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Leite ML, Oliveira KBS, Cunha VA, Dias SC, da Cunha NB, Costa FF. Epigenetic Therapies in the Precision Medicine Era. ADVANCED THERAPEUTICS 2020. [DOI: 10.1002/adtp.201900184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Michel Lopes Leite
- Genomic Sciences and Biotechnology Program UCB ‐ Brasilia, SgAN 916, Modulo B, Bloco C, 70790‐160 Brasília DF Brazil
| | | | - Victor Albuquerque Cunha
- Genomic Sciences and Biotechnology Program UCB ‐ Brasilia, SgAN 916, Modulo B, Bloco C, 70790‐160 Brasília DF Brazil
| | - Simoni Campos Dias
- Genomic Sciences and Biotechnology Program UCB ‐ Brasilia, SgAN 916, Modulo B, Bloco C, 70790‐160 Brasília DF Brazil
- Animal Biology DepartmentUniversidade de Brasília UnB, Campus Darcy Ribeiro. Brasilia DF 70910‐900 Brazil
| | - Nicolau Brito da Cunha
- Genomic Sciences and Biotechnology Program UCB ‐ Brasilia, SgAN 916, Modulo B, Bloco C, 70790‐160 Brasília DF Brazil
| | - Fabricio F. Costa
- Cancer Biology and Epigenomics ProgramAnn & Robert H Lurie Children's Hospital of Chicago Research Center, Northwestern University's Feinberg School of Medicine 2430 N. Halsted St., Box 220 Chicago IL 60611 USA
- Northwestern University's Feinberg School of Medicine 2430 N. Halsted St., Box 220 Chicago IL 60611 USA
- MATTER Chicago 222 W. Merchandise Mart Plaza, Suite 12th Floor Chicago IL 60654 USA
- Genomic Enterprise (www.genomicenterprise.com) San Diego, CA 92008 and New York NY 11581 USA
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Fodor A, Cozma A, Suharoschi R, Sitar-Taut A, Roman G. Clinical and genetic predictors of diabetes drug's response. Drug Metab Rev 2019; 51:408-427. [PMID: 31456442 DOI: 10.1080/03602532.2019.1656226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Diabetes is a major health problem worldwide. Glycemic control is the main goal in the management of type 2 diabetes. While many anti-diabetic drugs and guidelines are available, almost half of diabetic patients do not reach their treatment goal and develop complications. The glucose-lowering response to anti-diabetic drug differs significantly between individuals. Relatively little is known about the factors that might underlie this response. The identification of predictors of response to anti-diabetic drugs is essential for treatment personalization. Unfortunately, the evidence on predictors of drugs response in type 2 diabetes is scarce. Only a few trials were designed for specific groups of patients (e.g. patients with renal impairment or older patients), while subgroup analyses of larger trials are frequently unreported. Physicians need help in picking the drug which provides the maximal benefit, with minimal side effects, in the right dose, for a specific patient, using an omics-based approach besides the phenotypic characteristics.
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Affiliation(s)
- Adriana Fodor
- Department of Diabetes and Metabolic Diseases, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,Clinical Center of Diabetes, Nutrition and Metabolic Disease, Cluj-Napoca, Romania
| | - Angela Cozma
- 4th Internal Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Ramona Suharoschi
- Department of Food Science, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca, Romania
| | - Adela Sitar-Taut
- 4th Internal Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Gabriela Roman
- Department of Diabetes and Metabolic Diseases, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,Clinical Center of Diabetes, Nutrition and Metabolic Disease, Cluj-Napoca, Romania
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Sitar-Tăut DA, Sitar-Tăut AV, Mican D, Cozma A, Orăşan OH, Mureşan C, Suharoschi R, Negrean V, Sampelean D, Vulturar R, Zdrenghea DT, Pop D, Dogaru G, Dădârlat A, Fodor A. Collaborative platform development in nutrition as support for cardiovascular patients’ rehabilitation. BALNEO RESEARCH JOURNAL 2019. [DOI: 10.12680/balneo.2019.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Introduction. Enrollment of patients with cardiovascular disease in rehabilitation programs may contribute to implementation of a healthy lifestyle, including by promotion of a diet adequate for each patient’s profile. In this context, the current study is aimed at creating a traffic light system model allowing to obtain the development, innovation and diversification of menus and to improve the nutritional programs for this category of patients. Material and method. Based on the data provided by USDA Food Composition Databases, the composition in terms of different nutritive principles was determined for each ingredient and for each final menu. Comparison of menus depending on each nutritive principle, as well as comparison between menus and nutrient requirements according to indications for patients attending cardiovascular rehabilitation programs was made. Results. The traffic light system was developed, using color codes, comparing daily nutrient requirements with preparations’ content. Conclusions. The major benefit of the traffic light system would reside in the fact that starting from classic menus, an intervention on these can be achieved, and healthier, more nutritionally balanced models can be created, according to healthy nutrition principles. These new menus will be calorically and nutritionally adapted for patients attending cardiovascular rehabilitation programs.
Key words: nutrition, rehabilitation, traffic light system,
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Affiliation(s)
| | - Adela-Viviana Sitar-Tăut
- Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | | | - Angela Cozma
- Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Olga Hilda Orăşan
- Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Crina Mureşan
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Food Science &Technology
| | - Ramona Suharoschi
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Food Science &Technology
| | - Vasile Negrean
- Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Dorel Sampelean
- Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Romana Vulturar
- Department of Cell Biology, “Iuliu Hatieganu”, University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Dumitru Tudor Zdrenghea
- Clinical Rehabilitation Hospital, Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Pop
- Clinical Rehabilitation Hospital, Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriela Dogaru
- Clinical Rehabilitation Hospital, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandra Dădârlat
- „Niculae Stãncioiu” Heart Institute, Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Adriana Fodor
- Clinical Center of Diabetes, Nutrition, Metabolic diseases, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
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Capobianco E. Systems and precision medicine approaches to diabetes heterogeneity: a Big Data perspective. Clin Transl Med 2017; 6:23. [PMID: 28744848 PMCID: PMC5526830 DOI: 10.1186/s40169-017-0155-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 06/26/2017] [Indexed: 12/15/2022] Open
Abstract
Big Data, and in particular Electronic Health Records, provide the medical community with a great opportunity to analyze multiple pathological conditions at an unprecedented depth for many complex diseases, including diabetes. How can we infer on diabetes from large heterogeneous datasets? A possible solution is provided by invoking next-generation computational methods and data analytics tools within systems medicine approaches. By deciphering the multi-faceted complexity of biological systems, the potential of emerging diagnostic tools and therapeutic functions can be ultimately revealed. In diabetes, a multidimensional approach to data analysis is needed to better understand the disease conditions, trajectories and the associated comorbidities. Elucidation of multidimensionality comes from the analysis of factors such as disease phenotypes, marker types, and biological motifs while seeking to make use of multiple levels of information including genetics, omics, clinical data, and environmental and lifestyle factors. Examining the synergy between multiple dimensions represents a challenge. In such regard, the role of Big Data fuels the rise of Precision Medicine by allowing an increasing number of descriptions to be captured from individuals. Thus, data curations and analyses should be designed to deliver highly accurate predicted risk profiles and treatment recommendations. It is important to establish linkages between systems and precision medicine in order to translate their principles into clinical practice. Equivalently, to realize their full potential, the involved multiple dimensions must be able to process information ensuring inter-exchange, reducing ambiguities and redundancies, and ultimately improving health care solutions by introducing clinical decision support systems focused on reclassified phenotypes (or digital biomarkers) and community-driven patient stratifications.
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Affiliation(s)
- Enrico Capobianco
- Center for Computational Science, University of Miami, Miami, FL, USA.
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Abstract
The novel genome-wide assays of epigenetic marks have resulted in a greater understanding of how genetics and the environment interact in the development and inheritance of diabetes. Chronic hyperglycemia induces epigenetic changes in multiple organs, contributing to diabetic complications. Specific epigenetic-modifying compounds have been developed to erase these modifications, possibly slowing down the onset of diabetes-related complications. The current review is an update of the previously published paper, describing the most recent advances in the epigenetics of diabetes.
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Affiliation(s)
- Adriana Fodor
- University of Medicine & Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
- County Emergency Clinical Hospital, Department of Diabetes, Nutrition & Metabolic Diseases, Cluj-Napoca, Romania
| | - Angela Cozma
- University of Medicine & Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
- Clinical Hospital CF, Department of Internal Medicine, Cluj-Napoca, Romania
| | - Eddy Karnieli
- The Institute of Endocrinology, Diabetes & Metabolism, Rambam Medical Center, Haifa, Israel
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Lee C, An D, Park J. Hyperglycemic memory in metabolism and cancer. Horm Mol Biol Clin Investig 2017; 26:77-85. [PMID: 27227713 DOI: 10.1515/hmbci-2016-0022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 04/14/2016] [Indexed: 12/17/2022]
Abstract
Hyperglycemia is a hallmark of both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Recent evidence strongly suggests that prolonged exposure to hyperglycemia can epigenetically modify gene expression profiles in human cells and that this effect is sustained even after hyperglycemic control is therapeutically achieved; this phenomenon is called hyperglycemic memory. This metabolic memory effect contributes substantially to the pathology of various diabetic complications, such as diabetic retinopathy, hypertension, and diabetic nephropathy. Due to the metabolic memory in cells, diabetic patients suffer from various complications, even after hyperglycemia is controlled. With regard to this strong association between diabetes and cancer risk, cancer cells have emerged as key target cells of hyperglycemic memory in diabetic cancer patients. In this review, we will discuss the recent understandings of the molecular mechanisms underlying hyperglycemic memory in metabolism and cancer.
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Pradhan P, Upadhyay N, Tiwari A, Singh LP. Genetic and epigenetic modifications in the pathogenesis of diabetic retinopathy: a molecular link to regulate gene expression. ACTA ACUST UNITED AC 2016; 2:192-204. [PMID: 28691104 DOI: 10.15761/nfo.1000145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intensification in the frequency of diabetes and the associated vascular complications has been a root cause of blindness and visual impairment worldwide. One such vascular complication which has been the prominent cause of blindness; retinal vasculature, neuronal and glial abnormalities is diabetic retinopathy (DR), a chronic complicated outcome of Type 1 and Type 2 diabetes. It has also become clear that "genetic" variations in population alone can't explain the development and progression of diabetes and its complications including DR. DR experiences engagement of foremost mediators of diabetes such as hyperglycemia, oxidant stress, and inflammatory factors that lead to the dysregulation of "epigenetic" mechanisms involving histone acetylation and histone and DNA methylation, chromatin remodeling and expression of a complex set of stress-regulated and disease-associated genes. In addition, both elevated glucose concentration and insulin resistance leave a robust effect on epigenetic reprogramming of the endothelial cells too, since endothelium associated with the eye aids in maintaining the vascular homeostasis. Furthermore, several studies conducted on the disease suggest that the modifications of the epigenome might be the fundamental mechanism(s) for the proposed metabolic memory' resulting into prolonged gene expression for inflammation and cellular dysfunction even after attaining the glycemic control in diabetics. Henceforth, the present review focuses on the aspects of genetic and epigenetic alterations in genes such as vascular endothelial growth factor and aldose reductase considered being associated with DR. In addition, we discuss briefly the role of the thioredoxin-interacting protein TXNIP, which is strongly induced by high glucose and diabetes, in cellular oxidative stress and mitochondrial dysfunction potentially leading to chromatin remodeling and ocular complications of diabetes. The identification of disease-associated genes and their epigenetic regulations will lead to potential new drugs and gene therapies as well as personalized medicine to prevent or slow down the progression of DR.
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Affiliation(s)
- Priya Pradhan
- School of Biotechnology, Rajiv Gandhi Technical University, Bhopal, Madhya Pradesh, India
| | - Nisha Upadhyay
- School of Biotechnology, Rajiv Gandhi Technical University, Bhopal, Madhya Pradesh, India
| | - Archana Tiwari
- School of Biotechnology, Rajiv Gandhi Technical University, Bhopal, Madhya Pradesh, India
| | - Lalit P Singh
- Departments of Anatomy/Cell Biology and Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
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Fodor A, Karnieli E. Challenges of implementing personalized (precision) medicine: a focus on diabetes. Per Med 2016; 13:485-497. [DOI: 10.2217/pme-2016-0022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The concept of personalized (precision) medicine (PM) emphasizes the scientific and technological innovations that enable the physician to tailor disease prediction, diagnosis and treatment to the individual patient, based on a personalized data-driven approach. The major challenge for the medical systems is to translate the molecular and genomic advances into clinical available means. Patients and healthcare providers, the pharmaceutical and diagnostic industries manifest a growing interest in PM. Multiple stakeholders need adaptation and re-engineering for successful clinical implementation of PM. Drawing primarily from the field of ‘diabetes’, this article will summarize the main challenges to implementation of PM into current medical practice and some of the approaches currently being implemented to overcome these challenges.
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Affiliation(s)
- Adriana Fodor
- University of Medicine & Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - Eddy Karnieli
- Galil Center for Telemedicine, Medical Informatics & Personalized Medicine, Rappaport Faculty of Medicine, Technion, Haifa, Israel
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