Effects of blood glucose fluctuation on skin biophysical properties, structure and antioxidant status in an animal model

Glycemic Variability in Diabetes Increases the Severity of Influenza

Every winter, people with diabetes are at increased risk of severe influenza. At present, the mechanisms that cause this increased susceptibility are unclear. Here, we show that the fluctuations in blood glucose levels common in people with diabetes are associated with severe influenza. These data suggest that glycemic stability could become a greater clinical priority for patients with diabetes during outbreaks of influenza.

People with diabetes are two times more likely to die from influenza than people with no underlying medical condition. The mechanisms underlying this susceptibility are poorly understood. In healthy individuals, small and short-lived postprandial peaks in blood glucose levels occur. In diabetes mellitus, these fluctuations become greater and more frequent. This glycemic variability is associated with oxidative stress and hyperinflammation. However, the contribution of glycemic variability to the pathogenesis of influenza A virus (IAV) has not been explored. Here, we used an in vitro model of the pulmonary epithelial-endothelial barrier and novel murine models to investigate the role of glycemic variability in influenza severity. In vitro, a history of glycemic variability significantly increased influenza-driven cell death and destruction of the epithelial-endothelial barrier. In vivo, influenza virus-infected mice with a history of glycemic variability lost significantly more body weight than mice with constant blood glucose levels. This increased disease severity was associated with markers of oxidative stress and hyperinflammation both in vitro and in vivo. Together, these results provide the first indication that glycemic variability may help drive the increased risk of severe influenza in people with diabetes mellitus.

Blood glucose fluctuation affects skin collagen metabolism in the diabetic mouse by inhibiting the mitogen-activated protein kinase and Smad pathways

BACKGROUND

We recently reported that in mice, blood glucose fluctuations (BGF) produced more detrimental effects on skin structure and function than did diabetes alone.

AIM

To determine whether treatment of BGF changes the collagen metabolism in the skin of diabetic mice, and to explore its possible molecular mechanism further.

METHODS

The study used diabetic and BGF animal models. Immunohistochemistry, western blotting and real-time PCR analysis were used to detect the expression of type I collagen, matrix metalloproteinase (MMP)-1, MMP-2 and MMP-13, tissue inhibitor of metalloproteinase (TIMP)-1, extracellular signal-regulated kinase, p38, and Smad2/3. The activities of mitogen-activated protein kinase (MAPK) and Smad signal molecules were also detected by western blotting, and the skin fibroblast ultrastructure was examined using an electron microscope.

RESULTS

BGF treatment produced a twofold reduction in type I collagen synthesis compared with diabetes-only mice. Expression of MMP-1, MMP-2 and MMP-13 increased markedly in the BGF-treated mice, but TIMP-1 expression was strongly downregulated by the BGF treatment. There was also evidence of higher levels of apoptosis of skin fibroblasts after BGF treatment.

CONCLUSIONS

BGF treatment can affect collagen production in the skin of diabetic BGF mice by inhibiting collagen synthesis and increasing collagen degradation. Furthermore, both MAPK and Smad signalling pathways seem to play a role in the inhibition of collagen production in diabetic mice treated with BGF.

Both ERK/MAPK and TGF-Beta/Smad signaling pathways play a role in the kidney fibrosis of diabetic mice accelerated by blood glucose fluctuation

BACKGROUND

The notion that diabetic nephropathy is the leading cause of renal fibrosis prompted us to investigate the effects of blood glucose fluctuation (BGF) under high glucose condition on kidney in the mice.

METHODS

The diabetic and BGF animal models were established in this study. Immunohistochemistry, Western blot, and RT-PCR analysis were applied to detect the expression of type I collagen, matrix metalloproteinase-1 (MMP1), metalloproteinase inhibitor 1 (TIMP1), transforming growth factor beta 1 (TGF- β 1), phosphorylated-ERK, p38, smad2/3, and Akt.

RESULTS

BGF treatment increased type I collagen synthesis by two times compared with the control. The expression of MMP1 was reduced markedly while TIMP1 synthesis was enhanced after BGF treatment. ERK phosphorylation exhibits a significant increase in the mice treated with BGF. Furthermore, BGF can markedly upregulate TGF- β 1 expression. The p-smad2 showed 2-fold increases compared with the only diabetic mice. However, p-AKT levels were unchanged after BGF treatment.

CONCLUSIONS

These data demonstrate that BGF can accelerate the trend of kidney fibrosis in diabetic mice by increasing collagen production and inhibiting collagen degradation. Both ERK/MAPK and TGF- β /smad signaling pathways seem to play a role in the development of kidney fibrosis accelerated by blood glucose fluctuation.

Effects of diabetes and/or hypercholesterolemia on skin development of rat fetuses

OBJECTIVE

To investigate the effects of diabetes and/or hypercholesterolemia on skin development during in utero life at 15, 17 & 19 days old.

METHODS

Sixty pregnant female albino Wistar rats were arranged into three groups: control, diabetic (single i.p. 60 mg streptozotocin/kg B.wt) and hypercholesterolemic (diet supplement 3% cholesterol 6 week prior to conception and throughout gestation). Pregnant rats were sacrificed at 15, 17 & 19 days prenatal). Vibrissae skin biopsies were removed and allowed for scanning (SEM), light, and transmission electron microscopic (TEM) investigation. Also, DNA fragmentation and sodium dodecyl polyacrylamides gel electrophoresis (SDS-PAGE) were carried out.

RESULTS

Scanning electron microscopic observations revealed retarded hair follicle growth and deformations of their pattern structure. At light microscopic level, skin exhibited decreased epidermal cornification, as well as degeneration of hair follicles in fetuses of both diabetic and hypercholesterolemic groups. Transmission electron microscopy revealed abundant vacuolar spaces in the epidermis. Degenerative phases become more abundant in keratinocytes as well as in stratum germinativum cells. Fetal skin possessed altered protein expression and missing bands as well as separation of genomic DNA to several degraded bands in skin of 15-, 17-, and 19-day-old, maternally diabetic and/or hypercholesterolemic fetuses.

CONCLUSION

These findings showed that maternal diabetes and/or hypercholesterolemia increased average deformation of hair follicles, vacuolation, and degeneration of epidermal cell layers. The observed findings resulted from altered protein expression and increased DNA fragmentation, which, in turn, disrupt epidermal cell differentiation.

Looking through the cracks of diabetic candidal balanoposthitis!

India is becoming an epicentre of type II diabetes mellitus with a crude prevalence rate of about 9%. Candida balanoposthitis is a known feature of diabetes mellitus especially in Indian males who are predominantly uncircumcised. In this country, diabetes is often diagnosed for the first time by dermatologists. Diabetes is much more frequently the cause of candida balanoposthitis than sexual intercourse in India. Fissuring along with balanoposthitis was found to be more common in sexually active males. The biomechanical basis of fissuring and the effect of diabetes in this phenomenon are explained. The issue of circumcision is debated under various aspects.

The malondialdehyde-derived fluorophore DHP-lysine is a potent sensitizer of UVA-induced photooxidative stress in human skin cells

Light-driven electron and energy transfer involving non-DNA skin chromophores as endogenous photosensitizers induces oxidative stress in UVA-exposed human skin, a process relevant to photoaging and photocarcinogenesis. Malondialdehyde is an electrophilic dicarbonyl-species derived from membrane lipid peroxidation. Here, we present experimental evidence suggesting that the malondialdehyde-derived protein epitope dihydropyridine (DHP)-lysine is a potent endogenous UVA-photosensitizer of human skin cells. Immunohistochemical analysis revealed the abundant occurrence of malondialdehyde-derived and DHP-lysine epitopes in human skin. Using the chemically protected dihydropyridine-derivative (2S)-Boc-2-amino-6-(3,5-diformyl-4-methyl-4H-pyridin-1-yl)-hexanoic acid-t-butylester as a model of peptide-bound DHP-lysine, photodynamic inhibition of proliferation and induction of cell death were observed in human skin Hs27 fibroblasts as well as primary and HaCaT keratinocytes exposed to the combined action of UVA and DHP-lysine. DHP-lysine photosensitization induced intracellular oxidative stress, p38 MAPkinase activation, and upregulation of heme oxygenase-1 expression. Consistent with UVA-driven ROS formation from DHP-lysine, formation of superoxide, hydrogen peroxide, and singlet oxygen was detected in chemical assays, but little protection was achieved using SOD or catalase during cellular photosensitization. In contrast, inclusion of NaN(3) completely abolished DHP-photosensitization. Taken together, these data demonstrate photodynamic activity of DHP-lysine and support the hypothesis that malondialdehyde-derived protein-epitopes may function as endogenous sensitizers of UVA-induced oxidative stress in human skin.