Turmeric: Reemerging of a neglected Asian traditional remedy

Effect of Structured Diabetes Education on Diabetic Angiopathies Among Kidney Transplant Recipients With Posttransplant Diabetes: Kuwait Experience

OBJECTIVES

Diabetes knowledge among kidney transplant recipients with posttransplant diabetes has not been exhaustively assessed. Here, we evaluated the effects of structured diabetes education on development of diabetic micro- and macroangiopathies in kidney transplant patients with posttransplant diabetes.

MATERIALS AND METHODS

This prospective randomized controlled study categorized 210 renal transplant patients with posttransplant diabetes mellitus into 2:1 groups according to type of diabetes education. Group 1 (n = 140) received structured education, and group 2 (n = 70) received conventional education. Patient data were collected through patient identification and metabolic control parameter forms.

RESULTS

Most patients in groups 1 and 2, respectively, were Kuwaiti (60.7% vs 58.6%), men (57.9% vs 68.6%), and had high school-level education (43.6% vs 48.6%). Chronic glomerulonephritis was the original disease in 36.4% versus 35.4% of patients. Most patients (72.8% vs 78.6% in group 1 vs 2) received pretransplant hemodialysis. At study start, the rate of patients with diabetic neuropathy was comparable between groups (32.4% vs 27.9%). Moreover, after completion of 24 months of education, neurological evaluation by electromyograph and nerve conduction studies did not show any significant differences between the groups (P > .05). Similarly, the number of patients with fundus imaging showing retinopathy was comparable between groups at start and end of study (P > .05). Although macroangiopathic events were higher in group 1, this finding was not significant (P > .05). However, although the percentage of patients with nephropathy was comparable in both groups at start of study, the percentage decreased significantly in group 1 at 24 months after completion of education compared with group 2 and baseline value (P = .016).

CONCLUSIONS

Structured diabetes education was associated with reduced diabetic nephropathy but had no significant effects on other micro- or macroangiopathies. However, we recommend education for all kidney transplant recipients with diabetes.

Effect of Turmeric Supplementation on Blood Pressure and Serum Levels of Sirtuin 1 and Adiponectin in Patients with Nonalcoholic Fatty Liver Disease: A Double-Blind, Randomized, Placebo-Controlled Trial

Nonalcoholic fatty liver disease (NAFLD) is commonly associated with obesity. This randomized, double-blind, placebo-controlled trial aimed to evaluate the effects of turmeric on serum adiponectin and sirtuin 1 (SIRT1) levels, blood pressure, and body mass index (BMI) in patients with NAFLD. A total of 46 eligible patients with NAFLD (BMI, 25.0∼39.9 kg/m²) were randomly allocated to turmeric and placebo groups using block randomization. The turmeric group (n=23) was administered 3,000 mg/d turmeric powder in six 500-mg capsules for 12 weeks, whereas the placebo group (n=23) was administered six placebo capsules/d for 12 weeks. Body weight, BMI, serum SIRT1 and adiponectin levels, and systolic and diastolic blood pressures were measured at baseline and 12 weeks after intervention. Serum SIRT1 levels increased significantly in the turmeric group compared with the placebo group. Additionally, participants in the turmeric group exhibited lower weight, BMI, and systolic blood pressure after 12 weeks of intervention compared with the baseline. Turmeric effectively improved SIRT1 levels in patients with NAFLD compared with the placebo. The efficacy of turmeric might increase with long-term use at higher doses.

Immunomodulatory effects of curcumin in systemic autoimmune diseases

Systemic autoimmune diseases like rheumatoid arthritis, multiple sclerosis, and systemic lupus erythematosus represent various autoimmune conditions identified by immune system dysregulation. The activation of immune cells, auto-antigen outbreak, inflammation, and multi-organ impairment is observed in these disorders. The immune system is an essential complex network of cells and chemical mediators which defends the organism's integrity against foreign microorganisms, and its precise operation and stability are compulsory to avoid a wide range of medical complications. Curcumin is a phenolic ingredient extracted from turmeric and belongs to the Zingiberaceae, or ginger family. Curcumin has multiple functions, such as inhibiting inflammation, oxidative stress, tumor cell proliferation, cell death, and infection. Nevertheless, the immunomodulatory influence of curcumin on immunological reactions/processes remains mostly unknown. In the present narrative review, we sought to provide current information concerning the preclinical and clinical uses of curcumin in systemic autoimmune diseases.

Low curcumin concentration enhances the anticancer effect of 5-fluorouracil against colorectal cancer

BACKGROUND

Colon cancer treatments include surgery, radiotherapy, and chemotherapy. Chemotherapy using 5-fluorouracil (5-FU) has been widely applied to treat colorectal cancer (CRC). However, it is important to explore the use of chemotherapy drugs in combination with other agents to decrease severe adverse effects.

PURPOSE

This study aimed to investigate the effects of curcumin in combination with 5-FU on the proliferation, migration, and apoptosis of CRC SW620 cell line both in vitro and in vivo.

METHODS

Flow cytometry was used to study the effect of curcumin on chemotherapy-induced apoptosis in CRC cells. The mechanism of curcumin's enhanced antitumor effect in vivo was investigated using gene knockdown, TUNEL, western blot, qRT-PCR and immunohistochemistry.

RESULTS

The results showed a synergistic effect of the two compounds on CRC cells. Considerable reduction in the proliferation and migration of SW620 cells was observed in the combination treatment group. Significantly increased apoptosis rate extended the survival of immunodeficient mice in the combination group as compared to that of the 5-FU group (p < 0.05). The results showed that curcumin significantly inhibited pERK signaling and downregulated L1 expression in SW620 cells.

CONCLUSIONS

We conclude that curcumin promotes chemosensitivity of CRC cells to 5-FU by downregulating L1 expression. Our findings provide experimental evidence for the synergism between curcumin and 5-FU, which can be utilized in clinical applications for reducing the toxicity and adverse effects of 5-FU.

Can curcumin supplementation reduce plasma levels of gut-derived uremic toxins in hemodialysis patients? A pilot randomized, double-blind, controlled study

BACKGROUND

Gut dysbiosis is common in patients with chronic kidney disease (CKD) and is closely related to inflammatory processes. Some nutritional strategies, such as bioactive compounds present in curcumin, have been proposed as an option to modulate the gut microbiota and decrease the production of uremic toxins such as indoxyl sulfate (IS), p-cresyl sulfate (pCS) and indole-3 acetic acid (IAA).

OBJECTIVE

To evaluate the effects of curcumin supplementation on uremic toxins plasma levels produced by gut microbiota in patients with CKD on hemodialysis (HD).

METHODS

Randomized, double-blind trial in 28 patients [53.6 ± 13.4 years, fourteen men, BMI 26.7 ± 3.7 kg/m², dialysis vintage 37.5 (12-193) months]. Fourteen patients were randomly allocated to the curcumin group and received 100 mL of orange juice with 12 g carrot and 2.5 g of turmeric and 14 patients to the control group who received the same juice but without turmeric three times per week after HD sessions for three months. IS, pCS, IAA plasma levels were measured by reverse-phase high-performance liquid chromatography RESULTS: After three months of supplementation, the curcumin group showed a significant decrease in pCS plasma levels [from 32.4 (22.1-45.9) to 25.2 (17.9-37.9) mg/L, p = 0.009], which did not occur in the control group. No statistical difference was observed in IS and IAA levels in both groups.

CONCLUSION

The oral supplementation of curcumin for three months seems to reduce p-CS plasma levels in HD patients, suggesting a gut microbiota modulation.

Opportunities for Health Promotion: Highlighting Herbs and Spices to Improve Immune Support and Well-being

CONTEXT

Consuming a balanced and varied diet is beneficial for health, especially when individuals feel stressed, scared, insecure, unequipped, or disempowered from maintaining their health during the COVID-19 pandemic. Nutrient deficiencies from inadequate intake of healthful foods can contribute to a weakened immune system and greater susceptibility to infection. Including herbs and spices in a balanced and diverse diet is one of the highlights of nutritious eating that supports health and immunity.

OBJECTIVE

The review intended to examine ways to integrate specific herbs and spices into people's diets and to use them therapeutically in holistic, integrated health promotion.

DESIGN

The research team performed a narrative review by searching PubMed Central and Google Scholar databases. The team developed a search strategy focused on specific common names of spices and herbs in combination with other terms, such as health benefits, health promotion, immunity, inflammation.

SETTING

This review was conducted in Muncie and Columbus, Indiana.

RESULTS

This review uncovered studies documenting the many therapeutic properties of herbs within the lamiaceae family, particularly basil and spearmint, and spices, including cloves, ginger, and turmeric. Substantial evidence suggests that consumption of a healthful diet, inclusive of herbs and spices, may strengthen the body's immune system against diseases including highly contagious viruses.

CONCLUSIONS

With respect to herbs and spices, the current review's findings can help to inform and support future recommendations for a standard within the professions of health to provide an improved, healthier, and well-educated dietary guidance for individuals. More studies are needed on the consumption of herbs and spices in human trials to elicit evidence beyond preclinical and animal studies.

Curcumin as a major active component of turmeric attenuates proteinuria in patients with overt diabetic nephropathy

Background:

Diabetic nephropathy (DN) is a common cause of end-stage renal disease (ESRD). The benefits and effects of renin–angiotensin system blocker drugs are obvious in decreasing albuminuria, but there is a need to find other drugs that can decrease albuminuria. The aim of our study is to evaluate the effect of short-term administration of curcumin on overt albuminuria in patients with type 2 diabetes mellitus (T2DM).

Materials and Methods:

A randomized, double-blind clinical trial was performed on 46 patients with T2DM, overt albuminuria ≥300 mg/24 h, and estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m². After the random allocation of the patients, they were divided into two groups. In the curcumin group, the patients received 500 mg (one capsule) of curcumin with each meal (three times/day after meal) for 16 weeks. Other variables including blood urea nitrogen (BUN), creatinine (Cr), fasting blood sugar (FBS), 2-h postprandial blood sugar (2-h pp BS), lipid profile, 24-h urine analysis for albuminuria, serum albumin, and hemoglobin A1C (HbA1C) were checked at baseline and bimonthly too.

Results:

two groups at baseline were comparable in terms of basic characteristics (P > 0.05). Albuminuria decreased significantly from 900.42 ± 621.91 at the baseline to 539.68 ± 375.16 at the end of the study in the curcumin group (P_Time = 0.002); however, no statistically significant changes were observed in the placebo group (519.94 ± 214.33 at the baseline vs. 444.00 ± 219.10 at the end of the trial; P_Time = 0.43), and the decrease was significantly higher in the curcumin group than that of the placebo group (P_Intervention = 0.01). No significant differences were observed between the placebo and curcumin in terms of changes in serum BUN, Cr, FBS, 2-h pp BS, HbA1C, lipid profile, and albumin.

Conclusion:

Our study showed that curcumin as an active turmeric metabolite was an effective adjuvant therapy for ameliorating macroscopic proteinuria in type 2 diabetic patients. Its effect may appear after 2 months of therapy and even in patients with a mild decrease in GFR. Further studies with larger sample size and longer duration are recommended.

Therapeutic effects of curcumin on sepsis and mechanisms of action: A systematic review of preclinical studies

Sepsis is a complex disease that begins with an infectious disorder and causes excessive immune responses. Curcumin is considered as an active component of turmeric that can improve the condition in sepsis due to its anti-inflammatory and antioxidant properties. PubMed, Embase, Google Scholar, Web of Science, and Scopus databases were searched. Searching was not limited to a specific publication period. Only English-language original articles, which had examined the effect of curcumin on sepsis, were included. At first, 1,098 articles were totally found, and 209 articles were selected after excluding duplicated data; 46 articles were remained due to the curcumin effects on sepsis. These included 23 in vitro studies and 23 animal studies. Our results showed that curcumin and various analogs of curcumin can have an inhibitory effect on sepsis-induced complications. Curcumin has the ability to inhibit the inflammatory, oxidative coagulation factors, and regulation of immune responses in sepsis. Despite the promising evidence of the therapeutic effects of curcumin on the sepsis complication, further studies seem necessary to investigate its effect and possible mechanisms of action in human studies.

Diabetes mellitus and renal failure: Prevention and management

Nowadays, diabetes mellitus (DM) and hypertension are considered as the most common causes of end-stage renal disease (ESRD). In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL, 1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c) is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes. Administration of metformin should be avoided in chronic renal failure (CRF) because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices.

Protection of renal tubular cells by antioxidants: current knowledge and new trends

Acute renal damage mainly develops following toxic or ischemic insults and is defined as acute. These damages have largely been attributed to oxidative stress. Recently much attention has been directed toward decreased renal tubular cell regeneration during tubular cell injury. Antioxidants have recently been the focus of researchers and scientists for prevention and treatment of various oxidative stress-related conditions, including renal toxicities. Although free radicals are known to contribute in kidney injury and abundant researches, particularly laboratory trials, have shown the beneficial effects of antioxidants against these complications, long term clinical trials do not uniformly confirm this matter, especially for single antioxidant consumption such as vitamin C. The aim of this paper is to discuss the possible explanation of this matter.

Atherosclerosis: process, indicators, risk factors and new hopes

Background:

Atherosclerosis is the major cause of morbidities and mortalities worldwide. In this study we aimed to review the mechanism of atherosclerosis and its risk factors, focusing on new findings in atherosclerosis markers and its risk factors. Furthermore, the role of antioxidants and medicinal herbs in atherosclerosis and endothelial damage has been discussed and a list of important medicinal plants effective in the treatment and prevention of hyperlipidemia and atherosclerosis is presented.

Methods:

The recently published papers about atherosclerosis pathogenesis and herbal medicines effective in the treatment and prevention of hyperlipidemia and atherosclerosis were searched.

Results:

Inflammation has a crucial role in pathogenesis of atherosclerosis. The disease is accompanied by excessive fibrosis of the intima, fatty plaques formation, proliferation of smooth muscle cells, and migration of a group of cells such as monocytes, T cells, and platelets which are formed in response to inflammation. The oxidation of low density lipoprotein (LDL) to Ox-LDL indicates the first step of atherosclerosis in cardiovascular diseases. Malondialdehyde factor shows the level of lipoperoxidation and is a sign of increased oxidative pressure and cardiovascular diseases. In special pathological conditions such as severe hypercholesterolemia, peroxynitrite concentration increases and atherosclerosis and vascular damage are intensified. Medicinal plants have shown to be capable of interacting these or other pathogenesis factors to prevent atherosclerosis.

Conclusions:

The pathogenesis factors involved in atherosclerosis have recently been cleared and the discovery of these factors has brought about new hopes for better prevention and treatment of atherosclerosis.

Metformin and diabetic kidney disease: a mini-review on recent findings

Metformin, an oral anti-diabetic agent in the biguanide class is a widely prescribed drug to treat high blood glucose in patients with type 2 diabetes mellitus. Metformin has three different roles, including blood glucose regulatory effect, protection of kidney tubular cell by acting as an effective antioxidant and finally ameliorative effect on diabetic kidney disease through saving the podocytes. Therefore, diabetic patients may benefit from all of these three distinct ameliorative effects.

Anethum graveolens and hyperlipidemia: A randomized clinical trial

BACKGROUND

It has been established that hyperlipidemia increases the incidence and mortality associated with coronary heart disease. In this study, the effects of Dill (Anethum graveolens) were evaluated on lipid profile of hypercholesterolemic patients.

MATERIALS AND METHODS

In this clinical study, 91 hyperlipidemic patients were randomly designated into two groups. One group received gemfibrozil (900 mg daily) and the other group received Dill tablet (six tablets daily) for 2 months. The blood lipids including total cholesterol, triglyceride and high density lipoprotein (HDL)-cholesterol from each group were assessed at the beginning and end of the trial.

RESULTS

Use of gemfibrozil brought about increased HDL-cholesterol by 3.91% (P < 0.05) and reduced triglyceride and total cholesterol by 32.7% (P < 0.05) and 9.41% (P < 0.05), respectively. Applying Dill tablet for 2 months resulted in reduction of total cholesterol up to 18% (P < 0.05) and triglyceride by 7.38% (P < 0.05). However, circulating HDL-cholesterol was not affected by this treatment. In this study, gemfibrozil decreased triglyceride and increased HDL-cholesterol more than anethum (P < 0.05). Anethum decreased total cholesterol more than gemfibrozil (P < 0.05). Patients treated with anethum did not report any side effects.

CONCLUSION

The results of this trial indicate that Dill might be beneficial for hypercholesterolemic and hypertriglycemic patients.

The theme of the world diabetes day 2014; healthy living and diabetes; a nephrology viewpoint

Annually, on November 14, the world diabetes day (WDD) is celebrated. WDD is a campaign led by the International Diabetes Federation (IDF) and its member associations throughout the world. It was created in 1991 by IDF and World Health Organization (WHO) in response to increasing concerns about the intensifying threat of diabetes worldwide. The WDD 2014 organization marks the first of a three-year (2014-16) emphasis on "healthy living and diabetes". Replacement of whole grain and cereal-based foods with refined grains in diet planning could be an operative and practical strategy in type II diabetic patients. This strategy beyond the development of glycemic control, leads to more benefits for management of other features of diabetes, diminution of diabetes-induced metabolic disorders, and prevents long-term complications especially diabetic kidney disease and cardiovascular disease.

Renoprotective effects of antioxidants against cisplatin nephrotoxicity

Nephrotoxicity is the major limitation for the clinical use of cisplatin as an anti-tumoural drug. Intracellular effects of cisplatin cause tubular damage and tubular dysfunction with sodium, potassium, and magnesium wasting. Renoperotective strategies against cisplatin are classified on 8 targets: 1) Decrease of cisplatin uptake by renal cell, 2) Inhibition of cisplatin metabolism, 3) Blocking cell death pathways, 4) Cyclin-dependent kinase inhibitors, 5) Pharmacologic, molecular, and genetic blockade of p53, 6) Inhibition of specific Mitogen-activated protein kinase, 7) Antioxidants usage for renoprotection against cisplatin injury and inhibit of oxidative stress, 8) Suppress of inflammation. The oxidation reactions can produce free radicals, which start chain reactions and subsequently can cause a large number of diseases in humans. Antioxidant from natural products have attracted the physicians' attentions, nowadays. The natural product antioxidants detoxify reactive oxygen species (ROS) in kidneys, without affecting the anticancer efficacy of cisplatin. Hence, antioxidants have potential therapeutic applications.

In Vitro Impact of Hydro-alcoholic Extract of Rosa damascena Mill. on Rat Ileum Contractions and the Mechanisms Involved

BACKGROUND

The petal's hydro-alcoholic extract of Rosa damascena Mill. on ileum contractions of Wistar rats and its possible mechanism were investigated.

METHODS

Forty-eight male Wistar rats were divided into six groups. Ileum was placed adjacent to propranolol (1 μM), naloxone (1 μM) and L-NAME (100 μM) and also under the influence of different doses (2-8 mM) of calcium chloride.

RESULTS

Cumulative extract of R. damascena Mill. (100, 500, and 1000 mg/L) decreased ileum contractions induced by KCl (60 mM) in a dose-dependent manner (P < 0.0001). Propranolol and naloxone significantly decreased the inhibitory effect of the extract on contractions induced by KCl (P < 0.001), but L-NAME was ineffective. Furthermore, calcium led to the contraction of depolarized tissue through KCI and this contractile effect decreased significantly induced by the cumulative concentrations of the extract (P < 0.001).

CONCLUSIONS

The results indicate that R. damascena Mill. dose-dependently (100, 500, and 1000 mg/L) decreases ileum movements of the rat probably through stimulating the β-adrenergic and opioid receptors and voltage-dependent calcium channels, and it may be used to treat digestive disorders.

A double blind clinical trial on the efficacy of honey drop in vernal keratoconjunctivitis

Purpose. This trial was designed to evaluate the efficacy and safety of topical honey eye drops in patients with diagnosed VKC. Methods. This clinical trial was conducted on 60 patients with diagnosed VKC. The patients were selected and randomly allocated between two groups of 30. Patients in two groups received honey eye drop (60% in artificial tear) or placebo, other than cromolyn and fluorometholone 1% eye drops, to be used topically in each eye, four times per day. The patients were examined with slit lamp and torch at baseline and the follow-up visits on the 1st, 3rd, and 6th months of the study for redness, limbal papillae, and intraocular pressure. Results. Out of 60 patients who completed the study, 19 patients (31.7%) were female. There was significant increase in eye pressure and reduction in redness as well as limbal papillae, following the consumption of the honey drop in honey group compared to placebo control group (P < 0.05). At the end of trial, one patient in honey group and 7 ones in placebo group had limbal papillae (P < 0.05). Conclusion. Topical honey eye drops, when used along with Cromolyn and Fluorometholone eye drops, might be beneficial for the treatment of VKC.

Comparative evaluation of three different methods for HbA1c measurement with High-performance liquid chromatography in diabetic patients

Background:

The global prevalence of diabetes mellitus is increasing rapidly. Measurement of glycated hemoglobin, predominantly HbA_1c, is fundamental to the management of patients with diabetes. HbA_1c is used to monitor long-term glycemic control, adjust therapy, assess the quality of diabetes care and predict the risk for the development of complications. While HbA_1c is the standard method for long-term glycemic control in diabetic patients, there are different methods for measurement of HbA_1c and all laboratories do not use the reference method (high-performance liquid chromatography [HPLC]). The objective of this study is comparison of three different methods with HPLC to find out which method has an acceptable concordance and correlation with the reference method.

Materials and Methods:

Fifty-eight diabetic patients were assessed in this study. The blood sample of each patient was checked with Diazyme (enzymatic assay), Nycocard (boronate-affinity binding) and Biosystem (micro column chromatography). The values of HbA_1c of each method were compared with the Knauer-HPLC results.

Results:

The means of the differential values between each method and HPLC in the ANOVA test are as follows: M = 1.8, SD = 1.09 for Nycocard-HPLC; M = 1.5, SD = 1.08 for biosystem-HPLC; M = 1.3, SD = 1.2 for Diazyme-HPLC. Pearson's correlation coefficient between HPLC and Nycocard; 0.76, HPLC and Diazyme; 0.75 and between HPLC and Biosystem was 0.68. Linear regression parameters for each method with HPLC were also determined.

Conclusion:

Diazyme had a better performance and showed a greater concordance with HPLC among others, although it was not an ideal alternative for HPLC.

Suppressive impact of anethum graveolens consumption on biochemical risk factors of atherosclerosis in hypercholesterolemic rabbits

BACKGROUND

We aimed to determine the effects of Anethum graveolens (Dill) powder on postprandial lipid profile, markers of oxidation and endothelial activation when added to a fatty meal.

METHODS

In an experimental study, 32 rabbits were randomly designated into four diet groups: normal diet, high cholesterol diet (1%), high cholesterol diet plus 5% (w/w) dill powder and high cholesterol diet plus lovastatin (10 mg/kg, bw). The concentrations of glucose, total cholesterol (TC), low-density lipoproteins-cholesterol (LDL-C), alanine aminotransferase (alt), aspartate aminotransferase (ast), fibrinogen, factor VII, apolipoprotein B (ApoB), nitrite and nitrate were measured in blood samples following 15 h of fasting and 3 h after feeding.

RESULTS

Concurrent use of A. graveolens powder or lovastatin significantly decreased ALT, TC, glucose, fibrinogen and LDL-C values in comparison with hypercholesterolemic diet group (P < 0.05). Consumption of A. graveolens or lovastatin did not change factor VII, ApoB, nitrite and nitrate levels significantly in comparison with hypercholesterolemic diet group. Intake of A. graveolens significantly decreased serum AST compared to hypercholesterolemic diet.

CONCLUSIONS

A. graveolens might have some protective values against atherosclerosis and that it significantly affects some biochemical risk factors of this disease. Our findings also confirm the potential harmful effects of oxidized fats and the importance of dietary polyphenols in the meal.

Renoprotective effects of metformin

Metformin as a biguanid drug entered to the market 50 years ago and now is generally recommended as the first-line treatment in type 2 diabetes, especially in overweight patients, however in recent years new indications for its use have emerged . It improves peripheral and liver sensitivity to insulin, reduces basal hepatic glucose production, increases insulin-stimulated uptake and utilization of glucose by peripheral tissues, decreases hunger and causes weight reduction.Recently, much attention has been made toward the possible kidney protective efficacy of metformin. Recent studies have proven that metformin, possesses antioxidant properties, too.

Efficacy of Co-administration of Garlic Extract and Metformin for Prevention of Gentamicin-Renal Toxicity in Wistar Rats: A Biochemical Study

BACKGROUND

Gentamicin (GM) nephrotoxicity has been related to oxidative stress. Garlic and metformin (MF) have anti-oxadant activity and therefore, this study was aimed to evaluate the preventive and curative effects of garlic, MF and their combination on GM indeced tubular toxicity in Wistar rats.

METHODS

In a pre-clinical study, 70 male Wistar rats were randomly designated into 7 groups of 10 and treated as follows: Group 1: Received saline for 20 days. Group 2: Were injected 100 mg/kg/d of GM intraperitoneally (ip), for 10 days and saline for 10 more days. Group 3: Received GM for 10 days then 20 mg/kg garlic ip for the next 10 days. Group 4: Received GM for 10 days and MF (100 mg/kg) orally for the next 10 days. Group 5: Received GM for 10 days and a combination of MF and garlic for the next 10 days (100 and 20 mg/kg, respectively). Group 6: The same as group 5but with half-doses of MF and Garlic. Group 7: Received GM for 10 days together with a combination ofMF and garlic. On 20(th) day of the experiment the serum blood urea nitrogen (BUN) and creatinine (Cr) were measured and compared in different groups.

RESULTS

GM injection significantly increased the serum BUN and Cr (P < 0.05). Administration of MF, garlic or their combination with or after injection of GM (high doses) could atenuate BUN and Cr.

CONCLUSIONS

The results indicate that MF and garlic or their combination have curative and protective activity against GM nephrotoxicity.

Preventive and curative effects of ginger extract against histopathologic changes of gentamicin-induced tubular toxicity in rats

BACKGROUND

Gentamicin (GM) is a commonly used aminoglycoside, however, renal toxicity has limited its usage. This study was designed to evaluate the curative and protective effects of Zingiber officinale (ginger) against gentamicin tubular toxicity in rats. The phenolic and flavonoid components and antioxidant activity of ginger were also evaluated.

METHODS

In a preclinical study, 50 male Wistar rats were designated into 5 groups of 10 and treated as follows: Group I: vehicle. Group II: 200 mg/kg/d of ginger for 3 days then, GM (80 mg/kg) for 7 days. Group III: 200 mg/kg ginger orally for 3 days, then ginger plus GM for 7 days. Group IV: GM for 7 days. Group V: GM for 10 days. Group VI: GM for 7 days, then 200 mg/kg ginger orally for 10 days. At the end of the study, the animals were sacrificed and their kidneys were histologically evaluated.

RESULTS

Ginger could prevent degeneration of the renal cells and reduce the severity of tubular damage caused by gentamicin. However, it could not regenerate the GM degeneration.

CONCLUSIONS

The results indicate that ginger is effective as a prophylaxis agent, but has not curative effect.

Comment on: Anti-Oxidative Stress Activity of Stachys lavandulifolia Aqueous Extract in Humans

A recent article by Rahzani et al. (1) published in the esteemed Cell Journal reported the antioxidative stress activity of Stachys lavandulifolia aqueous extract in humans and suggested its consumption as a supplement in the management of diseases related to oxidative stress. We would like to emphasize some of the limitations regarding antioxidant supplementation, in general, and Stachys lavandulifolia, in particular. It has been established that oxidative stress is involved in the development of a wide variety of chronic and degenerative diseases such as cancer, Parkinson and Alzheimer's (2-5). Antioxidants are also effective in the prevention or reduction of adverse effects related to medication usage (5-10). However, they may potentially have deleterious effects. A major concern of antioxidant supplementation is their harmful effect on reactive oxygen species (ROS) production (prooxidant action), particularly when precise modulation of ROS levels are necessary for normal cell function (4-10). In fact, it has been reported that antioxidants may exhibit pro-oxidant activity under specific conditions. Of particular importance are redox conditions the dosage and the presence of free transition metals at cellular sites. For example, the antioxidant vitamin C in the presence of ferric iron may act as a potent mediator of lipid peroxidation. It has been suggested that β-carotene sometimes acts as a pro-oxidant in the lungs of smokers and similarly vitamin C may increase DNA damage in humans (11, 12). Therefore, it is necessary to take into account the bioavailability and differential activities of antioxidant compounds before their administration. Other than general considerations for antioxidant consumption, the aspects of each particular antioxidant should also be considered (3, 13, 14). Recently, in a preclinical study we reported the renal toxicity of hydroalcoholic extract of Stachys lavandulifolia Vahl in Wistar rats (15). In this experimental study we randomly assigned 100 male Wistar rats to five equal groups, one control and four experimental. Animals received intraperitoneal injections of saline or Stachys lavandulifolia extract (50, 100, 150, 200 mg/kg) for one month after which blood samples were collected from half of the animals from each group. Other animals received no injections for one additional month, then blood samples were obtained. In the groups that Stachys lavandulifolia Vahl extracts were used for one month we observed mild degeneration of renal tubular epithelial cells (6, 9). In the second month of the study these histologic lesions significantly increased (p< 0.05). We concluded that hydroalcoholic extract of Stachys lavandulifolia has renal tubular toxicity which might continue following drug discontinuation (6, 9, 15). Therefore, although antioxidant supplements generally have beneficial effects, as a caution it is advised to only consume such supplements under medical supervision in order to avoid any potential negative effects.

Association of serum uric acid with proteinuria in type 2 diabetic patients

BACKGROUND

Various findings suggest that uric acid is an inflammatory factor and may have a role in endothelial dysfunction and act as a mediator of diabetic nephropathy. The objective of this study was to evaluate the relationships between serum uric acid level and level of proteinuria in type 2 diabetic (T2D) patients.

MATERIALS AND METHODS

A cross-sectional analytical study was conducted in 60 patients with T2D without a history of gout. None was treated with allopurinol. Venous blood samples were obtained in fasting state for determinations of serum creatinine, uric acid, and hemoglobin A1c (HbA1c) (reference range 3.8-5.5%); 24-h urine proteinuria was also measured.

RESULTS

Mean age of the patients was 57 ± 8.3 years. Mean ± standard error (SE) of serum creatinine was 0.98 ± 0.028 mg/dL, mean ± SE of serum uric acid was 4.5 ± 0.15 mg/dL, and mean ± SE of proteinuria was 388 ± 28.7 mg/day (median = 303.5 mg/day). There was no significant difference in serum uric acid, HbA1c, and creatinine level between males and females (P > 0.05). There was a significant positive association between body mass index (BMI) and serum uric acid levels (r = 0.428, P = 0.001). After adjustment for weight, a significant positive association of serum uric acid with level of proteinuria was seen (r = 0.47, P < 0.001).

CONCLUSION

Serum uric acid had a significant positive association with diabetic nephropathy. It might be hypothesized that serum uric acid plays a role in diabetic nephropathy in T2D.

Erythropoietin ameliorates genetamicin-induced renal toxicity: A biochemical and histopathological study

BACKGROUND

Investigations have attempted to modify the outcome of tubular injury by either ameliorating renal tubular damage or promoting tubular regeneration in the case of acute tubular necrosis.

OBJECTIVES

We investigated the protective effect of Eprex an erythropoietin analogue on tubular injury induced by gentamicin (GM).

MATERIALS AND METHODS

Forty male Wistar rats were randomly divided into four groups. In group 1,rats were served as a sham group. In group 2, rats were injected intraperitoneally with 100 mg/kg of GM for 10 consecutive days (positive control group) and then were sacrificed. In group 3, rats received GM for 10 days then Eprex 100U/kg was injected intraperitoneally for the next 10 days and then they were sacrificed at the day 20th. In group 4 rats were injected a combination of GM (80 mg/kg) and Eprex 100U/kg intraperitoneally for 10 days and then were sacrificed.

RESULTS

The results indicated that, Eprex prevented the increase in serum creatinine (Cr) and blood urea nitrogen (BUN). The effect of Eprex on damage score, showed that co-administration of GM and Eprex (group 3 and 4) reduced the kidney tissue damage compared to positive control group (P<0.05). This result indicat that Eprex potentially can reduce or prevent the kidney tissue damage.

CONCLUSIONS

Ameliorative effect of Eprex when the drug was given in combination with GM and also when the drug was applied after GM-induced tubular damage, revealed the renoprotective potency of Eprex. Eprex is a promising drug to prevent or attenuate tubular damage induced by GM or other nephrotoxic agents which act through the same mechanisms as gentamicin.

Ameliorative effects of metformin on renal histologic and biochemical alterations of gentamicin-induced renal toxicity in Wistar rats

BACKGROUND

The aim of this study was to test the potential properties of metformin (MF) to protect the kidney from gentamicin (GM)-induced renal toxicity.

MATERIALS AND METHODS

In this preclinical study, 50 male Wistar rats were randomly divided into five groups of 10 rats in each. In the first group (group I), they were kept in the same condition as others without receiving drugs for 10 days. In group II, the rats were injected intraperitoneally with 100 mg/kg/day of GM for 10 consecutive days. Group III rats received 100 mg/kg/day MF orally for 10 days. In group IV, the rats received GM (100 mg/kg; intraperitoneally) for 10 days and 100 mg/kg/day MF orally for the next 10 days. In the last group (group V), the rats received a combination of GM 100 mg/kg/day intraperitoneally and MF 100 mg/kg/day orally for 10 days simultaneously. Serum blood urea nitrogen (BUN) and creatinine (Cr) values were measured and renal tissues of the animals were processed for light microscope examination.

RESULTS

The levels of BUN in groups II, IV, and V, and also the serum level of Cr in groups II and V were increased significantly after the experiment. Furthermore, post-treatment with MF or co-treatment with MF could prevent the elevation of serum BUN and Cr induced by GM and also attenuates the damage score (P < 0.05).

CONCLUSIONS

MF may prevent or ameliorate GM-induced acute renal failure, and therefore it might be beneficial in patients under treatment with this medicine.