteristics. The present study reports the heat-induced aggregation of soluble proteins isolated from human cataract lenses and the formation of amyloid-like structures. Exposure of protein at 55 °C for 4 h resulted in extensive (≈ 60%) protein aggregation. The heat-induced protein aggregates displayed substantial (≈ 20 nm) redshift in the wavelength of maximum absorption (λmax) of Congo red (CR) and increase in Thioflavin T (ThT) fluorescence emission intensity, indicating the presence of amyloid-like structures in the heat-induced protein aggregates. Subsequently, the addition of trehalose resulted in substantial inhibition of heat-induced aggregation and the formation of amyloid-like structure. The ability of trehalose to inhibit the heat-induced aggregation was found to be linearly dependent upon its concentration used. The optimum effect was observed in the presence of 30-40% (w/v) trehalose where the aggregated was found to be reduced from 60 to 30%. The present study demonstrated the ability to trehalose to inhibit the protein aggregation and interfere with the formation of amyloid-like structures.
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Affiliation(s)
- Lakshman Ram
- Department of Biotechnology, Central University of Rajasthan, NH-8 Bandersindri, Kishangarh, Ajmer, Rajasthan, 305817, India
| | - Chandrika Mittal
- Department of Biotechnology, Central University of Rajasthan, NH-8 Bandersindri, Kishangarh, Ajmer, Rajasthan, 305817, India
| | - Ram Swaroop Harsolia
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Jay Kant Yadav
- Department of Biotechnology, Central University of Rajasthan, NH-8 Bandersindri, Kishangarh, Ajmer, Rajasthan, 305817, India.
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Inanc M, Kiziltoprak H, Hekimoglu R, Tekin K, Ozalkak S, Koc M, Bayramoglu E, Zirh S, Yuruker S, Aycan Z. Alterations of Tear Film and Ocular Surface in Children with Type 1 Diabetes Mellitus. Ocul Immunol Inflamm 2020; 28:362-369. [PMID: 30806526 DOI: 10.1080/09273948.2019.1571212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To investigate whether diabetes mellitus (DM) affects ocular surface of children with well-controlled type 1 DM.Methods: Sixty-five diabetic patients and 55 age-matched controls enrolled to study. Detailed ocular surface assessment including, ocular surface disease index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test, and conjunctival impression cytologic analysis were performed.Results: Schirmer test and TBUT results were significantly lower in DM group than controls (p = 0.001, for all). OSDI scores of all participants were within normal range. Impression cytology analysis showed grade 0 changes in all participants and there was no difference between groups for goblet cell density (p > 0.05). The TBUT results were significantly associated with duration of DM (r = -0.309, p = 0.036).Conclusion: Diabetic children without symptoms, signs, and definite diagnosis of dry eye still had lower TBUT and Schirmer test results than controls; however, impression cytology analysis was similar in both groups.
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Affiliation(s)
- Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Hasan Kiziltoprak
- Department is Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Rumeysa Hekimoglu
- Histology and Embryology Department, Kastamonu University, Kastamonu, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Servan Ozalkak
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Department is Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Elvan Bayramoglu
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Selim Zirh
- Histology and Embryology Department, Hacettepe University, Ankara, Turkey
| | - Sinan Yuruker
- Histology and Embryology Department, Usak University, Usak, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
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Shree J, Choudhary R, Bodakhe SH. Losartan delays the progression of streptozotocin‐induced diabetic cataracts in albino rats. J Biochem Mol Toxicol 2019; 33:e22342. [DOI: 10.1002/jbt.22342] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 03/15/2019] [Accepted: 03/25/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Jaya Shree
- Department of Pharmacology, SLT Institute of Pharmaceutical SciencesGuru Ghasidas Vishwavidyalaya Bilaspur Chhattisgarh India
| | - Rajesh Choudhary
- Department of Pharmacology, SLT Institute of Pharmaceutical SciencesGuru Ghasidas Vishwavidyalaya Bilaspur Chhattisgarh India
| | - Surendra H Bodakhe
- Department of Pharmacology, SLT Institute of Pharmaceutical SciencesGuru Ghasidas Vishwavidyalaya Bilaspur Chhattisgarh India
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Wang R, Chen ZH, Wang Y, Huang HB, Fan SJ, Chen LL. Recombination and identification of human alpha B-crystallin. Int J Ophthalmol 2018; 11:1916-1921. [PMID: 30588422 DOI: 10.18240/ijo.2018.12.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 10/22/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To recombine the human alpha B-crystallin (αB-crystallin) using gene cloning technology and prokaryotic expression vector and confirm the biological activity of recombinant human αB-crystallin. METHODS Cloning the human αB-crystallin cDNA according to the nucleotide sequence of the human αB-crystallin, constructing the pET-28/CRYAB prokaryotic expression plasmid by restriction enzyme digestion method, and stably expressing transformed into the Escherichia coli (E. coli) DH5 alpha. The recombinant human αB-crystallin was purified by Q sepharose. By enzyme digestion analysis, Western blotting and sequencing, the recombinant human αB-crystallin was identified and the activity of its molecular protein was detected. RESULTS Compared with the gene bank (GeneBank), the cloned human sequence of human αB-crystallin cDNA has the same open reading frame. Identification and sequencing of the cloned human αB-crystallin cDNA in prokaryotic expression vector confirmed the full length sequence, and the vector was constructed successfully. The E. coli containing plasmid pET-28/CRYAB induced by isopropyl-β-D-thiogalactoside successfully expressed the human αB-crystallin. Insulin confirmed that the recombinant human αB-crystallin has a molecular chaperone activity. CONCLUSION The prokaryotic expression vector pET-28/CRYAB of recombinant human αB-crystallin is successfully constructed, and the recombinant human αB-crystallin with molecular chaperone activity is obtained, which lay a foundation for the research and application of the recombinant human αB-crystallin and its chaperone activity.
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Affiliation(s)
- Rui Wang
- Department of Ophthalmology, Hainan Branch of PLA General Hospital, Sanya 572000, Hainan Province, China
| | - Ze-Hua Chen
- Department of Ophthalmology, Hainan Branch of PLA General Hospital, Sanya 572000, Hainan Province, China
| | - Yi Wang
- Chongqing Aier General Hospital, Aier School of Ophthalmology, Central South University, Chongqing 400020, China
| | - Hou-Bin Huang
- Department of Ophthalmology, Hainan Branch of PLA General Hospital, Sanya 572000, Hainan Province, China
| | - Si-Jun Fan
- PLA Rocket Force General Hospital, Beijing 100088, China
| | - Lan-Lan Chen
- Department of Ophthalmology, Hainan Branch of PLA General Hospital, Sanya 572000, Hainan Province, China
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Wojnar W, Zych M, Kaczmarczyk-Sedlak I. Antioxidative effect of flavonoid naringenin in the lenses of type 1 diabetic rats. Biomed Pharmacother 2018; 108:974-984. [PMID: 30372909 DOI: 10.1016/j.biopha.2018.09.092] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/03/2018] [Accepted: 09/15/2018] [Indexed: 02/07/2023] Open
Abstract
Oxidative stress arising during diabetes may lead to cataract formation. Thus, in order to prevent oxidative stress development, antioxidants could be considered helpful agents. Naringenin, a flavonoid with a well-documented antioxidative activity, can be found in many plant-derived products, especially citrus fruits. The aim of the study was to examine the effect of naringenin on oxidative stress markers in the lenses of type 1 diabetic rats. The study was conducted on 3-month-old male Wistar rats with streptozotocin-induced type 1 diabetes. The rats were treated orally with naringenin at the doses of 50 and 100 mg/kg for 4 weeks. In the lenses obtained from the animals, enzymatic and non-enzymatic parameters connected with oxidative stress were measured. The enzymatic parameters included superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glucose-6-phosphate dehydrogenase activity. For non-enzymatic parameters, the total thiol groups, reduced and oxidized glutathione, protein carbonyl groups, advanced oxidation protein products, malondialdehyde and vitamin C level were assayed. Oral administration of naringenin counteracted most of the unfavorable changes induced by diabetes, including reduction of elevated antioxidative enzymes activity and amelioration of oxidative damage in proteins and lipids. Naringenin administered orally reduces oxidative stress markers in the lenses of type 1 diabetic rats.
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Affiliation(s)
- Weronika Wojnar
- Department of Pharmacognosy and Phytochemistry, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.
| | - Maria Zych
- Department of Pharmacognosy and Phytochemistry, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.
| | - Ilona Kaczmarczyk-Sedlak
- Department of Pharmacognosy and Phytochemistry, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.
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Reddy VS, Madala SK, Trinath J, Reddy GB. Extracellular small heat shock proteins: exosomal biogenesis and function. Cell Stress Chaperones 2018; 23:441-454. [PMID: 29086335 PMCID: PMC5904088 DOI: 10.1007/s12192-017-0856-z] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 12/18/2022] Open
Abstract
Small heat shock proteins (sHsps) belong to the family of heat shock proteins (Hsps): some are induced in response to multiple stressful events to protect the cells while others are constitutively expressed. Until now, it was believed that Hsps, including sHsps, are present inside the cells and perform intracellular functions. Interestingly, several groups recently reported the extracellular presence of Hsps, and sHsps have also been detected in sera/cerebrospinal fluids in various pathological conditions. Secretion into the extracellular milieu during many pathological conditions suggests additional or novel functions of sHsps in addition to their intracellular properties. Extracellular sHsps are implicated in cell-cell communication, activation of immune cells, and promoting anti-inflammatory and anti-platelet responses. Interestingly, exogenous administration of sHsps showed therapeutic effects in multiple disease models implying that extracellular sHsps are beneficial in pathological conditions. sHsps do not possess signal sequence and, hence, are not exported through the classical Endoplasmic reticulum-Golgi complex (ER-Golgi) secretory pathway. Further, export of sHsps is not inhibited by ER-Golgi secretory pathway inhibitors implying the involvement of a nonclassical secretory pathway in sHsp export. In lieu, lysoendosomal and exosomal pathways have been proposed for the export of sHsps. Heat shock protein 27 (Hsp27), αB-crystallin (αBC), and Hsp20 are shown to be exported by exosomes. Exosomes packaged with sHsps have beneficial effects in in vivo disease models. However, secretion mechanisms and therapeutic use of sHsps have not been elucidated in detail. Therefore, this review aimed at highlighting the current understanding of sHsps (Hsp27, αBC, and Hsp20) in the extracellular medium.
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Affiliation(s)
- V Sudhakar Reddy
- Biochemistry Division, National Institute of Nutrition, Tarnaka, Jamai-Osmania, Hyderabad, 500007, India.
| | - Satish K Madala
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jamma Trinath
- Department of Biological Sciences, BITS-Pilani, 500078, Hyderabad Campus, Hyderabad, Telangana, India
| | - G Bhanuprakash Reddy
- Biochemistry Division, National Institute of Nutrition, Tarnaka, Jamai-Osmania, Hyderabad, 500007, India.
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15
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Jakhotia S, Sivaprasad M, Shalini T, Reddy PY, Viswanath K, Jakhotia K, Sahay R, Sahay M, Reddy GB. Circulating levels of Hsp27 in microvascular complications of diabetes: Prospects as a biomarker of diabetic nephropathy. J Diabetes Complications 2018; 32:221-225. [PMID: 29175119 DOI: 10.1016/j.jdiacomp.2017.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/26/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
AIM Heat shock protein 27 (Hsp27) is a small heat shock protein known to protect the cells from apoptosis under stress. In the present study, we determined the plasma Hsp27 levels in type 2 diabetes subjects without and with microvascular complications- diabetic retinopathy (DRe), diabetic nephropathy (DNe), and diabetic neuropathy (DNu) to understand if it could serve as a marker for these complications. METHODS This is a hospital-based case-control study with 754 subjects including 247 controls, 195 subjects with diabetes, 123 with DRe, 80 with DNe and 109 with DNu. Plasma Hsp27 levels were measured by ELISA. RESULTS The mean plasma Hsp27 was higher in the DNe group (631.5±355.2) compared to the control (496.55±308.54), diabetes (523.41±371.01), DRe (494.60±391.48) and DNu (455.21±319.74) groups with a p-value of 0.018. Receiver operating characteristic (ROC) curve analysis of Hsp27 in DNe group showed an area under the curve (AUC) of 0.617. Spearman correlation analysis shows a positive correlation of plasma Hsp27 with serum creatinine (p=0.053, r-value 0.083). Gender, age and BMI did not affect the plasma Hsp27 levels. CONCLUSION The plasma Hsp27 levels in the DNe group are higher compared to the control and other complications, thereby it could be explored to be used as a potential biomarker of DNe.
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Affiliation(s)
- Sneha Jakhotia
- Biochemistry, National Institute of Nutrition, Hyderabad, India
| | | | - Tattari Shalini
- Biochemistry, National Institute of Nutrition, Hyderabad, India
| | | | | | | | - Rakesh Sahay
- Osmania Medical College and General Hospital, Hyderabad, India
| | - Manisha Sahay
- Osmania Medical College and General Hospital, Hyderabad, India
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16
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Sudnitsyna MV, Gusev NB. Methylglyoxal and Small Heat Shock Proteins. BIOCHEMISTRY (MOSCOW) 2017; 82:751-759. [PMID: 28918740 DOI: 10.1134/s000629791707001x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Methylglyoxal is a highly reactive dicarbonyl compound formed during glucose metabolism and able to modify phospholipids, nucleic acids, and proteins belonging to the so-called dicarbonyl proteome. Small heat shock proteins participating in protection of the cell against different unfavorable conditions can be modified by methylglyoxal. The probability of methylglyoxal modification is increased in the case of distortion of glucose metabolism (diabetes), in the case of utilization of glycolysis as the main source of energy (malignancy), and/or at low rate of modified protein turnover. We have analyzed data on modification of small heat shock protein HspB1 in different tumors and under distortion of carbohydrate metabolism. Data on the effect of methylglyoxal modification on stability, chaperone-like activity, and antiapoptotic activity of HspB1 were analyzed. We discuss data on methylglyoxal modifications of lens α-crystallins. The mutual dependence and mutual effects of methylglyoxal modification and other posttranslational modifications of lens crystallins are analyzed. We conclude that although there is no doubt that the small heat shock proteins undergo methylglyoxal modification, the physiological significance of this process remains enigmatic, and new experimental approaches should be developed for understanding how this type of modification affects functioning of small heat shock proteins in the cell.
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Affiliation(s)
- M V Sudnitsyna
- Lomonosov Moscow State University, Faculty of Biology, Moscow, 119991, Russia.
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17
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Moghadam SS, Oryan A, Kurganov BI, Tamaddon AM, Alavianehr MM, Moosavi-Movahedi AA, Yousefi R. The structural damages of lens crystallins induced by peroxynitrite and methylglyoxal, two causative players in diabetic complications and preventive role of lens antioxidant components. Int J Biol Macromol 2017; 103:74-88. [PMID: 28472684 DOI: 10.1016/j.ijbiomac.2017.04.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 04/24/2017] [Accepted: 04/24/2017] [Indexed: 12/12/2022]
Abstract
Peroxynitrite (PON) and methylglyoxal (MGO), two diabetes-associated compounds, are believed to be important causative players in development of diabetic cataracts. In the current study, different spectroscopic methods, gel electrophoresis, lens culture and microscopic assessments were applied to examine the impact of individual, subsequent or simultaneous modification of lens crystallins with MGO and PON on their structure, oligomerization and aggregation. The protein modifications were confirmed with detection of the significantly increased quantity of carbonyl groups and decreased levels of sulfhydryl, tyrosine and tryptophan. Also, lens proteins modification with these chemical agents was accompanied with important structural alteration, oligomerization, disulfide/chromophore mediated protein crosslinking and important proteolytic instability. All these structural damages were more pronounced when the lens proteins were modified in the presence of both mentioned chemical agents, either in sequential or simultaneous manner. Ascorbic acid and glutathione, as the main components of lens antioxidant defense mechanism, were also capable to markedly prevent the damaging effects of PON and MGO on lens crystallins, as indicated by gel electrophoresis. The results of this study may highlight the importance of lens antioxidant defense system in protection of crystallins against the structural insults induced by PON and MGO during chronic hyperglycemia in the diabetic patients.
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Affiliation(s)
- Sogand Sasan Moghadam
- Protein Chemistry Laboratory (PCL), Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Boris I Kurganov
- Bach Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Leninsky pr. 33, Moscow, 119071, Russia
| | - Ali-Mohammad Tamaddon
- Center for Nanotechnology in Drug Delivery and School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Reza Yousefi
- Protein Chemistry Laboratory (PCL), Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran.
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Reddy GB, Reddy PY, Surolia A. Alzheimer's and Danish dementia peptides induce cataract and perturb retinal architecture in rats. Biomol Concepts 2017; 8:45-84. [PMID: 28222009 DOI: 10.1515/bmc-2016-0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/08/2016] [Indexed: 02/08/2023] Open
Abstract
Familial Danish dementias (FDDs) are autosomal dominant neurodegenerative disorders that are associated with visual defects. In some aspects, FDD is similar to Alzheimer's disease (AD)- the amyloid deposits in FDD and AD are made of short peptides: amyloid β (Aβ) in AD and ADan in FDD. Previously, we demonstrated an interaction between the dementia peptides and α-crystallin leading to lens opacification in organ culture due to impaired chaperone activity of α-crystallin. Herein, we report the in vivo effects of ADan and Aβ on the eye. ADan [reduced (ADan-red) and oxidized (ADan-oxi)] and Aβ (Aβ1-40 and Aβ1-42) were injected intravitreally in rats. The onset of cataract was seen after injection of all the peptides, but the cataract matured by 2 weeks in the case of ADan-red, 5 weeks for ADan-oxi and 6 weeks for Aβ1-40, while Aβ1-42 had minimal effect on cataract progression. The severity of cataract is associated with insolubilization and alterations in crystallins and loss of chaperone activity of α-crystallin. Further, disruption of the architecture of the retina was evident from a loss of rhodopsin, increased gliosis, and the thinning of the retina. These results provide a basis for the dominant heredo-otoophthalmo-encephalopathy (HOOE)/FDD syndrome and indicate that ADan peptides are more potent than Aβpeptides in inflicting visual impairment.
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Affiliation(s)
- G Bhanuprakash Reddy
- Biochemistry Division, National Institute of Nutrition, Hyderabad 500007, Telangana, India
| | - P Yadagiri Reddy
- Biochemistry Division, National Institute of Nutrition, Hyderabad, India
| | - Avadhesha Surolia
- Molecular Biophysics Unit, Indian Institute of Science, Bengaluru 560012, Karnataka, India
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19
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Association of alcohol intake with risk of diabetic retinopathy: a meta-analysis of observational studies. Sci Rep 2017; 7:4. [PMID: 28127054 PMCID: PMC5428369 DOI: 10.1038/s41598-017-00034-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 12/20/2016] [Indexed: 01/10/2023] Open
Abstract
Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM). The associations of alcohol intake with DR risk have demonstrated contradictory results. Relevant studies were identified by searching electronic databases (Medline, EMBASE and Web of Science) until May 2016. We identified a total of 12,875 DR cases among 37,285 participants in 15 observational studies. The pooled estimation of all the included observational studies was 0.91 (95% CI, 0.79 to 1.06) in a random-effect model. Analyses stratified by study design showed no significant association between alcohol intake and DR incidence in cohort, case control or cross-sectional studies. In the subgroup analyses, neither beer nor spirits intake were associated with DR risk. Furthermore, it was interesting to find that protective effects were detected in the wine (OR = 0.77, 95% CI = 0.64 to 0.92) and sherry (OR = 0.22, 95% CI = 0.05 to 0.95) groups. In conclusion, this current meta-analysis demonstrated that alcohol intake was not associated with risk of DR. Subgroup analysis by alcoholic beverage types showed that wine consumption would reduce the incidence of DR. In the future, more large-scale prospective studies with detailed alcohol subtypes and contents are still warranted to clarify the association.
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Sadowska-Bartosz I, Bartosz G. Effect of glycation inhibitors on aging and age-related diseases. Mech Ageing Dev 2016; 160:1-18. [PMID: 27671971 DOI: 10.1016/j.mad.2016.09.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/30/2016] [Accepted: 09/21/2016] [Indexed: 02/07/2023]
Abstract
Vast evidence supports the view that glycation of proteins is one of the main factors contributing to aging and is an important element of etiopathology of age-related diseases, especially type 2 diabetes mellitus, cataract and neurodegenerative diseases. Counteracting glycation can therefore be a means of increasing both the lifespan and healthspan. In this review, accumulation of glycation products during aging is presented, pathophysiological effects of glycation are discussed and ways of attenuation of the effects of glycation are described, concentrating on prevention of glycation. The effects of glycation and glycation inhibitors on the course of selected age-related diseases, such as Alzheimer's disease, Parkinson's disease and cataract are also reviewed.
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Affiliation(s)
- Izabela Sadowska-Bartosz
- Department of Biochemistry and Cell Biology, Faculty of Biology and Agriculture, University of Rzeszow, Zelwerowicza St. 4, 35-604 Rzeszów, Poland.
| | - Grzegorz Bartosz
- Department of Biochemistry and Cell Biology, Faculty of Biology and Agriculture, University of Rzeszow, Zelwerowicza St. 4, 35-604 Rzeszów, Poland; Department of Molecular Biophysics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236 Lodz, Poland
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21
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Muranova LK, Perfilov MM, Serebryakova MV, Gusev NB. Effect of methylglyoxal modification on the structure and properties of human small heat shock protein HspB6 (Hsp20). Cell Stress Chaperones 2016; 21:617-29. [PMID: 27061807 PMCID: PMC4907992 DOI: 10.1007/s12192-016-0686-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/06/2016] [Accepted: 03/26/2016] [Indexed: 01/01/2023] Open
Abstract
Human small heat shock protein HspB6 (Hsp20) was modified by metabolic α-dicarbonyl compound methylglyoxal (MGO). At low MGO/HspB6 molar ratio, Arg13, Arg14, Arg27, and Arg102 were the primary sites of MGO modification. At high MGO/HspB6 ratio, practically, all Arg and Lys residues of HspB6 were modified. Both mild and extensive MGO modification decreased susceptibility of HspB6 to trypsinolysis and prevented its heat-induced aggregation. Modification by MGO was accompanied by formation of small quantities of chemically crosslinked dimers and did not dramatically affect quaternary structure of HspB6. Mild modification by MGO did not affect whereas extensive modification decreased interaction of HspB6 with HspB1. Phosphorylation of HspB6 by cyclic adenosine monophosphate (cAMP)-dependent protein kinase was inhibited after mild modification and completely prevented after extensive modification by MGO. Chaperone-like activity of HspB6 measured with subfragment 1 of skeletal myosin was enhanced after MGO modifications. It is concluded that Arg residues located in the N-terminal domain of HspB6 are easily accessible to MGO modification and that even mild modification by MGO affects susceptibility to trypsinolysis, phosphorylation by cAMP-dependent protein kinase, and chaperone-like activity of HspB6.
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Affiliation(s)
- Lydia K Muranova
- Department of Biochemistry, School of Biology, Moscow State University, Moscow, 119991, Russian Federation
| | - Maxim M Perfilov
- Department of Biochemistry, School of Biology, Moscow State University, Moscow, 119991, Russian Federation
| | - Marina V Serebryakova
- A.N. Belozersky Institute of Physico-Chemical Biology, Moscow State University, Moscow, 119991, Russian Federation
| | - Nikolai B Gusev
- Department of Biochemistry, School of Biology, Moscow State University, Moscow, 119991, Russian Federation.
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22
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Gunay M, Celik G, Yildiz E, Bardak H, Koc N, Kirmizibekmez H, Gunay BO, Yesiltepe Mutlu RG. Ocular Surface Characteristics in Diabetic Children. Curr Eye Res 2016; 41:1526-1531. [DOI: 10.3109/02713683.2015.1136421] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Murat Gunay
- Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Gokhan Celik
- Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Elvin Yildiz
- Haydarpasa Numune Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Handan Bardak
- Haydarpasa Numune Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Nermin Koc
- Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital, Department of Pathology, Istanbul, Turkey
| | - Heves Kirmizibekmez
- Umraniye Training and Research Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Betul Onal Gunay
- Umraniye Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Rahime Gul Yesiltepe Mutlu
- Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey
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