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Rivera RG, Regidor PJS, Ruamero EC, Delos Santos CDR, Gomez CB, Allanigue EJV, Salinas MV. Applying Network Pharmacology and Molecular Docking in the Screening for Molecular Mechanisms of Ampalaya ( Momordica charantia L.) and Banaba ( Lagerstroemia speciosa L.) against Type 2 Diabetes Mellitus. ACTA MEDICA PHILIPPINA 2024; 58:108-124. [PMID: 38812760 PMCID: PMC11132292 DOI: 10.47895/amp.vi0.7351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Background and Objectives Type 2 diabetes mellitus (T2DM) is a global health concern affecting more than 400 million people worldwide. Diabetic neuropathy, nephropathy, retinopathy, and cardiovascular complications lead to debilitating effects to patients. To prevent these, the treatment goal is to lower the blood sugar levels and maintain at a normal range which is achieved through conventional treatments like insulin and oral hypoglycemic agents. However, the high cost of these medications implicates patient treatment outcomes. Hence, alternatives are sought for including the use of herbal medicines. Momordica charantia (MC) and Lagerstroemia speciosa (LS) are common herbal medicines used to manage T2DM. In the Philippines, these herbal preparations are validated for their glucose lowering effects and are commonly found in combination in food supplements. The study aims to screen the possible mechanisms of compounds present in these herbal medicines which can offer possible explanations for their synergistic effects and rationalization of their combination in preparations. Methods Network pharmacology was employed to determine pivotal proteins that are targeted by MC and LS compounds. Molecular docking was then done to evaluate the favorability of the binding of these compounds toward their target proteins. Results Our results showed that TNF, HSP90AA1, MAPK3, ALDH2, GCK, AKR1B1, TTR and RBP4 are the possible pivotal targets of MC and LS compounds in T2DM. Conclusion Terpenoids from MC and decanoic acid from LS are the compounds which showed favorable binding towards pivotal protein targets in T2DM. By binding towards the different key proteins in T2DM, they may exhibit their synergistic effects. However, the results of this study are bound to the limitations of computational methods and experimental validation are needed to verify our findings.
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Affiliation(s)
- Robertson G. Rivera
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of the Philippines Manila, Manila, Philippines
| | - Patrick Junard S. Regidor
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of the Philippines Manila, Manila, Philippines
| | - Edwin C. Ruamero
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of the Philippines Manila, Manila, Philippines
| | | | - Clinton B. Gomez
- Department of Industrial Pharmacy, College of Pharmacy, University of the Philippines Manila, Manila, Philippines
| | - Eric John V. Allanigue
- Department of Pharmacology and Toxicology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Melanie V. Salinas
- Medical Device Clinical Research, Safety and Medical Affairs Department, Clinchoice, Inc., Fort Washington, Pennsylvania, USA
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Ghaiad HR, Ali SO, Al-Mokaddem AK, Abdelmonem M. Regulation of PKC/TLR-4/NF-kB signaling by sulbutiamine improves diabetic nephropathy in rats. Chem Biol Interact 2023; 381:110544. [PMID: 37224990 DOI: 10.1016/j.cbi.2023.110544] [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: 02/27/2023] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
One of the serious complications of diabetes mellitus is diabetic nephropathy (DN) which may finally lead to renal failure. The current study aimed to explore the effect of sulbutiamine, a synthetic derivative of vitamin B1, in streptozotocin (STZ)-induced DN and related pathways. Experimental DN was successfully induced 8 weeks after a single low dose of STZ (45 mg/kg, I.P.). Four groups of rats were used in this study and divided randomly into: control group, diabetic group, sulbutiamine control (control + sulbutiamine) group, and sulbutiamine-treated (60 mg/kg) (diabetic + sulbutiamine) group. The fasting blood glucose level (BGL) and the levels of kidney injury molecule-1 (Kim-1), urea, creatinine in serum, and the renal content of malondialdehyde (MDA), protein kinase C (PKC), toll-like receptor-4 (TLR-4) and nuclear factor kappa B (NF-κB) were determined. Additionally, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) contents were evaluated immunohistochemically. Sulbutiamine treatment decreased fasting BGL and improved the kidney function tests compared to diabetic rats. Moreover, TLR-4, NF-κB, MDA and PKC contents were substantially reduced following sulbutiamine treatment compared to the diabetic group. Sulbutiamine managed to obstruct the production of the pro-inflammatory TNF-α and IL-1β and suppressed TGF-β1 level, in addition to attenuating the histopathological changes associated with DN. This study revealed, for the first time, the ability of sulbutiamine to ameliorate STZ-induced diabetic nephropathy in rats. This nephroprotective outcome of sulbutiamine against DN may be attributed to glycemic control in addition to its anti-oxidative, anti-inflammatory and anti-fibrotic effects.
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Affiliation(s)
- Heba R Ghaiad
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Shimaa O Ali
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Asmaa K Al-Mokaddem
- Pathology Department, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt.
| | - Maha Abdelmonem
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
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Abdelaziz TA, Atfy M, Elalawi SM, Baz EG. Thiamine status during treatment of diabetic ketoacidosis in children - tertiary care centre experience. J Pediatr Endocrinol Metab 2023; 36:179-184. [PMID: 36440592 DOI: 10.1515/jpem-2022-0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES There is a lack of information regarding thiamine status in children with diabetic ketoacidosis (DKA). This study was designed to assess the thiamine status upon admission and 24 h after treatment initiation of DKA, whether newly diagnosed children or with established T1DM diagnosis, who presented with DKA. METHODS We enrolled 90 children (mean age, 9.8 ± 2.6 years; 58 females and 32 males) with type 1 diabetes mellitus (T1DM), whether newly diagnosed or with an established T1DM diagnosis (from 1 to 5.2 years ago), who presented with DKA. We observed the initial Glasgow Coma Scale (GCS) and recovery time. The whole blood thiamine diphosphate levels were measured upon admission (baseline point) and 24 h after initiation of the DKA treatment (second-time point). RESULTS The mean blood thiamine levels at the second-time point (90.11 ± 15.76 nmol/L) significantly decreased compared with their levels at baseline (108.8 ± 17.6 nmol/L) (p<0.001). We compared thiamine levels with the initial GCS, patient's age, and recovery time. Thiamine levels at the second-time point were positively correlated with baseline thiamine levels (r=0.86, p=0.0001) and the initial GCS (r=0.68, p=0.001) but were negatively correlated with patient's age (r=-0.61, p=0.001) and recovery time (r=-0.724, p=0.001). Based on multiple regression analysis, thiamine levels at the second-time point were directly related to the initial GCS and inversely related to the patient's age. CONCLUSIONS The current study indicates that blood thiamine diphosphate levels significantly decreased after 24 h of DKA treatment initiation compared to pre-treatment levels. After 24 h of treatment initiation, blood thiamine levels are directly related to the initial GCS and inversely related to the patient's age.
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Affiliation(s)
- Tarek A Abdelaziz
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mervat Atfy
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Saffaa M Elalawi
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman Gamal Baz
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Ganguly R, Singh SV, Jaiswal K, Kumar R, Pandey AK. Modulatory effect of caffeic acid in alleviating diabetes and associated complications. World J Diabetes 2023; 14:62-75. [PMID: 36926656 PMCID: PMC10011896 DOI: 10.4239/wjd.v14.i2.62] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/04/2022] [Accepted: 12/14/2022] [Indexed: 02/14/2023] Open
Abstract
Diabetes mellitus (DM) is one of the most common metabolic disorders characterized by elevated blood glucose levels. Prolonged uncontrolled hyperglycemia often leads to multi-organ damage including diabetic neuropathy, nephropathy, retinopathy, cardiovascular disorders, and diabetic foot ulcers. Excess production of free radicals causing oxidative stress in tissues is often considered to be the primary cause of onset and progression of DM and associated complications. Natural polyphenols can be used to induce or inhibit the expression of antioxidant enzymes such as glutathione peroxidase, heme oxygenase-1, superoxide dismutase, and catalase that are essential in maintaining redox balance, and ameliorate oxidative stress. Caffeic acid (CA) is a polyphenolderived from hydroxycinnamic acid and possesses numerous physiological properties includ-ing antioxidant, anti-inflammatory, anti-atherosclerotic, immune-stimulatory, cardioprotective, antiproliferative, and hepatoprotective activities. CA acts as a regulatory compound affecting numerous biochemical pathways and multiple targets. These include various transcription factors such as nuclear factor-B, tumor necrosis factor-α, interleukin-6, cyclooxygenase-2, and nuclear factor erythroid 2-related factor 2. Therefore, this review summarizes the pharmacological properties, molecular mechanisms, and pharmacokinetic profile of CA in mitigating the adverse effects of DM and associated complications. The bioavailability, drug delivery, and clinical trials of CA have also been discussed.
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Affiliation(s)
- Risha Ganguly
- Department of Biochemistry, University of Allahabad, Allahabad (Prayagraj) 211002, India
| | - Shiv Vardan Singh
- Department of Biochemistry, University of Allahabad, Allahabad (Prayagraj) 211002, India
| | - Kritika Jaiswal
- Department of Biochemistry, University of Allahabad, Allahabad (Prayagraj) 211002, India
| | - Ramesh Kumar
- Department of Biochemistry, University of Allahabad, Allahabad (Prayagraj) 211002, India
| | - Abhay K Pandey
- Department of Biochemistry, University of Allahabad, Allahabad (Prayagraj) 211002, India
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The Effect of Diet and Lifestyle on the Course of Diabetic Retinopathy-A Review of the Literature. Nutrients 2022; 14:nu14061252. [PMID: 35334909 PMCID: PMC8955064 DOI: 10.3390/nu14061252] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 12/23/2022] Open
Abstract
Diabetes is a major social problem. As shown by epidemiological studies, the world incidence of diabetes is increasing and so is the number of people suffering from its complications. Therefore, it is important to determine possible preventive tools. In the prevention of diabetic retinopathy, it is essential to control glycemia, lipid profile and blood pressure. This can be done not only by pharmacological treatment, but first of all by promoting a healthy lifestyle, changing dietary habits and increasing physical activity. In our work, we present a review of the literature to show that physical exercise and an adequate diet can significantly reduce the risk of diabetes and diabetic retinopathy.
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Vafadar Ghasemi L, Behnam Rassouli M, Matin MM, Mahdavi-Shahri N. Benfotiamine reduced collagen IV contents of sciatic nerve in hyperglycemic rats. J Diabetes Metab Disord 2021; 20:21-30. [PMID: 34222057 PMCID: PMC8212243 DOI: 10.1007/s40200-020-00666-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/19/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Neuropathy as a common complication of hyperglycemia in diabetic patients is probably caused by metabolic and structural changes in extracellular matrix (ECM) of peripheral nerves. This study was designed to evaluate the effects of benfotiamine (BT) on the structural, biological and mechanical characteristics of rat sciatic nerve in hyperglycemic condition. MATERIALS AND METHODS Forty eight adult male Wistar rats were assigned to 6 groups (n = 8): control (healthy rats with no treatment; C), positive control (healthy rats received BT treatment; B), negative control groups 1&2 (hyperglycemic rats kept for 4 and/or 8 weeks; 4WD and 8WD, respectively) and experimental groups 1&2 (hyperglycemic rats treated by daily oral gavage of 100 mg kg- 1 body weight BT for 4 and/or 8 weeks; 4WD + BT and 8WD + BT, respectively). Hyperglycemia was induced by a single intraperitoneal injection of of streptozotocin (55 mg kg- 1 body weight). After a period of experimental period (4 and/or 8 weeks) rats were sacrificed and from each two segments (1 cm length) of left sciatic nerve were sampled. These samples were prepared for histological examinations (light and electron microscopy), collagen IV immunohistochemistry and strength tensile test. RESULTS In comparison to control groups, in 4WD and 8WD groups the amount of type IV collagen was increased, the structure of myelin sheath and nerve fibers were extensively altered and the tensile strength was significantly decreased (p < 0.05) while in 4WD + BT and 8WD + BT groups these abnormalities were attenuated. CONCLUSIONS It seems that BT treatment may rescue the sciatic nerve from the hyperglycemic-induced ECM structural abnormality. This beneficial advantage of BT is likely exerted through the modification of glucose metabolism pathways.
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Affiliation(s)
- Leila Vafadar Ghasemi
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
- Department of Biology, Faculty of Sciences, University of Zabol, Zabol, Iran
| | - Morteza Behnam Rassouli
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
| | - Maryam M. Matin
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
- Novel Diagnostics and Therapeutics Research Group, Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Naser Mahdavi-Shahri
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
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Duc HN, Oh H, Kim MS. Effects of Antioxidant Vitamins, Curry Consumption, and Heavy Metal Levels on Metabolic Syndrome with Comorbidities: A Korean Community-Based Cross-Sectional Study. Antioxidants (Basel) 2021; 10:808. [PMID: 34069726 PMCID: PMC8161368 DOI: 10.3390/antiox10050808] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022] Open
Abstract
The burden of metabolic syndrome (MetS) has increased worldwide, especially during the COVID-19 pandemic, and this phenomenon is related to environmental, dietary, and lifestyle risk factors. We aimed to determine the association between the levels of serum heavy metals, hs-CRP, vitamins, and curry intake and to predict risks of MetS based on marginal effects. A data set of 60,256 Koreans aged ≥ 15 years between 2009 and 2017 was used to obtain information on sociodemographic, lifestyle, family history characteristics, MetS, food intake survey, and serum heavy metals. Daily intake of vitamins was measured by a one-day 24 h recall, and curry consumption was calculated using a food frequency questionnaire. Serum heavy metal levels were quantified by graphite furnace atomic absorption spectrometry and using a mercury analyzer. We found that vitamin B1, B2, B3, C, and A intakes were significantly lower in subjects with than without MetS. In contrast, serum levels of Pb, Hg, Cd, vitamin A, E, and hs-CRP were significantly higher in subjects with MetS. The risk of MetS was significantly lower for high curry consumers than low curry consumers (adjusted odds ratio 0.85, 95%CI 0.74-0.98). The risks of MetS were reduced by 12% and 1%, when vitamin B1 and C intakes increased by one mg, respectively, but were increased by 14%, 3%, and 9%, when serum levels of Pb, Hg, and hs-CRP increased by one unit. These results show that the potential health benefits resulting from vitamin and curry intakes could protect the public against the dual burden of communicable and non-communicable diseases. Further studies are required to reduce risk factors associated with serum heavy metal levels and to determine whether interactions between vitamin and curry consumption influence the presence of MetS.
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Affiliation(s)
| | | | - Min-Sun Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon 57922, Korea; (H.N.D.); (H.O.)
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Alpha-lipoic acid alters the antitumor effect of bortezomib in melanoma cells in vitro. Sci Rep 2020; 10:14287. [PMID: 32868799 PMCID: PMC7459291 DOI: 10.1038/s41598-020-71138-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 08/04/2020] [Indexed: 12/27/2022] Open
Abstract
Bortezomib (BOZ) is a proteasome inhibitor chemotherapeutic agent utilized to treat multiple myeloma and recently offered to cure melanoma. Bortezomib-induced neuropathy is one of the dose-limiting side-effects, which can be treated with antioxidants (e.g. alpha-lipoic acid-ALA and Vitamin B1-vit B1). We hypothesized that these antioxidants may counteract the antitumor activity by disrupting the BOZ-induced pathways (e.g. proteasome inhibition or reactive oxygen species generation). The objectives were: (i) to verify the anti-proliferative effect of BOZ; (ii) to compare the influence of the antioxidants on the antitumor effect of BOZ in melanoma (A2058) and myeloma (U266) cells. At first, the reduction in the anti-proliferative effect of BOZ by ALA was proved in melanoma cells. Analysis of p53 phosphorylation and the cell cycle progression revealed that ALA failed to counteract these effects of BOZ. Nevertheless, a good correlation was found between the inhibition of the anti-proliferative effect, the anti-proteasome activity and the oxidative stress level after the co-treatment with 20 ng/mL BOZ + 100 μg/mL ALA. Downregulation of apoptotic proteins such as HO-1 and Claspin along with the inhibition of the cleavage of Caspase-3 indicated the proteomic background of the altered responsiveness of the melanoma cells exposed to BOZ + ALA. This phenomenon draws attention to the proper application of cancer supportive care to avoid possible interactions.
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Blood thiamine pyrophosphate concentration and its correlation with the stage of diabetic retinopathy. Int Ophthalmol 2020; 40:3279-3284. [PMID: 32715366 DOI: 10.1007/s10792-020-01513-2] [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: 05/14/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the possible relationship between blood thiamine pyrophosphate (TPP) concentration and stage of diabetic retinopathy (DR). METHODS This comparative cross-sectional study included 80 patients with type 2 diabetes mellitus (T2DM) and 20 age- and gender-matched healthy controls. Diabetic patients were subclassified into four groups each consisting of 20 subjects: no DR, mild-moderate non-proliferative DR (mild-moderate NPDR), severe NPDR, and proliferative DR (PDR). Blood TPP concentration was assessed with high-performance liquid chromatography (HPLC) assay and was correlated with the stage of DR. RESULTS Mean blood TPP concentration was 80.2 ± 14.8 nmol/L in control group. It was, respectively, 69.85 ± 18.1, 64.95 ± 13.4, 61.9 ± 13.4 and 60.75 ± 14.3 nmol/L in no DR, mild-moderate NPDR, severe NPDR and PDR groups. For mild-moderate NPDR, severe NPDR and PDR groups, TPP concentrations were significantly lower compared with controls (p: 0.014, 0.002, 0.001, respectively). Mean TPP concentration for NPDR patients was higher than for PDR patients, but the difference was not significant (p: 0.478). ANOVA revealed a significant difference between TPP concentrations of groups (p: 0.001). Mean TPP concentration decreased with the stage of DR, and number of patients with thiamine deficiency increased gradually with the stage of DR. A negative correlation was found between the TPP level and occurrence of DR (p: 0.000). CONCLUSION The results suggest that lower blood TPP concentrations were associated with higher risk of DR. Thiamine might play an important role in the pathophysiology and progression of DR. Thiamine and its derivatives might represent an approach to the prevention and/or treatment of early DR.
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Fan L, Cacicedo JM, Ido Y. Impaired nicotinamide adenine dinucleotide (NAD + ) metabolism in diabetes and diabetic tissues: Implications for nicotinamide-related compound treatment. J Diabetes Investig 2020; 11:1403-1419. [PMID: 32428995 PMCID: PMC7610120 DOI: 10.1111/jdi.13303] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 01/08/2023] Open
Abstract
One of the biochemical abnormalities found in diabetic tissues is a decrease in the cytosolic oxidized to reduced forms of the nicotinamide adenine dinucleotide ratio (NAD+/NADH also known as pseudohypoxia) caused by oxidation of excessive substrates (glucose through the polyol pathway, free fatty acids and lactate). Subsequently, a decline in NAD+ levels as a result of the activation of poly adenine nucleotide diphosphate‐ribose polymerase (mainly in type 1 diabetes) or the inhibition of adenine nucleotide monophosphate‐activated protein kinase (in type 2 diabetes). Thus, replenishment of NAD+ levels by nicotinamide‐related compounds could be beneficial. However, these compounds also increase nicotinamide catabolites that cause oxidative stress. This is particularly troublesome for patients with diabetes, because they have impaired nicotinamide salvage pathway reactions at the level of nicotinamide phosphoribosyl transferase and phosphoribosyl pyrophosphate, which occurs by the following mechanisms. First, phosphoribosyl pyrophosphate synthesis from pentose phosphate pathway is compromised by a decrease in plasma thiamine and transketolase activity. Second, nicotinamide phosphoribosyl transferase expression is decreased because of reduced adenosine monophosphate‐activated protein kinase activity, which occurs in type 2 diabetes. The adenosine monophosphate‐activated protein kinase inhibition is caused by an activation of protein kinase C and D1 as a result of enhanced diacylglycerol synthesis caused by pseudohypoxia and increased fatty acids levels. In this regard, nicotinamide‐related compounds should be given with caution to treat diabetes. To minimize the risk and maximize the benefit, nicotinamide‐related compounds should be taken with insulin sensitizers (for type 2 diabetes), polyphenols, benfotiamine, acetyl‐L‐carnitine and aldose reductase inhibitors. The efficacy of these regimens can be monitored by measuring serum NAD+ and urinary nicotinamide catabolites.
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Affiliation(s)
- Lan Fan
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jose M Cacicedo
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Yasuo Ido
- Boston University School of Medicine, Boston, Massachusetts, USA
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Shi C, Wang P, Airen S, Brown C, Liu Z, Townsend JH, Wang J, Jiang H. Nutritional and medical food therapies for diabetic retinopathy. EYE AND VISION (LONDON, ENGLAND) 2020; 7:33. [PMID: 32582807 PMCID: PMC7310218 DOI: 10.1186/s40662-020-00199-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
Diabetic retinopathy (DR) is a form of microangiopathy. Reducing oxidative stress in the mitochondria and cell membranes decreases ischemic injury and end-organ damage to the retina. New approaches are needed, which reduce the risk and improve the outcomes of DR while complementing current therapeutic approaches. Homocysteine (Hcy) elevation and oxidative stress are potential therapeutic targets in DR. Common genetic polymorphisms such as those of methylenetetrahydrofolate reductase (MTHFR), increase Hcy and DR risk and severity. Patients with DR have high incidences of deficiencies of crucial vitamins, minerals, and related compounds, which also lead to elevation of Hcy and oxidative stress. Addressing the effects of the MTHFR polymorphism and addressing comorbid deficiencies and insufficiencies reduce the impact and severity of the disease. This approach provides safe and simple strategies that support conventional care and improve outcomes. Suboptimal vitamin co-factor availability also impairs the release of neurotrophic and neuroprotective growth factors. Collectively, this accounts for variability in presentation and response of DR to conventional therapy. Fortunately, there are straightforward recommendations for addressing these issues and supporting traditional treatment plans. We have reviewed the literature for nutritional interventions that support conventional therapies to reduce disease risk and severity. Optimal combinations of vitamins B1, B2, B6, L-methylfolate, methylcobalamin (B12), C, D, natural vitamin E complex, lutein, zeaxanthin, alpha-lipoic acid, and n-acetylcysteine are identified for protecting the retina and choroid. Certain medical foods have been successfully used as therapy for retinopathy. Recommendations based on this review and our clinical experience are developed for clinicians to use to support conventional therapy for DR. DR from both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) have similar retinal findings and responses to nutritional therapies.
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Affiliation(s)
- Ce Shi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peng Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shriya Airen
- College of Arts and Sciences, University of Miami, Miami, FL USA
| | - Craig Brown
- Department of Ophthalmology, College of Medicine, the University of Arkansas for Medical Sciences, Fayetteville, AR USA
| | - Zhiping Liu
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- Ophthalmic Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong China
| | - Justin H. Townsend
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
| | - Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
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Deshmukh SV, Prabhakar B, Kulkarni YA. Water Soluble Vitamins and their Role in Diabetes and its Complications. Curr Diabetes Rev 2020; 16:649-656. [PMID: 31526351 DOI: 10.2174/1573399815666190916114040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/18/2019] [Accepted: 08/20/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Diabetes is a metabolic disorder associated with abnormally high levels of glucose in the blood due to inadequate production of insulin or inadequate sensitivity of cells to the action of insulin. Diabetes has become an increasing challenge in the world. The predicted diabetic population according to the World Health Organization is 8.7% between the age group 20-70 years. There are many complications linked to prolonged high blood glucose levels, such as microvascular complications and macrovascular complications. Vitamins play an important role in glucose metabolism and the potential utility of supplementation is relevant for the prevention and/or management of diabetes mellitus and its complications. METHODS Literature search was performed using various dataset like PUBMED, EBSCO, ProQuest, Scopus and selected websites like the National Institute of Health and the World Health Organization. RESULT Water-soluble vitamins have been thoroughly studied for their activity in diabetes and diabetic complications. CONCLUSION Water-soluble vitamins like B1, B3, B6, B7, B9 and B12 have notable effects in diabetes mellitus and its related complications like nephropathy, neuropathy, retinopathy and cardiomyopathy.
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Affiliation(s)
- Shreeya V Deshmukh
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta road, Vile Parle (W), Mumbai-400056, India
| | - Bala Prabhakar
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta road, Vile Parle (W), Mumbai-400056, India
| | - Yogesh A Kulkarni
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta road, Vile Parle (W), Mumbai-400056, India
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13
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Serhiyenko VA, Serhiyenko AA, Segin VB, Azhmi S, Serhiyenko LM. Effects of benfotiamine on the insulin resistance state, some pro- and anti-inflammatory factors content in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy. ACTA ACUST UNITED AC 2019. [DOI: 10.15829/1560-4071-2019-4-78-82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | | | - V. B. Segin
- Lviv Regional State Clinical Medical and Diagnostic Endocrinology Center
| | - S. Azhmi
- Danylo Halytsky Lviv National Medical University
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14
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Cinici E, Mammadov R, Findik H, Suleyman B, Cetin N, Calik I, Balta H, Hakki Tas I, Sener E, Altuner D. The Protective Effect of Thiamine Pryophosphate Against Sugar-Induced Retinal Neovascularisation in Rats. INT J VITAM NUTR RES 2019; 88:137-143. [PMID: 31165688 DOI: 10.1024/0300-9831/a000248] [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: 01/17/2023]
Abstract
The aim of this study was to investigate the effect of thiamine pyrophosphate (TPP), administered via sugar water, on retinal neovascularisation in rats. Animals were assigned to three groups, namely the TPP sugar-water group (TPSWG, n = 12), the control group (CG, n = 12) and the healthy group (HG, n = 12). The TPSWG was injected intraperitoneally with TPP once a day for 6 months. CG and HG rats were given distilled water in the same way. TPSWG and CG rats were left free to access an additional 0.292 mmol /ml of sugar water for 6 months. The fasting blood glucose (FBG) levels of the animals were measured monthly. After 6 months, biochemical, gene expression and histopathologic analyses were carried out in the retinal tissues removed from the animals after they were killed. The measured FBG levels were 6.96 ± 0.09 mmol/ml (p < 0.0001 vs. HG), 6.95 ± 0.06 mmol/ml (p < 0.0001 vs. HG) and 3.94 ± 0.10 mmol/ml in the CG, TPSWG and HG groups, respectively. The malondialdehyde (MDA) levels were found to be 2.82 ± 0.23 (p < 0.0001 vs. HG), 1.40 ± 0.32 (p < 0.0001 vs. HG) and 1.66 ± 0.17 in the CG, TPSWG and HG, respectively. Interleukin 1 beta (IL-1β) gene expression was increased (3.78 ± 0.29, p < 0.0001) and total glutathione (tGSH) was decreased (1.32 ± 0.25, p < 0.0001) in the retinal tissue of CG compared with TPSWG (1.92 ± 0.29 and 3.18 ± 0.46, respectively). Increased vascularisation and oedema were observed in the retinal tissue of CG, while the retinal tissues of TPSWG and HG rats had a normal histopathological appearance. A carbohydrate-rich diet may lead to pathological changes in the retina even in nondiabetics, but this may be overcome by TPP administration.
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Affiliation(s)
- Emine Cinici
- 1 Department of Ophthalmology, Erzurum Region Education and Research Hospital, Erzurum, Turkey
| | - Renad Mammadov
- 2 Department of Pharmacology, Faculty of Medicine, Pharmacology Research Laboratory, Erzincan University, Erzincan, Turkey
| | - Huseyin Findik
- 3 Department of Ophthalmology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Bahadir Suleyman
- 2 Department of Pharmacology, Faculty of Medicine, Pharmacology Research Laboratory, Erzincan University, Erzincan, Turkey
| | - Nihal Cetin
- 2 Department of Pharmacology, Faculty of Medicine, Pharmacology Research Laboratory, Erzincan University, Erzincan, Turkey
| | - Ilknur Calik
- 4 Department of Pathology, Erzurum Region Education and Research Hospital, Pathology Laboratory, Erzurum, Turkey
| | - Hilal Balta
- 4 Department of Pathology, Erzurum Region Education and Research Hospital, Pathology Laboratory, Erzurum, Turkey
| | - Ismail Hakki Tas
- 5 Department of Parasitology, Veterinary Faculty, Ataturk University, Erzurum, Turkey
| | - Ebru Sener
- 4 Department of Pathology, Erzurum Region Education and Research Hospital, Pathology Laboratory, Erzurum, Turkey
| | - Durdu Altuner
- 2 Department of Pharmacology, Faculty of Medicine, Pharmacology Research Laboratory, Erzincan University, Erzincan, Turkey
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15
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Kuang Z, Bao Y, Thomson J, Caldwell M, Peissig P, Stewart R, Willett R, Page D. A Machine-Learning-Based Drug Repurposing Approach Using Baseline Regularization. Methods Mol Biol 2019; 1903:255-267. [PMID: 30547447 PMCID: PMC6296259 DOI: 10.1007/978-1-4939-8955-3_15] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We present the baseline regularization model for computational drug repurposing using electronic health records (EHRs). In EHRs, drug prescriptions of various drugs are recorded throughout time for various patients. In the same time, numeric physical measurements (e.g., fasting blood glucose level) are also recorded. Baseline regularization uses statistical relationships between the occurrences of prescriptions of some particular drugs and the increase or the decrease in the values of some particular numeric physical measurements to identify potential repurposing opportunities.
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Affiliation(s)
| | - Yujia Bao
- The Massachusetts Institute of Technology
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16
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Yadlapalli JSK, Dogra N, Walbaum AW, Prather PL, Crooks PA, Dobretsov M. Pinprick hypo- and hyperalgesia in diabetic rats: Can diet content affect experimental outcome? Neurosci Lett 2018; 673:24-27. [PMID: 29490230 DOI: 10.1016/j.neulet.2018.02.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 02/23/2018] [Accepted: 02/24/2018] [Indexed: 11/16/2022]
Abstract
Existing literature concerning the effect of experimentally-induced diabetes on pain thresholds in rodent models remains controversial. In this work, we describe a phenotypical switch from streptozotocin-induced pinprick hypoalgesia to hyperalgesia observed in the same laboratory, in the same strain of rats, obtained from the same vendor, and measured by the same technique carried out by the investigators. This switch was observed around January 2015, at the time when there was a change in the diet of rats at the Radley North Carolina Charles River facility. These data support the contention that diet may significantly modify disease progression, including progression of signs of diabetic neuropathy.
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Affiliation(s)
- Jai Shankar K Yadlapalli
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, 72205, USA
| | - Navdeep Dogra
- Department of Anesthesiology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, 72205, USA
| | - Anqi W Walbaum
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, 72205, USA
| | - Paul L Prather
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, 72205, USA
| | - Peter A Crooks
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, 72205, USA
| | - Maxim Dobretsov
- Department of Anesthesiology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, 72205, USA.
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17
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Organic cation transporter 1 (OCT1) modulates multiple cardiometabolic traits through effects on hepatic thiamine content. PLoS Biol 2018; 16:e2002907. [PMID: 29659562 PMCID: PMC5919692 DOI: 10.1371/journal.pbio.2002907] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 04/26/2018] [Accepted: 03/20/2018] [Indexed: 01/07/2023] Open
Abstract
A constellation of metabolic disorders, including obesity, dysregulated lipids, and elevations in blood glucose levels, has been associated with cardiovascular disease and diabetes. Analysis of data from recently published genome-wide association studies (GWAS) demonstrated that reduced-function polymorphisms in the organic cation transporter, OCT1 (SLC22A1), are significantly associated with higher total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels and an increased risk for type 2 diabetes mellitus, yet the mechanism linking OCT1 to these metabolic traits remains puzzling. Here, we show that OCT1, widely characterized as a drug transporter, plays a key role in modulating hepatic glucose and lipid metabolism, potentially by mediating thiamine (vitamin B1) uptake and hence its levels in the liver. Deletion of Oct1 in mice resulted in reduced activity of thiamine-dependent enzymes, including pyruvate dehydrogenase (PDH), which disrupted the hepatic glucose–fatty acid cycle and shifted the source of energy production from glucose to fatty acids, leading to a reduction in glucose utilization, increased gluconeogenesis, and altered lipid metabolism. In turn, these effects resulted in increased total body adiposity and systemic levels of glucose and lipids. Importantly, wild-type mice on thiamine deficient diets (TDs) exhibited impaired glucose metabolism that phenocopied Oct1 deficient mice. Collectively, our study reveals a critical role of hepatic thiamine deficiency through OCT1 deficiency in promoting the metabolic inflexibility that leads to the pathogenesis of cardiometabolic disease. The liver is the major organ for glucose and lipid metabolism; impairment in liver energy metabolism is often found in metabolic disorders. Traditionally, excesses in macronutrients (fat and glucose) are linked to the development of metabolic disorders. Our study provides evidence that imbalances in a micronutrient, vitamin B1 (thiamine), can serve as an etiological cause of lipid and glucose disorders and implicates the organic cation transporter, OCT1, in these disorders. OCT1 is a key determinant of thiamine levels in the liver. In humans, reduced-function polymorphisms of OCT1 significantly associate with high LDL cholesterol levels. Using Oct1 knockout mice, we show that reduced OCT1-mediated thiamine uptake in the liver leads to reduced levels of TPP—the active metabolite of thiamine—and decreased activity of key TPP-dependent enzymes. As a result, a shift from glucose to fatty acid oxidation occurs, leading to imbalances in key metabolic intermediates, alterations in metabolic flux pathways, and disruptions of various metabolic regulatory mechanisms. The extensive characterization of Oct1 knockout mice provides evidence for the molecular mechanisms responsible for various metabolic traits and indicates an important role for imbalances in micronutrients in cardiometabolic disorders.
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18
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Botchlett R, Woo SL, Liu M, Pei Y, Guo X, Li H, Wu C. Nutritional approaches for managing obesity-associated metabolic diseases. J Endocrinol 2017; 233:R145-R171. [PMID: 28400405 PMCID: PMC5511693 DOI: 10.1530/joe-16-0580] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 04/11/2017] [Indexed: 01/10/2023]
Abstract
Obesity is an ongoing pandemic and serves as a causal factor of a wide spectrum of metabolic diseases including diabetes, fatty liver disease, and cardiovascular disease. Much evidence has demonstrated that nutrient overload/overnutrition initiates or exacerbates inflammatory responses in tissues/organs involved in the regulation of systemic metabolic homeostasis. This obesity-associated inflammation is usually at a low-grade and viewed as metabolic inflammation. When it exists continuously, inflammation inappropriately alters metabolic pathways and impairs insulin signaling cascades in peripheral tissues/organs such as adipose tissue, the liver and skeletal muscles, resulting in local fat deposition and insulin resistance and systemic metabolic dysregulation. In addition, inflammatory mediators, e.g., proinflammatory cytokines, and excessive nutrients, e.g., glucose and fatty acids, act together to aggravate local insulin resistance and form a vicious cycle to further disturb the local metabolic pathways and exacerbate systemic metabolic dysregulation. Owing to the critical role of nutrient metabolism in controlling the initiation and progression of inflammation and insulin resistance, nutritional approaches have been implicated as effective tools for managing obesity and obesity-associated metabolic diseases. Based on the mounting evidence generated from both basic and clinical research, nutritional approaches are commonly used for suppressing inflammation, improving insulin sensitivity, and/or decreasing fat deposition. Consequently, the combined effects are responsible for improvement of systemic insulin sensitivity and metabolic homeostasis.
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Affiliation(s)
- Rachel Botchlett
- Department of Nutrition and Food ScienceTexas A&M University, College Station, USA
- Pinnacle Clinical ResearchLive Oak, USA
| | - Shih-Lung Woo
- Department of Nutrition and Food ScienceTexas A&M University, College Station, USA
| | - Mengyang Liu
- Department of Nutrition and Food ScienceTexas A&M University, College Station, USA
| | - Ya Pei
- Department of Nutrition and Food ScienceTexas A&M University, College Station, USA
| | - Xin Guo
- Department of Nutrition and Food ScienceTexas A&M University, College Station, USA
- Baylor College of MedicineHouston, USA
| | - Honggui Li
- Department of Nutrition and Food ScienceTexas A&M University, College Station, USA
| | - Chaodong Wu
- Department of Nutrition and Food ScienceTexas A&M University, College Station, USA
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Affiliation(s)
- Jennifer C Kerns
- Department of Medicine, Veterans Affairs Medical Center, Washington, DC
| | - Jean L Gutierrez
- Department of Nutrition and Metabolism, University of Texas Medical Branch, Galveston, TX
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20
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Kuang Z, Thomson J, Caldwell M, Peissig P, Stewart R, Page D. Computational Drug Repositioning Using Continuous Self-Controlled Case Series. KDD : PROCEEDINGS. INTERNATIONAL CONFERENCE ON KNOWLEDGE DISCOVERY & DATA MINING 2016; 2016:491-500. [PMID: 28316874 DOI: 10.1145/2939672.2939715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Computational Drug Repositioning (CDR) is the task of discovering potential new indications for existing drugs by mining large-scale heterogeneous drug-related data sources. Leveraging the patient-level temporal ordering information between numeric physiological measurements and various drug prescriptions provided in Electronic Health Records (EHRs), we propose a Continuous Self-controlled Case Series (CSCCS) model for CDR. As an initial evaluation, we look for drugs that can control Fasting Blood Glucose (FBG) level in our experiments. Applying CSCCS to the Marshfield Clinic EHR, well-known drugs that are indicated for controlling blood glucose level are rediscovered. Furthermore, some drugs with recent literature support for the potential effect of blood glucose level control are also identified.
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21
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Duan J, Zheng C, Gao K, Hao M, Yang L, Guo D, Wu J, Tian Y, Song X, Liu J, Guo S, Murtaza G, Zheng M. Ultrasonography of lower limb vascular angiopathy and plaque formation in type 2 diabetes patients and finding its relevance to the carotid atherosclerotic formation. Pak J Med Sci 2014; 30:54-8. [PMID: 24639831 PMCID: PMC3955542 DOI: 10.12669/pjms.301.3907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 06/05/2013] [Accepted: 09/28/2013] [Indexed: 01/18/2023] Open
Abstract
Objective: One of the major complications of diabetes is blood vessel disease, termed angiopathy, which is characterized by abnormal angiogenesis. The objective of this study was to discuss the characteristics of lower limb vascular angiopathy and plaque formation in type 2 diabetes patients and finding its relevance to the carotid atherosclerotic plaque formation, thus directing the clinical diagnosis and treatment. Methods: The ultrasonography was used to monitor the patients with carotid artery and lower limb artery. Results: Compared with the control group, decreased blood flow to lower limb and lower limb angiopathy occurred more obviously in dorsal artery of foot than in popliteal artery. The study revealed that the detection rate of the prevalence of carotid atherosclerosis plaque and lower limb arterial plaque and the combination of plaque both carotid and lower limb arteries in diabetic patients was 369:342:296 (about 1.25:1.15:1) and that the prevalence of carotid plaque and lower limb arterial plaque in all subjects with plaque was 71.3%. The risk of plaque formation also had positive correlation with patient’s age. Color Doppler ultrasound had a clinical significance in the early diagnosis and curative effect observation in type 2 diabetes with lower limb angiopathy. The risk of simultaneous plaque formation in both carotid artery and lower extremity artery was greater in type 2 diabetes than that of control subjects, but they were not necessarily to occur simultaneously. The symptoms were inconspicuous in the early course of diabetes. Conclusion: The application of ultrasound monitoring in patients with carotid artery and lower limb artery might play a role in early warning, delaying the occurrence of macrovascular diseases, and slowing down the development of macroangiopathy such as cerebral infarction and diabetic foot and so on, thus providing a significant basis for clinical diagnosis and treatment.
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Affiliation(s)
- Jun Duan
- Jun Duan, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Chenglong Zheng
- Chenglong Zheng, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, ChaoYang District, Beijing 100029, P. R. China
| | - Kuo Gao
- Kuo Gao, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Meina Hao
- Meina Hao, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, ChaoYang District, Beijing 100029, P. R. China
| | - Lin Yang
- Lin Yang, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Dandan Guo
- Dandan Guo, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Jingping Wu
- Jingping Wu, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Yan Tian
- Yan Tian, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Xueni Song
- Xueni Song, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Jian Liu
- Jian Liu, Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
| | - Shuwen Guo
- Shuwen Guo, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, ChaoYang District, Beijing 100029, P. R. China
| | - Ghulam Murtaza
- Ghulam Murtaza, Department of Pharmaceutical Sciences, COMSATS Institute of Information Technology, Abbottabad, Pakistan
| | - Min Zheng
- Min Zheng, 1,4-10,13: Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, P.R. China
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22
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Moskowitz A, Graver A, Giberson T, Berg K, Liu X, Uber A, Gautam S, Donnino MW. The relationship between lactate and thiamine levels in patients with diabetic ketoacidosis. J Crit Care 2013; 29:182.e5-8. [PMID: 23993771 DOI: 10.1016/j.jcrc.2013.06.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 06/10/2013] [Accepted: 06/16/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE Thiamine functions as an important cofactor in aerobic metabolism and thiamine deficiency can contribute to lactic acidosis. Although increased rates of thiamine deficiency have been described in diabetic outpatients, this phenomenon has not been studied in relation to diabetic ketoacidosis (DKA). In the present study, we hypothesize that thiamine deficiency is associated with elevated lactate in patients with DKA. MATERIALS AND METHODS This was a prospective observational study of patients presenting to a tertiary care center with DKA. Patient demographics, laboratory results, and outcomes were recorded. A one-time blood draw was performed and analyzed for plasma thiamine levels. RESULTS Thirty-two patients were enrolled. Eight patients (25%) were thiamine deficient, with levels lower than 9 nmol/L. A negative correlation between lactic acid and plasma thiamine levels was found (r = -0.56, P = .002). This relationship remained significant after adjustment for APACHE II scores (P = .009). Thiamine levels were directly related to admission serum bicarbonate (r = 0.44, P = .019), and patients with thiamine deficiency maintained lower bicarbonate levels over the first 24 hours (slopes parallel with a difference of 4.083, P = .002). CONCLUSIONS Patients with DKA had a high prevalence of thiamine deficiency. Thiamine levels were inversely related to lactate levels among patients with DKA. A study of thiamine supplementation in DKA is warranted.
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Affiliation(s)
- Ari Moskowitz
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
| | - Amanda Graver
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Tyler Giberson
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Katherine Berg
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Xiaowen Liu
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Amy Uber
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Shiva Gautam
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Michael W Donnino
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA
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