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Masilela C, Pearce B, Ongole JJ, Adeniyi OV, Benjeddou M. Single Nucleotide Polymorphisms Associated with Metformin and Sulphonylureas' Glycaemic Response among South African Adults with Type 2 Diabetes Mellitus. J Pers Med 2021; 11:jpm11020104. [PMID: 33561991 PMCID: PMC7914534 DOI: 10.3390/jpm11020104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/31/2022] Open
Abstract
Aims: To examine the association of polymorphisms belonging to SLC22A1, SP1, PRPF31, NBEA, SCNN1B, CPA6 and CAPN10 genes with glycaemic response to metformin and sulphonylureas (SU) combination therapy among South African adults with diabetes mellitus type 2 (T2DM). Methods: A total of 128 individuals of Swati (n = 22) and Zulu (n = 106) origin attending chronic care for T2DM were recruited. Nine SNPs previously associated with metformin and SUs were selected and genotyped using MassArray. Uncontrolled T2DM was defined as HbA1c > 7%. The association between genotypes, alleles and glycaemic response to treatment was determined using multivariate logistic regression model analysis. Results: About 85.93% (n = 110) of the study participants were female and 77.34% (n = 99) had uncontrolled T2DM (HbA1c > 7%). In the multivariate (adjusted) logistic regression model analysis, the CC genotype of rs2162145 (CPA6), GG and GA genotypes of rs889299 (SCNN1B) were significantly associated with uncontrolled T2DM. On the other hand, the C allele of rs254271 (PRPF31) and the GA genotype of rs3792269 (CAPN10) were associated with controlled T2DM. A significant interaction between rs2162145 and rs889299 in response to metformin and SU combination therapy was observed. Conclusions: In this study, we reported the association of rs2162145 (CC) and rs889299 (GG and GA) with uncontrolled T2DM. We also reported the association of rs254271 (C) and rs3792269 (GA) with controlled T2DM in response to metformin and SU combination therapy. Furthermore, an interaction between rs2162145 and rs889299 was established, where the genotype combination GA (rs889299) and TT (rs2162145) was associated with uncontrolled T2DM.
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Affiliation(s)
- Charity Masilela
- Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa; (B.P.); (M.B.)
- Correspondence:
| | - Brendon Pearce
- Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa; (B.P.); (M.B.)
| | - Joven Jebio Ongole
- Center for Teaching and Learning, Department of Family Medicine, Piet Retief Hospital, Mkhondo 2380, South Africa;
| | | | - Mongi Benjeddou
- Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa; (B.P.); (M.B.)
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Gitaka J, Ogwang C, Ngari M, Akoo P, Olotu A, Kerubo C, Fegan G, Njuguna P, Nyakaya G, Otieno T, Mwambingu G, Awuondo K, Lowe B, Chilengi R, Berkley JA. Clinical laboratory reference values amongst children aged 4 weeks to 17 months in Kilifi, Kenya: A cross sectional observational study. PLoS One 2017; 12:e0177382. [PMID: 28493930 PMCID: PMC5426761 DOI: 10.1371/journal.pone.0177382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 04/26/2017] [Indexed: 12/24/2022] Open
Abstract
Reference intervals for clinical laboratory parameters are important for assessing eligibility, toxicity grading and management of adverse events in clinical trials. Nonetheless, haematological and biochemical parameters used for clinical trials in sub-Saharan Africa are typically derived from industrialized countries, or from WHO references that are not region-specific. We set out to establish community reference values for haematological and biochemical parameters amongst children aged 4 weeks to 17 months in Kilifi, Kenya. We conducted a cross sectional study nested within phase II and III trials of RTS, S malaria vaccine candidate. We analysed 10 haematological and 2 biochemical parameters from 1,070 and 423 community children without illness prior to experimental vaccine administration. Statistical analysis followed Clinical and Laboratory Standards Institute EP28-A3c guidelines. 95% reference ranges and their respective 90% confidence intervals were determined using non-parametric methods. Findings were compared with published ranges from Tanzania, Europe and The United States. We determined the reference ranges within the following age partitions: 4 weeks to <6 months, 6 months to less than <12 months, and 12 months to 17 months for the haematological parameters; and 4 weeks to 17 months for the biochemical parameters. There were no gender differences for all haematological and biochemical parameters in all age groups. Hb, MCV and platelets 95% reference ranges in infants largely overlapped with those from United States or Europe, except for the lower limit for Hb, Hct and platelets (lower); and upper limit for platelets (higher) and haematocrit(lower). Community norms for common haematological and biochemical parameters differ from developed countries. This reaffirms the need in clinical trials for locally derived reference values to detect deviation from what is usual in typical children in low and middle income countries.
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Affiliation(s)
- Jesse Gitaka
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Clinical Medicine, School of Health Sciences, Mount Kenya University, Thika, Kenya
| | - Caroline Ogwang
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Moses Ngari
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya.,The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| | - Pauline Akoo
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ally Olotu
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Christine Kerubo
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Greg Fegan
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya.,Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.,Swansea Trials Unit, Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Patricia Njuguna
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Godfrey Nyakaya
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Tuda Otieno
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Gabriel Mwambingu
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ken Awuondo
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Brett Lowe
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya.,Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
| | - Roma Chilengi
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - James A Berkley
- Clinical Trials Facility, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya.,The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya.,Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
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Goltsman I, Khoury EE, Winaver J, Abassi Z. Does Thiazolidinedione therapy exacerbate fluid retention in congestive heart failure? Pharmacol Ther 2016; 168:75-97. [PMID: 27598860 DOI: 10.1016/j.pharmthera.2016.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The ever-growing global burden of congestive heart failure (CHF) and type 2 diabetes mellitus (T2DM) as well as their co-existence necessitate that anti-diabetic pharmacotherapy will modulate the cardiovascular risk inherent to T2DM while complying with the accompanying restrictions imposed by CHF. The thiazolidinedione (TZD) family of peroxisome proliferator-activated receptor γ (PPARγ) agonists initially provided a promising therapeutic option in T2DM owing to anti-diabetic efficacy combined with pleiotropic beneficial cardiovascular effects. However, the utility of TZDs in T2DM has declined in the past decade, largely due to concomitant adverse effects of fluid retention and edema formation attributed to salt-retaining effects of PPARγ activation on the nephron. Presumably, the latter effects are potentially deleterious in the context of pre-existing fluid retention in CHF. However, despite a considerable body of evidence on mechanisms responsible for TZD-induced fluid retention suggesting that this class of drugs is rightfully prohibited from use in CHF patients, there is a paucity of experimental and clinical studies that investigate the effects of TZDs on salt and water homeostasis in the CHF setting. In an attempt to elucidate whether TZDs actually exacerbate the pre-existing fluid retention in CHF, our review summarizes the pathophysiology of fluid retention in CHF. Moreover, we thoroughly review the available data on TZD-induced fluid retention and proposed mechanisms in animals and patients. Finally, we will present recent studies challenging the common notion that TZDs worsen renal salt and water retention in CHF.
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Affiliation(s)
- Ilia Goltsman
- Department of Physiology, Biophysics and Systems Biology, The Bruce Rappaport, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Emad E Khoury
- Department of Physiology, Biophysics and Systems Biology, The Bruce Rappaport, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Joseph Winaver
- Department of Physiology, Biophysics and Systems Biology, The Bruce Rappaport, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Zaid Abassi
- Department of Physiology, Biophysics and Systems Biology, The Bruce Rappaport, Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Laboratory Medicine, Rambam Human Health Care Campus, Haifa, Israel.
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Bełtowski J, Rachańczyk J, Włodarczyk M. Thiazolidinedione-induced fluid retention: recent insights into the molecular mechanisms. PPAR Res 2013; 2013:628628. [PMID: 23577024 PMCID: PMC3614122 DOI: 10.1155/2013/628628] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 02/19/2013] [Indexed: 01/11/2023] Open
Abstract
Peroxisome proliferator-activated receptor- γ (PPAR γ ) agonists such as rosiglitazone and pioglitazone are used to improve insulin sensitivity in patients with diabetes mellitus. However, thiazolidinediones induce fluid retention, edema, and sometimes precipitate or exacerbate heart failure in a subset of patients. The mechanism through which thiazolidinediones induce fluid retention is controversial. Most studies suggest that this effect results from the increase in tubular sodium and water reabsorption in the kidney, but the role of specific nephron segments and sodium carriers involved is less clear. Some studies suggested that PPAR γ agonist stimulates Na(+) reabsorption in the collecting duct by activating epithelial Na(+) channel (ENaC), either directly or through serum and glucocorticoid-regulated kinase-1 (SGK-1). However, other studies did not confirm this mechanism and even report the suppression of ENaC. Alternative mechanisms in the collecting duct include stimulation of non-ENaC sodium channel or inhibition of chloride secretion to the tubular lumen. In addition, thiazolidinediones may augment sodium reabsorption in the proximal tubule by stimulating the expression and activity of apical Na(+)/H(+) exchanger-3 and basolateral Na(+)-HCO3 (-) cotransporter as well as of Na(+),K(+)-ATPase. These effects are mediated by PPAR γ -induced nongenomic transactivation of the epidermal growth factor receptor and downstream extracellular signal-regulated kinases (ERK).
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Affiliation(s)
- Jerzy Bełtowski
- Department of Pathophysiology, Medical University of Lublin, 8 Jaczewskiego, 20090 Lublin, Poland
| | - Jolanta Rachańczyk
- Department of Pathophysiology, Medical University of Lublin, 8 Jaczewskiego, 20090 Lublin, Poland
| | - Mirosław Włodarczyk
- Department of Pathophysiology, Medical University of Lublin, 8 Jaczewskiego, 20090 Lublin, Poland
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Genetic predisposition and nongenetic risk factors of thiazolidinedione-related edema in patients with type 2 diabetes. Pharmacogenet Genomics 2012; 21:829-36. [PMID: 21934636 DOI: 10.1097/fpc.0b013e32834bfff1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to analyze the association of thiazolidinedione (TZD)-related edema with genetic and clinical variables and develop a simple points system to predict the risk of developing TZD-related edema. METHODS Fifty-eight (21.6%) of 268 individuals who received TZD for type 2 diabetes developed peripheral edema. Twenty-eight tag single nucleotide polymorphisms (SNPs) from candidate genes involved in sodium and water reabsorption were genotyped. Cox regression and logistic regression models were used to analyze the associations of different genotypes and weighted genotypic scores with TZD-related edema risk. RESULTS Individuals with edema were older, predominantly female, and had greater weight gain. The AQP2 rs296766 T allele was associated with TZD-related edema [allelic P=0.0059; odds ratio (OR), 2.89; 95% confidence interval (CI), 1.61-5.17]. The SLC12A rs12904216 G allele had borderline significance (allelic P=0.049), which disappeared after correction for multiple testing. Patients with two SNP-based (AQP2 rs296766 and SLC12A1 rs12904216), who weighted genotypic scores within the top quartile, had a higher risk of developing TZD-related edema (OR, 16.45; 95% CI, 3.05-88.76). Combining the weighted genetic scores of two SNPs or all SNPs with age and sex information significantly improved the predictive power for TZD-related edema. We also developed a simple risk factor-based points system to predict an individual's risk of developing TZD-related edema. CONCLUSION A clinically applicable prediction model including age, sex, and genetic information from AQP2 rs296766 and/or SLC12A rs12904216 SNPs can be developed to estimate the risk of TZD-related edema in type 2 diabetes patients.
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Bailey SD, Xie C, Do R, Montpetit A, Diaz R, Mohan V, Keavney B, Yusuf S, Gerstein HC, Engert JC, Anand S. Variation at the NFATC2 locus increases the risk of thiazolidinedione-induced edema in the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) study. Diabetes Care 2010; 33:2250-3. [PMID: 20628086 PMCID: PMC2945168 DOI: 10.2337/dc10-0452] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Thiazolidinediones are used to treat type 2 diabetes. Their use has been associated with peripheral edema and congestive heart failure-outcomes that may have a genetic etiology. RESEARCH DESIGN AND METHODS We genotyped 4,197 participants of the multiethnic DREAM (Diabetes REduction Assessment with ramipril and rosiglitazone Medication) trial with a 50k single nucleotide polymorphisms (SNP) array, which captures ∼2000 cardiovascular, inflammatory, and metabolic genes. We tested 32,088 SNPs for an association with edema among Europeans who received rosiglitazone (n = 965). RESULTS One SNP, rs6123045, in NFATC2 was significantly associated with edema (odds ratio 1.89 [95% CI 1.47-2.42]; P = 5.32 × 10(-7), corrected P = 0.017). Homozygous individuals had the highest edema rate (hazard ratio 2.89, P = 4.22 × 10(-4)) when compared with individuals homozygous for the protective allele, with heterozygous individuals having an intermediate risk. The interaction between the SNP and rosiglitazone for edema was significant (P = 7.68 × 10(-3)). Six SNPs in NFATC2 were significant in both Europeans and Latin Americans (P < 0.05). CONCLUSIONS Genetic variation at the NFATC2 locus contributes to edema among individuals who receive rosiglitazone.
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Affiliation(s)
- Swneke D Bailey
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
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Renauld S, Tremblay K, Ait-Benichou S, Simoneau-Roy M, Garneau H, Staub O, Chraïbi A. Stimulation of ENaC Activity by Rosiglitazone is PPARγ-Dependent and Correlates with SGK1 Expression Increase. J Membr Biol 2010; 236:259-70. [DOI: 10.1007/s00232-010-9297-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 08/10/2010] [Indexed: 02/02/2023]
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Abstract
Genetic variation can impact on efficacy and risk of adverse events to commonly used oral agents in -diabetes. Metformin is not metabolized and its mechanism of action remains debated; however, several cation transporters have been identified. Variation in these pharmacokinetic genes might influence metformin response. Conversely, although the cytochrome P450 system has been implicated in sulfonylurea response in some small studies, to date variants affecting pharmacodynamics, including those in ABCC8 (SUR1) and TCF7L2, are the most promising. For thiazolidinedione response, variants in PPARG or ADIPOQ (adiponectin) have been variably associated with response. With increasing well-phenotyped cohorts and new methods, including genome-wide association studies, the next few years offer great hope to use pharmacogenetics to unravel drug and disease mechanisms, as well as the possibility to individualize therapy by genotype.
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Affiliation(s)
- Ewan R Pearson
- Biomedical Research Institute, Ninewells Hospital and Medical School, Ninewells Avenue, Dundee, DD1 9SY, UK.
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Wu CF, Xu Y, Tao Y, Yang JY. Establishment of hypoglycemic agent screening method based on human glucokinase. BIOMEDICAL AND ENVIRONMENTAL SCIENCES : BES 2009; 22:62-69. [PMID: 19462690 DOI: 10.1016/s0895-3988(09)60024-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To establish a reliable platform for screening glucokinase activators (GKAs) in vitro. METHODS Pancreatic glucokinase (PGK) protein expressed in a prokaryotic expression system as a histidine-tagged fusion protein from Homo sapiens was produced. Then, response surface methodology (RSM) was used to optimize the microplate-based GKA screening platform. In the first step of optimization with Plackett-Burman design (PBD), initial pH, reaction time and MgCl2 were found to be important factors affecting the activity ratio of GKA (RO-28-1675) significantly. In the second step, a 2(3) full factorial central composite design (CCD) and RSM were applied to the optimal condition determination of each significant variable. A second-order polynomial was determined by a multiple regression analysis of the experimental data. RESULTS The following optimal values for the critical factors were obtained: initial pH 0 (7.0), reaction time-0.63 (13.7 min) and MgCl2 0.11 (2.11 mmol/L) with a predicted value of the maximum activity ratio of 34.1%. CONCLUSION Under the optimal conditions, the practical activity ratio is 34.8%. The determination coefficient (R2) is 0.9442, ensuring adequate credibility of the model. LLAE3, extracted from Folium nelumbinis in our laboratory, has prominently activated effects on PGK.
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Affiliation(s)
- Chou-Fei Wu
- Key Laboratory of State Food Science and Technology, Jiangxi-OAI Joint Research Institute, Nanchang University, Nanchang 330047, Jiangxi, China
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Joseph MF, Youngstrom EA, Soares JC. Antidepressant-coincident mania in children and adolescents treated with selective serotonin reuptake inhibitors. FUTURE NEUROLOGY 2009; 4:87-102. [PMID: 19884978 PMCID: PMC2655139 DOI: 10.2217/14796708.4.1.87] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Several factors have amplified concern about the possibility that antidepressant medication may contribute to induction of pediatric mania. These include the high rate of antidepressant medication prescription, the recent surge in the rate of diagnosis of pediatric bipolar disorder in the USA, and a growing number of case reports and clinical studies showing coincidence of manic symptoms with antidepressant pharmacotherapy in both youths and adults. However, the question of how medications and manic symptoms might be related is complicated, and decisive research studies with rigorous designs for evaluating the issues have not been published. The situation makes it difficult for practitioners to make good, evidence-based decisions. The scientific literature is ambiguous, and the stakes are high. We review the extant literature, offer seven different conceptual models of how medication and mania might be related, and comment on the evidence and clinical implications of each.
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Affiliation(s)
- Megan F Joseph
- University of North Carolina – Chapel Hill, Department of Psychology, CB #3270, Davie Hall, Chapel Hill, NC 27599, USA, Tel.: +1 919 843 3956, Fax: +1 919 962 2537,
| | - Eric A Youngstrom
- University of North Carolina – Chapel Hill, Department of Psychology, CB #3270, Davie Hall, Chapel Hill, NC 27599, USA, Tel.: +1 919 962 3997, Fax: +1 919 962 2537,
| | - Jair C Soares
- University of North Carolina – Chapel Hill School of Medicine, Department of Psychiatry, CB #7160, 10612 Neurosciences Hospital, 101 Manning Drive, Chapel Hill, NC 27599, USA, Tel.: +1 919 966 8832, Fax: +1 919 843 3950,
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