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Shetty S, Thoudam BD, Thokchom N, Khumukcham S, Sajjan A, Ponnan S. Comparative evaluation of serum high-density lipoprotein and low-density lipoprotein levels and glycated hemoglobin levels and periodontal status in type 2 diabetic patients: A pilot project. J Oral Maxillofac Pathol 2022; 26:421. [PMID: 36588826 PMCID: PMC9802524 DOI: 10.4103/jomfp.jomfp_412_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/02/2022] [Accepted: 01/24/2022] [Indexed: 01/03/2023] Open
Abstract
Background High levels of cholesterol in the body can be alarming and point toward a possible cardiac or diabetic problem. Current evidence reveals that the harmful low-density lipoproteins (LDL) cholesterol tend to increase in poorly controlled diabetes, whereas the useful high-density lipoprotein (HDL) cholesterol, known for its protective anti-inflammatory and antioxidant activities, is decreased. With a positive evidence of periodontal disease being implicated in diabetes, it was decided to investigate whether there was any association between serum HDL, LDL, glycated hemoglobin (HbA1c) and periodontal status with Type II diabetes mellitus patients. Materials and Methods A total of 500 nonsmoking patients (males and females) aged between 35 and 55 years with Type 2 diabetes mellitus and no other systemic disease were selected from the diabetic center, Diacon hospital, Bengaluru, Karnataka, India. Periodontal examination consisted of the clinical parameters, namely, attachment loss, gingival index (GI) and plaque index based on which the patients were divided into periodontally healthy and diseased groups. Blood samples were collected from each patient to evaluate the serum levels of HDL, LDL and HbA1c. Results No significant differences were observed between the HDL, LDL and HbA1c levels in both the periodontal groups (P > 0.05). Linear regression analysis showed significant positive correlations of clinical attachment level with LDL and negative correlation with HbA1c, whereas GI has a positive correlation with LDL and negatively with HDL and Hba1c levels (P < 0.05). Conclusion Varied associations were found between dyslipidemia, glycemic control and periodontal inflammation. Further longitudinal as well as interventional studies may be beneficial to ascertain the causal relationship between cholesterol levels, periodontal status and diabetes mellitus.
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Affiliation(s)
- Shreya Shetty
- Associate Professor, Dentistry Program, IBN Sina National College of Medical Sciences, Jeddah, KSA
| | - Bebika Devi Thoudam
- Department of Periodontology, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | - Natasha Thokchom
- Department of Oral Pathology and Microbiology, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | - Sophia Khumukcham
- Department of Periodontology, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | - Akshata Sajjan
- Periodontist, Chiniwalar's Dental Care, Gangavathi, Karnataka, India
| | - Soumya Ponnan
- Associate Professor, Dentistry Program, IBN Sina National College of Medical Sciences, Jeddah, KSA
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Ren H, Shao Y, Wu C, Ma X, Lv C, Wang Q. Metformin alleviates oxidative stress and enhances autophagy in diabetic kidney disease via AMPK/SIRT1-FoxO1 pathway. Mol Cell Endocrinol 2020; 500:110628. [PMID: 31647955 DOI: 10.1016/j.mce.2019.110628] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 02/08/2023]
Abstract
Metformin, as the basic pharmacological therapy and the first preventive drug in type 2 diabetes mellitus (T2DM), is proved to have potential protection in diabetic kidney disease (DKD). Here, we established a diabetic rat model induced by high-fat diet and low dose streptozotocin, and high glucose cultured rat mesangial cells (RMCs) pre-treated with metformin or transfected with AMPK, SIRT1 and FoxO1 small interfering RNA, and detected oxidative stress and autophagy related factors to explore the molecular mechanisms of metformin on DKD via adenosine monophosphate-activated protein kinase (AMPK)/silent mating type information regulation 2 homolog-1 (sirtuin-1, SIRT1)-Forkhead box protein O1 (FoxO1) pathway. We found that metformin effectively alleviated the disorders of glycolipid metabolism, renal function injury in diabetic rats, and relieved oxidative stress, enhanced autophagy and slowed down abnormal cell proliferation in high glucose cultured RMCs through AMPK/SIRT1-FoxO1 pathway, indicating the protective role of metformin against the pathological process of DKD.
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Affiliation(s)
- Huiwen Ren
- Department of Endocrinology, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
| | - Ying Shao
- Department of Endocrinology, the Second Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Can Wu
- Department of Gastroenterology and Endoscopy, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaoyu Ma
- The Cadre Department, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Chuan Lv
- Department of Endocrinology, the People's Hospital of Liaoning Province, Shenyang, Liaoning, China
| | - Qiuyue Wang
- Department of Endocrinology, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
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3
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Khaghanzadeh N, Naderi N, Pournasrollah N, Farahbakhsh E, Kheirandish M, Samiei A. TLR4 Polymorphisms (896A>G and 1196C>T) Affect the Predisposition to Diabetic Nephropathy in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2020; 13:1015-1021. [PMID: 32308451 PMCID: PMC7138628 DOI: 10.2147/dmso.s238942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 03/23/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Type 2 diabetes mellitus (T2DM) is a disease with a steadily increasing incidence throughout the world. Some molecules regulating the innate immune responses such as toll-like receptor 4 (TLR4) have shown to be involved in late diabetic complications. This study aimed to investigate the association of TLR4 gene polymorphisms with clinicopathological aspects of T2DM in the Iranian population. PATIENTS AND METHODS Two TLR4 896A>G and 1196C>T polymorphisms were assessed in 100 T2DM patients and 100 healthy controls using sequence-specific primers PCR. Demographic, anthropometric, and biochemical parameters were obtained from the participants. RESULTS After logistic regression, in 1196C>T, a significant association was shown between diabetic nephropathy (DN) and CT genotype (P= 0.04, OR= 4.35, CI= (1.04-18.1)). TG level has increased significantly in both T2DM and control subjects with CT genotype (P= 0.027, OR= 1.005, 95% CI= (1.001-1.01)). For 896A>G variant, a significant association was also detected between AG genotype and increased oral glucose tolerance test (OGTT) level (P= 0.048, OR= 1.003, 95% CI= (1.00-1.005)). CONCLUSION Although minor alleles of 1196C>T and 896A>G variants have not directly been associated with type 2 diabetes, by involving in the dysregulation of serum TG and blood sugar levels, they might increase the risk of DN.
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Affiliation(s)
- Narges Khaghanzadeh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nadereh Naderi
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nazanin Pournasrollah
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Elahe Farahbakhsh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Masoumeh Kheirandish
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Afshin Samiei
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Department of Immunology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Correspondence: Afshin Samiei Department of Immunology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas7919693116, IranTel +98 76 337103070Fax +98 76 33710371 Email
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PAQR3 regulates phosphorylation of FoxO1 in insulin-resistant HepG2 cells via NF-κB signaling pathway. Exp Cell Res 2019; 381:301-310. [PMID: 31095939 DOI: 10.1016/j.yexcr.2019.04.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 02/06/2023]
Abstract
Insulin resistance is a significant feature of type 2 diabetes mellitus and glucose and lipid metabolism disorders. Activation of NF-κB signaling pathway plays an important role in the formation of insulin resistance. FoxO1 plays a major role in regulating glucose and lipid metabolism, as well as insulin signaling pathway. Previous studies have shown that Progestin and AdipoQ Receptor 3 (PAQR3) suppresses the activity of PI3K/Akt, which is an upstream pathway of FoxO1, and additionally promotes the pathological process of diabetic renal inflammatory fibrosis via activating NF-κB pathway. On this basis, it has caused us great concern whether NF-κB is involved in PAQR3 regulation of FoxO1 under insulin resistance. In this study, we aimed to investigate whether PAQR3 regulates phosphorylation of FoxO1 via NF-κB pathway in palmitic acid (PA)-induced insulin-resistant HepG2 cells, thereby causing glucose and lipid metabolism disorders. We found that PA stimulation and PAQR3 overexpression decreased the phosphorylation of FoxO1 and the expressions of glucokinase (GCK) and low density lipoprotein receptor (LDLR), in addition, promoted the nuclear accumulation of NF-κB. Inhibition of NF-κB pathway increased the phosphorylation of FoxO1 and the expressions of GCK and LDLR which were downregulated by PA stimulation and PAQR3 overexpression. Taken together, in PA-induced insulin-resistant HepG2 cells, PAQR3 might regulate the phosphorylation of FoxO1 and the expressions of GCK and LDLR through NF-κB pathway, thereby regulating the glucose and lipid metabolism disorders induced by insulin resistance.
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Xu F, Xiao H, Liu R, Yang Y, Zhang M, Chen L, Chen Z, Liu P, Huang H. Paeonol Ameliorates Glucose and Lipid Metabolism in Experimental Diabetes by Activating Akt. Front Pharmacol 2019; 10:261. [PMID: 30941042 PMCID: PMC6433795 DOI: 10.3389/fphar.2019.00261] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/01/2019] [Indexed: 01/09/2023] Open
Abstract
Our previous study proved that paeonol (Pae) could lower blood glucose levels of diabetic mice. There are also a few reports of its potential use for diabetes treatment. However, the role of Pae in regulating glucose and lipid metabolism in diabetes remains largely unknown. Considering the critical role of serine/threonine kinase B (Akt) in glucose and lipid metabolism, we explored whether Pae could improve glucose and lipid metabolism disorders via Akt. Here, we found that Pae attenuated fasting blood glucose, glycosylated serum protein, serum cholesterol and triglyceride (TG), hepatic glycogen, cholesterol and TG in diabetic mice. Moreover, Pae enhanced glucokinase (GCK) and low-density lipoprotein receptor (LDLR) protein expressions, and increased the phosphorylation of Akt. In insulin-resistant HepG2 cells, Pae increased glucose uptake and decreased lipid accumulation. What’s more, Pae elevated LDLR and GCK expressions as well as Akt phosphorylation, which was consistent with the in vivo results. Knockdown and inhibition experiments of Akt revealed that Pae regulated LDLR and GCK expressions through activation of Akt. Finally, molecular docking assay indicated the steady hydrogen bond was formed between Pae and Akt2. Experiments above suggested that Pae ameliorated glucose and lipid metabolism disorders and the underlying mechanism was closely related to the activation of Akt.
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Affiliation(s)
- Futian Xu
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China.,Department of Endocrinology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Haiming Xiao
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China.,Department of Endocrinology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Renbin Liu
- Department of Traditional Chinese Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Yan Yang
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China
| | - Meng Zhang
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China
| | - Lihao Chen
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China
| | - Zhiquan Chen
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China
| | - Peiqing Liu
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China
| | - Heqing Huang
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China.,Department of Endocrinology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
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Liu Y, Wang G, Yang X, Li P, Ling H, Zhu S. MicroRNA-27b-3p regulates function and metabolism in insulin resistance cells by inhibiting receptor tyrosine kinase-like orphan receptor 1. EUR J INFLAMM 2018. [DOI: 10.1177/2058739218762058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with insulin resistance-induced lipid and glucose metabolism disorder. The study was aimed to explore the potential functional role of microRNA (miR)-27b-3p in T2DM, as well as underlying mechanisms. An insulin resistance cell model was induced in HepG2 cells and then expression of miR-27b-3p and receptor tyrosine kinase-like orphan receptor 1 (ROR1) was analyzed. The expression of miR-27b-3p was overexpressed or silenced, and the relationship between ROR1 and miR-27b-3p was investigated. Thereafter, the effects of miR-27b-3p on percentage of glucose uptake, fatty acid oxidation and cell cycle were analyzed. The expressions of miR-27b-3p were significantly increased, while the ROR1 levels were statistically decreased in the cells of the model group. Overexpression of miR-27b-3p dramatically decreased the levels of ROR1 and the percentage of glucose uptake, but had no effects on fatty acid oxidation. ROR1 was a target of miR-27b-3p. Moreover, overexpression of miR-27b-3p could remarkably highlight the percentages of cells at G0/G1 phase, but decreased the percentages of cells at S phase. In conclusion, our results suggest that miR-27b-3p regulates the function and metabolism of insulin resistance cells by inhibiting ROR1. miR-27b-3p might be a potential drug target in treating T2DM.
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Affiliation(s)
- Yong Liu
- Department of General Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guohui Wang
- Center of Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Xiangwu Yang
- Department of General Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Pengzhou Li
- Department of General Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hao Ling
- Department of Equipment, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Shaihong Zhu
- Department of General Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
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Glurich I, Nycz G, Acharya A. Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients. Clin Med Res 2017; 15:21-32. [PMID: 28373288 PMCID: PMC5572842 DOI: 10.3121/cmr.2017.1348] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/02/2017] [Accepted: 03/24/2017] [Indexed: 02/08/2023]
Abstract
Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oral-systemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care models to support holistic management of an escalating diabetic population by targeting modifiable risk factors including periodontitis is being recognized by the health industry. Cross-disciplinary efforts supported by high quality research are needed to mitigate previously- and newly-defined barriers of care integration and expedite development and implementation of integrated care models in various practice settings. Implementation of quality monitoring in the dental setting will support definition of the impact and efficacy of interventional clinical care models on patient outcomes.
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Affiliation(s)
- Ingrid Glurich
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Gregory Nycz
- Family Health Center of Marshfield, Marshfield Clinic, Marshfield, Wisconsin, USA
| | - Amit Acharya
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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9
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Wang Y, Ye J, Li J, Chen C, Huang J, Liu P, Huang H. Polydatin ameliorates lipid and glucose metabolism in type 2 diabetes mellitus by downregulating proprotein convertase subtilisin/kexin type 9 (PCSK9). Cardiovasc Diabetol 2016; 15:19. [PMID: 26833058 PMCID: PMC4736185 DOI: 10.1186/s12933-015-0325-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 12/28/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Abnormalities in lipid and glucose metabolism are constantly observed in type 2 diabetes. However, these abnormalities can be ameliorated by polydatin. Considering the important role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in metabolic diseases, we explore the possible mechanism of polydatin on lipid and glucose metabolism through its effects on PCSK9. METHODS An insulin-resistant HepG2 cell model induced by palmitic acid (PA) and a db/db mice model were used to clarify the role of polydatin on lipid and glucose metabolism. RESULTS In insulin-resistant HepG2 cells, polydatin upregulated the protein levels of LDLR and GCK but repressed PCSK9 protein expression, besides, polydatin also inhibited the combination between PCSK9 and LDLR. Knockdown and overexpression experiments indicated that polydatin regulated LDLR and GCK expressions through PCSK9. In the db/db mice model, we found that polydatin markedly enhanced GCK and LDLR protein levels, and inhibited PCSK9 expression in the liver. Molecular docking assay was further performed to analyze the possible binding mode between polydatin and the PCSK9 crystal structure (PDB code: 2p4e), which indicated that steady hydrogen bonds formed between polydatin and PCSK9. CONCLUSIONS Our study indicates that polydatin ameliorates lipid and glucose metabolism in type 2 diabetes mellitus by downregulating PCSK9.
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Affiliation(s)
- Yu Wang
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, 132 WaiHuan East Road, Guangzhou Higher Education Mega Center, Guangzhou, 510006, China.
| | - Jiantao Ye
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, 132 WaiHuan East Road, Guangzhou Higher Education Mega Center, Guangzhou, 510006, China. .,National and Local United Engineering Lab of Druggability and New Drugs Evaluation, Guangzhou, 510006, China.
| | - Jie Li
- Laboratory Animal Center, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Cheng Chen
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, 132 WaiHuan East Road, Guangzhou Higher Education Mega Center, Guangzhou, 510006, China.
| | - Junying Huang
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, 132 WaiHuan East Road, Guangzhou Higher Education Mega Center, Guangzhou, 510006, China.
| | - Peiqing Liu
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, 132 WaiHuan East Road, Guangzhou Higher Education Mega Center, Guangzhou, 510006, China. .,National and Local United Engineering Lab of Druggability and New Drugs Evaluation, Guangzhou, 510006, China.
| | - Heqing Huang
- Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, 132 WaiHuan East Road, Guangzhou Higher Education Mega Center, Guangzhou, 510006, China. .,Laboratory Animal Center, Sun Yat-sen University, Guangzhou, 510080, China. .,National and Local United Engineering Lab of Druggability and New Drugs Evaluation, Guangzhou, 510006, China.
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Juvenile idiopathic arthritis activity and function ability: deleterious effects in periodontal disease? Clin Rheumatol 2015; 35:81-91. [DOI: 10.1007/s10067-015-3125-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/11/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
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