Impact of calcium channel blockers and angiotensin receptor blockers on hematological parameters in type 2 diabetic patients

Antihypertensive medications have been associated with a reduction in hemoglobin (Hb) levels, leading to clinically significant anemia. We aimed to provide valuable insights into the impact of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on hematological parameters by measuring the levels of erythropoietin (EPO), ferritin, and complete blood count (CBC) in individuals with type 2 diabetes mellitus (T2DM), particularly considering the duration of the antihypertensives use. In addition to comparing their effects on blood pressure, glycemic status, and renal function, a retrospective cohort study was conducted at the consultation unit of Alsalam Teaching Hospital, Mosul, Nineveh Province, between October 2022 and February 2023. A total of 160 participants were enrolled after being fully examined by the consultants to detect their eligibility for inclusion in the study and to rule out any abnormality. They consisted of 40 healthy controls, 30 T2DM patients (T2DM group), 30 T2DM patients with newly diagnosed hypertension (HT) (T2DM+HT group), 30 type 2 diabetic-hypertensives on ARBs (T2DM+HT+ARBs group), and 30 type 2 diabetic-hypertensives on CCBs (T2DM+HT+CCBs group). Five milliliters of blood was drawn from a vein and divided into two parts. Two milliliters was transferred into an anticoagulant tube for the measurement of HbA1c and complete blood picture. Serum was obtained from the remaining blood and used for assessment of ferritin, EPO, FSG, creatinine, urea, and uric acid. Significantly reduced FSG and HbA1c levels were observed in T2DM+HT+CCBs and T2DM+HT+ARBs groups vs T2DM+HT group (p < 0.05). The T2DM+HT+CCBs group had statistically higher urea levels than the T2DM group (p < 0.05). Both CCBs and ARBs use resulted in reduced creatinine clearance (CrCl). T2DM+HT+CCBs group exhibited slightly higher uric acid levels compared to controls (p < 0.05). Prolonged use of CCBs and ARBs led to disturbances in hematological parameters, with CCBs users showing the lowest levels of hemoglobin (Hb), RBCs, and hematocrit (Hct) among the groups. ARBs users displayed the lowest values of EPO and ferritin compared to other patient groups, along with reduced levels of Hb, RBCs, and Hct, albeit slightly higher than CCBs users. Our study highlights the importance of a balanced approach in prescribing ARBs and CCBs to patients with T2DM, given their potential to induce blood abnormalities, particularly with prolonged usage.

Effects of bee propolis on thyroid function tests in healthy volunteers

Purpose: The current study investigates the effects of bee propolis as a dietary supplement on thyroid function in healthy individuals. Methods: Sixty-nine apparently healthy subjects of both genders aged between 25 and 45 years and had a body mass index in the range of 18.5-25 kg m-2 were enrolled in the study. The participants were divided into two groups, 34 volunteers treated with 1 gram of bee propolis daily and the other 35 were on placebo pills for 2 months. Total triiodothyronine (TT3), total thyroxine (TT4) and ultra-sensitive thyroid stimulating hormone (USTSH) were measured in the two groups before and after treatment to assess thyroid function. Results: The results showed a significant increase in body weight (from 73.4 ± 7.2 to 74.8 ± 7.5 kg, p < 0.05) and BMI (from 24.2 ± 1.2 to 24.7 ± 1.5 kg m-2 , p < 0.05) with significantly decreased TT3 (from 2.17 ± 0.07 to 1.87 ± 0.09 nmol/L, p < 0.01) in bee propolis-treated group, whereas TT4 and USTSH showed non-significant changes. Conclusion: The results reveal a significant association of bee propolis supplementation with reduced TT3 levels in healthy subjects. The link may assist clinicians in monitoring the safety of bee propolis supplementation.

Aspirin-aromatic amino acid conjugates as selective Cox-2 inhibitors: A docking study

Purpose: To examine eight compounds in which aspirin was conjugated with aromatic amino acids virtually using docking studies for their ability to inhibit cyclooxygenase 2 (Cox-2) enzyme. Methods: The compounds were drawn, energy minimised and then docked into the active site of Cox-2 along with celecoxib for comparison using GOLD docking program. Results: Five of the designed compounds docked into the active site with a bent conformation producing a pose similar to that of celecoxib, with the aromatic amino acid moiety facing the outside of the active site. The interactions were mainly hydrophobic with some hydrogen bonds formed between the compounds and the key residues in the active site. Although the obtained scores were less than that of celecoxib, they were the top ranked poses in the solutions generated for each compound. Conclusion: The conjugation of aspirin with amino acids may offer a potential for the development of selective, but safe, Cox-2 inhibitors.

Effects of Bee Propolis on FBG, HbA1c, and Insulin Resistance in Healthy Volunteers

Objectives

Bee propolis is a natural substance that is used in traditional medicine due to its versatile pharmacological actions. This study evaluates whether short term use of bee propolis supplementation could have an impact on glycemic control in healthy individuals.

Materials and Methods

A single daily dose of 1000 mg of bee propolis was administered orally to a total of 34 healthy individuals for 60 days. Body weight, body mass index (BMI), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), and insulin resistance were measured in all participants before and after the use of bee propolis.

Results

The results of this study showed that bee propolis was associated with a significant increase in body weight and BMI of healthy volunteers. Bee propolis supplementation decreased FBG and HbA1c, but did not affect insulin resistance.

Conclusion

Based on these results, bee propolis supplementation has a potential effect on glycemic control in healthy individuals and this should be considered when using this supplement in medical conditions.

Comparison of Antioxidant Effects of the Proton Pump-Inhibiting Drugs Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole, and Rabeprazole

INTRODUCTION

Peptic lesions usually develop when there is an imbalance between aggressive drivers and gastro-protective mediators that guard the lining of the gastrointestinal tract. The most crucial of these mediators are antioxidants, whose loss may predispose to oxidative stress, which is believed to be the main aggravator of several diseases including peptic ulcer. Proton pump inhibitors (PPIs) are drugs that are highly effective and widely used for therapeutic management of peptic disorders through inhibition of gastric acid secretion. In spite of this, oxidative damage may continue to be a major issue that can predispose to future lesions.

OBJECTIVE

The present study is designed to explore the possible antioxidant capability of different PPIs, including omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole, in an aim to suggest an agent that, in addition to its acid-suppression properties, can provide antioxidant profit.

METHODS

The antioxidant activity of different PPIs was evaluated calorimetrically to test the ability of each drug to quench oxygen free radical, using the well-known stable free radical α,α-diphenyl-β-picrylhydrazyl (DPPH), and compared to ascorbic acid (AA; vitamin C). The measurements were performed using a spectrophotometer at 517 nm.

RESULTS

All the studied drugs reduced DPPH, but to different extents. However, omeprazole and esomeprazole showed the highest ability to scavenge free radicals (50% inhibitory concentrations [IC50s] of the percentage for free radical scavenging activity are 18.7 ± 5.7 and 18.7 ± 5.7, respectively, and the AA equivalents are 83,772 ± 11,887 and 81,732 ± 8,523 mg AA/100 g, respectively). Conversely, lansoprazole, pantoprazole, and rabeprazole might be having no role in this story (IC50s of the percentage for free radical scavenging activity are 49.3 ± 3.1, 49 ± 9.4, and 40.7 ± 7.2, respectively, and the AA equivalents are 30,458 ± 3,884, 32,222 ± 10,377, and 37,876 ± 8,816 mg AA/100 g, respectively).

CONCLUSION

Thus, omeprazole and esomeprazole may confer a significant dual action in gastrointestinal protection by providing potent antioxidant properties in addition to their major role as acid-suppression agents. However, further studies are essential to elucidate the mechanism behind the difference between the drugs of the same class.