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Tonyalı NV, Arslan B, Sucu ST, Sarsmaz K, İbanoğlu MC, Örgül G, Aktemur G, Yücel A, Şahin D. Does Second Trimester Maternal Serum Zonulin Level Predict Gestational Diabetes Mellitus? J Clin Med 2024; 13:394. [PMID: 38256529 PMCID: PMC10816522 DOI: 10.3390/jcm13020394] [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: 11/06/2023] [Revised: 12/17/2023] [Accepted: 12/31/2023] [Indexed: 01/24/2024] Open
Abstract
Zonulin, a protein that regulates intestinal permeability, has attracted attention as a potential biomarker for GDM. Therefore, this study aims to investigate whether there are differences in zonulin levels between the GDM group and control groups, especially between those receiving different treatments (diet and insulin). Based on this idea, we included 90 patients with a gestational age between 24 and 28 weeks in our study. While GDM was not detected in 33 of these patients, as a result of OGTT, 57 patients were diagnosed with GDM and these patients were followed throughout their pregnancy. Gestational diabetes was diagnosed by an OGTT performed between 24 and 28 weeks of gestation according to American Diabetes Association (ADA) standards. During follow-up, GDM patients were divided into two groups according to whether they required insulin treatment. Plasma zonulin levels were determined using enzyme-linked immunosorbent assay (ELISA) techniques. The GDM group had significantly higher plasma zonulin levels than the control group (p < 0.005). According to our research, zonulin may be a non-invasive biomarker involved in the etiology of GDM. Large-scale research on this topic is still needed.
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Affiliation(s)
- Nazan Vanlı Tonyalı
- Department of Obstetrics and Gynecology, Division of Perinatology, Health Sciences University Ankara Etlik City Hospital, Ankara 06010, Turkey;
| | - Burak Arslan
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 42130 Mölndal, Sweden;
| | - Serap Topkara Sucu
- Department of Obstetrics and Gynecology, Health Sciences University Ankara Etlik City Hospital, Ankara 06010, Turkey;
| | - Kemal Sarsmaz
- Department of Obstetrics and Gynecology, Manisa Celal Bayar University, Manisa 45120, Turkey;
| | - Müjde Can İbanoğlu
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Gynecology Training and Research Hospital, Ankara 06010, Turkey;
| | - Gökçen Örgül
- Department of Obstetrics and Gynecology, Selçuk University, Konya 42100, Turkey;
| | - Gizem Aktemur
- Department of Obstetrics and Gynecology, Division of Perinatology, Health Sciences University Ankara Etlik City Hospital, Ankara 06010, Turkey;
| | - Aykan Yücel
- Department of Obstetrics and Gynecology, Division of Perinatology, Health Sciences University Ankara Bilkent City Hospital, Ankara 06800, Turkey; (A.Y.); (D.Ş.)
| | - Dilek Şahin
- Department of Obstetrics and Gynecology, Division of Perinatology, Health Sciences University Ankara Bilkent City Hospital, Ankara 06800, Turkey; (A.Y.); (D.Ş.)
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Fernández-Valero A, Peña-Montero N, Lima-Rubio F, Gutiérrez-Repiso C, Linares-Pineda TM, Picón-César MJ, Sancho-Marín R, Tinahones FJ, Morcillo S, Molina-Vega M. Changes in Oxidative Stress and Intestinal Permeability during Pregnancy in Women with Gestational Diabetes Mellitus Treated with Metformin or Insulin and Healthy Controls: A Randomized Controlled Trial. Antioxidants (Basel) 2023; 12:1981. [PMID: 38001834 PMCID: PMC10669428 DOI: 10.3390/antiox12111981] [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: 09/30/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
Both oxidative stress and intestinal permeability are increased in hyperglycemic situations and have been shown to be reduced by metformin in type 2 diabetes mellitus (T2DM) patients. The aim of this study was to elucidate the effect of metformin on oxidative stress and intestinal permeability in women with gestational diabetes mellitus (GDM) treated with metformin compared to those treated with insulin and healthy controls. A total of 120 women were included from August 2016 to February 2022: 41 received metformin (MET group), 38 received insulin (INS group), and 41 were healthy controls. Baseline and antenatal visits were carried out at 25.4 ± 4.8 and 36.1 ± 0.8 weeks of pregnancy, respectively. Advanced oxidation protein products (AOPPs), total antioxidant capacity (TAC), and zonulin levels were measured at every visit. Zonulin levels from baseline to prepartum visit increased significantly in both healthy controls (0.6 ± 0.9 to 1.2 ± 1.7 ng/mL, p = 0.004) and the INS group (0.4 ± 0.3 to 0.6 ± 0.5 ng/mL, p = 0.034) but did not significantly change in the MET group (0.4 ± 0.4 to 0.5 ± 0.4 ng/mL, p = 0.202). However, TAC and AOPP levels significantly increased in women with GDM, both in the INS and MET groups but not in the healthy controls. In conclusion, in our population, metformin has been shown to avoid an increase in intestinal permeability but failed to avoid an increase in oxidative stress related to hyperglycemia.
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Affiliation(s)
- Andrea Fernández-Valero
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Department of Medicine and Dermatology, Málaga University, 29010 Málaga, Spain
| | - Nerea Peña-Montero
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - Fuensanta Lima-Rubio
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Teresa María Linares-Pineda
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - María José Picón-César
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
| | - Raquel Sancho-Marín
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Department of Medicine and Dermatology, Málaga University, 29010 Málaga, Spain
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Sonsoles Morcillo
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
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Veres-Székely A, Szász C, Pap D, Szebeni B, Bokrossy P, Vannay Á. Zonulin as a Potential Therapeutic Target in Microbiota-Gut-Brain Axis Disorders: Encouraging Results and Emerging Questions. Int J Mol Sci 2023; 24:ijms24087548. [PMID: 37108711 PMCID: PMC10139156 DOI: 10.3390/ijms24087548] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/05/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
The relationship between dysbiosis and central nervous diseases has been proved in the last 10 years. Microbial alterations cause increased intestinal permeability, and the penetration of bacterial fragment and toxins induces local and systemic inflammatory processes, affecting distant organs, including the brain. Therefore, the integrity of the intestinal epithelial barrier plays a central role in the microbiota-gut-brain axis. In this review, we discuss recent findings on zonulin, an important tight junction regulator of intestinal epithelial cells, which is assumed to play a key role in maintaining of the blood-brain barrier function. In addition to focusing on the effect of microbiome on intestinal zonulin release, we also summarize potential pharmaceutical approaches to modulate zonulin-associated pathways with larazotide acetate and other zonulin receptor agonists or antagonists. The present review also addresses the emerging issues, including the use of misleading nomenclature or the unsolved questions about the exact protein sequence of zonulin.
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Affiliation(s)
- Apor Veres-Székely
- Pediatric Center, MTA Center of Excellence, Semmelweis University, 1083 Budapest, Hungary
- ELKH-SE Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary
| | - Csenge Szász
- Pediatric Center, MTA Center of Excellence, Semmelweis University, 1083 Budapest, Hungary
| | - Domonkos Pap
- Pediatric Center, MTA Center of Excellence, Semmelweis University, 1083 Budapest, Hungary
- ELKH-SE Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary
| | - Beáta Szebeni
- Pediatric Center, MTA Center of Excellence, Semmelweis University, 1083 Budapest, Hungary
- ELKH-SE Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary
| | - Péter Bokrossy
- Pediatric Center, MTA Center of Excellence, Semmelweis University, 1083 Budapest, Hungary
| | - Ádám Vannay
- Pediatric Center, MTA Center of Excellence, Semmelweis University, 1083 Budapest, Hungary
- ELKH-SE Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary
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