Management of Outpatients With Diabetes at High Risk of Hypoglycemia

This JAMA Clinical Guidelines Synopsis summarizes the Endocrine Society’s 2023 recommendations on management of outpatients with diabetes and high risk of hypoglycemia.

Improved Cryopreservation of Human Induced Pluripotent Stem Cell (iPSC) and iPSC-derived Neurons Using Ice-Recrystallization Inhibitors

Human induced pluripotent stem cells (iPSCs) and iPSC-derived neurons (iPSC-Ns) represent a differentiated modality toward developing novel cell-based therapies for regenerative medicine. However, the successful application of iPSC-Ns in cell-replacement therapies relies on effective cryopreservation. In this study, we investigated the role of ice recrystallization inhibitors (IRIs) as novel cryoprotectants for iPSCs and terminally differentiated iPSC-Ns. We found that one class of IRIs, N-aryl-D-aldonamides (specifically 2FA), increased iPSC post-thaw viability and recovery with no adverse effect on iPSC pluripotency. While 2FA supplementation did not significantly improve iPSC-N cell post-thaw viability, we observed that 2FA cryopreserved iPSC-Ns re-established robust neuronal network activity and synaptic function much earlier compared to CS10 cryopreserved controls. The 2FA cryopreserved iPSC-Ns retained expression of key neuronal specific and terminally differentiated markers and displayed functional electrophysiological and neuropharmacological responses following treatment with neuroactive agonists and antagonists. We demonstrate how optimizing cryopreservation media formulations with IRIs represents a promising strategy to improve functional cryopreservation of iPSCs and post-mitotic iPSC-Ns, the latter of which have been challenging to achieve. Developing IRI enabling technologies to support an effective cryopreservation and an efficiently managed cryo-chain is fundamental to support the delivery of successful iPSC-derived therapies to the clinic.

Impact of Stearic Acid as Heat Storage Material on Energy Efficiency and Economic Feasibility of a Vacuum Tube Solar Water Heater

The overheating of heat pipes, poor transfer of heat across the absorber and finned heat pipes, and inability to provide hot water in the late evening hours are major problems associated with conventional heat pipe vacuum collector systems. The amalgamation of highly conductive storage material between the absorber tube (heat collecting surface) and the heat pipe is an effective way to overcome these problems. In this study, a stearic acid amalgamated vacuum tube solar collector system was designed and fabricated and its thermal output compared with a conventional vacuum tube system without storage material under the same environmental conditions. The experimental results showed that the amalgamation of stearic acid as storage material enhanced the thermal output of the solar system compared to the conventional one. The desired heat gain of the solar system with storage material increased by 31.30, 23.34, and 18.78% for Test 1_40 °C, Test 2_45 °C, and Test 3_50 °C, respectively. The technoeconomic analysis showed that almost 118.80 USD in revenue could be earned by the proposed solar system at the end of 15 years. The total running cost of ELG and the developed solar system was observed to be 202.62 and 86.70 USD, respectively. On average, the cost of hot water production using the solar system and ELG was found to be 0.0016 and 0.004 USD/L, respectively. The value of LEC was found to be 0.062 USD/electricity unit, which was much lower than the LEC value of ELG (0.116 USD/electricity unit). The value of NPW (73.73 USD) indicated high acceptability of the proposed system. The payback time is lower than the life of the system, indicating its suitability for use in the commercial sector. Therefore, the proposed solar system is highly recommended over conventional water heating systems in urban and rural areas.

Online Classrooms: A Research Study to understand factors affecting Students’ motivation towards E-Learning

With advent of technology, disruptive ideas are witnessed blowing minds daily. Who could have thought students learning on internet will be witnessed? Distance Learning in India for education in India initiated within Correspondence Courses in 1962, responding to an ever-increasing demand for education could not be met by traditional system (Suresh, n.d.). Since then, online learning has seen a revolution, and now there is Khan Academy, Coursera, LinkedIn Learning, Udemy, Udacity, Codec demy, eDX, etc., among various online learning platforms available at one’s perusal. (MOOCs) are also examples of online learning options organizations are using to up skill their employees. In recent times, because of current COVID-19 situation, schools and colleges are facing a challenging time to provide quality education as they are unable to open their gates for students due to Government restrictions to contain spread of virus. This paper will discover influence of online education on students and what motivates them to pursue E-Learning.

Study of factors influencing online purchase intention of electronic household products

The paper aims to study the impact of various factors influencing consumer household electronic product purchase intention on online platforms. Hundred and eighty-six filled responses were considered for the study with the help of a structured questionnaire. Much information was studied employing various regression techniques. The multiple regression analysis revealed that eWOM and Perceived Benefits positively and significantly impact consumer household electronic products purchase intention on online platforms. Among the predictors, eWOM had the strongest effect on the purchase intention towards consumer household electronic products on online platforms. The study outcomes give vital insights regarding the impact of various factors influencing consumer household electronic product purchase intention on online platforms. Google forms were used and distributed to the invitees asking them to fill data voluntarily. All respondents were promised confidentiality for their personal information. Perceived Risks were adapted from 19, and three items of Perceived eWOM were modified and taken to suit the current. Three items of Perceived price were adapted from.

Selective ER-β agonists alleviate neuronal deficits in insulin-resistant estrogen-deficient rats

OBJECTIVE

The present study aimed to determine the effect of estrogen receptor (ER) agonists on depression and memory impairment in insulin-resistant ovariectomized (OVX) rats.

METHODS

Rats underwent bilateral ovariectomy, and low-dose streptozotocin (STZ) and a high-fat diet (58% fat, 25% protein, and 17% carbohydrates as a percentage of kilocalories) were administered to induce an estrogen-deficient insulin-resistant state. After 1 week of STZ administration, rats were treated with 17β-estradiol (17βE2) and selective ER-α (propylpyrazoletriol) and ER-β (diarylpropionitrile) agonists (10 μg/kg subcutaneously). Memory was evaluated using the Morris water maze and depression using the forced swim test.

RESULTS

Treatment with selective ER-β agonist and 17βE2 but not with selective ER-α agonist significantly modulated the neurobehavioral deficits in insulin-resistant OVX rats. These neurobehavioral parameters were further correlated with brain-derived neurotrophic factor (BDNF) levels and acetylcholinesterase (AChE) activity. Selective ER-β agonist and 17βE2 significantly modulated BDNF levels and AChE activity in insulin-resistant OVX rats. Significant increases in estradiol and uterine weight were observed in 17βE2-treated rats, but selective ER agonists did not show any effect.

CONCLUSION

ER-β agonist can be an effective strategy for the mitigation of memory loss and depression in an estrogen-deficient insulin-resistant state without all of the deleterious feminizing effects that occur with the use of 17βE2.

SUN-286 Growth Hormone Deficiency and Gingival Fibromatosis Due to Missense Mutation of KCNQ1

Background: Multiple genes have been implicated in the genetic etiology of growth hormone deficiency (GHD) including genes that contribute to hypothalamus and pituitary development. Mutations of these genes can be associated with additional pituitary hormone deficiencies and developmental abnormalities. KCNQ1 gene encodes the alpha subunit of the voltage-gated ion channel Kv7.1, which has been previously implicated in cardiac arrhythmia syndromes. In 2017, two missense mutations, c.347G>T p.(Arg116Leu) or c.1106C>T p.(Pro369Leu), in KCNQ1 were reported for the first time in three unrelated families causing GHD and maternally inherited gingival fibromatosis (GF) (1). Members of these families displayed variable phenotypes including GHD, multiple pituitary hormone deficiencies, small pituitary on MRI, GF, craniofacial dysmorphic features, and short QT syndrome. Many had hypogonadotropic hypogonadism. Clinical Case: 9 year old male was referred to pediatric endocrinology for short stature and slow growth. He maintained height around 6%ile (Z=-1.55) until the age of 9 years with subsequent slowing to 0.95%ile (Z=-2.34). He had history of significant gingival hyperplasia requiring 5 surgical interventions in the past. He has done well developmentally. No history of cardiac arrhythmia. Physical exam showed coarse facial features and normal pre-pubertal genitalia. Family history was negative for short stature, arrhythmia, gingival hyperplasia, or coarse facial features. Studies showed delayed bone age of 6 years, low IGF-1 of 57 ng/ml, max growth hormone level of only 3 ng/ml on Arginine-Glucagon tolerance test, and normal other pituitary hormones. EKG and MRI of brain and pituitary were normal. Given his coarse facial features and gingival problem, he had a detailed work up for lysosomal storage disorders with negative results. Whole exome sequencing showed a missense variant in the maternal KCNQ1 gene denoted as c.1106C>T p.(Pro369Leu). Neither of his parents were found to have this KCNQ1 variant. He was started on growth hormone therapy with appropriate catchup growth. He was noticed 9 months later to have pubertal changes with testicular volume of 4-5 ml, LH 1.1 mIU/ml, and testosterone level of 98 ng/dl. Conclusion: To our knowledge, this is the first case of GHD and GF due to KCNQ1 mutation to be reported in the United States. Our patient had many unique features in contrast to previous report including lack of identified parental mutation, lack of clinical features in the family and early puberty indicating that there is still more to learn about clinical spectrum of KCNQ1 mutations in children. Reference: (1) Two missense mutations in KCNQ1 cause pituitary hormone deficiency and maternally inherited gingival fibromatosis. J.Tommiska et al, Nat Commun. 2017 Nov 3;8(1):1289.

An integrated genomic profile that includes copy number alterations is highly predictive of minimal residual disease status in childhood precursor B-lineage acute lymphoblastic leukemia

INTRODUCTION

Copy number alterations (CNA) have been described in childhood precursor B-lineage acute lymphoblastic leukemia (B-ALL) which in conjunction with chromosomal abnormalities drive leukemogenesis. There is no consensus on the clinical incorporation of CNA in B-ALL. An integrated genomic classification (IGC) has been proposed which includes CNA and cytogenetics.

METHODS

We correlated this IGC with immunophenotypic minimal residual disease (MRD) as well as other standard criteria for 245 patients of B-ALL such as National Cancer Institute (NCI) risk, D+8 prednisolone response, cytogenetics, and ploidy status.

RESULTS

MRD was detectable in 81 patients (33.1%). The most common abnormalities were seen in CDKN2A/B (25.7%) followed by PAX5(20%), ETV6(16.7%), IKZF1(15.5%), Rb1(5.3%), BTG (3.3%), EBF1(2.0%), and PAR1(0.8%). On integrating CNA into the IGC, 170 patients (69.4%) were classified into good genomic risk (GEN-GR) whereas 75 (30.6%) belonged to the poor genomic risk (GEN-PR) category. The IGC showed a significant correlation with MRD and NCI risk. The presence of CNA predicted MRD clearance in intermediate cytogenetics group.

CONCLUSION

These data seem to indicate that in addition to cytogenetics, CNA should be incorporated into routine clinical testing and risk algorithms for B-ALL. The IGC is of prognostic relevance and offers an additional avenue for prognostication and risk-adapted therapy.

Curcumin loaded solid lipid nanoparticles ameliorate adjuvant-induced arthritis in rats

BACKGROUND

Rheumatoid arthritis (RA), a chronic and systemic inflammation, results in destruction of joints and cartilages. Effectiveness of curcumin has been established in a wide variety of inflammatory disorders, but its utility as a therapeutic agent is limited by its poor absorption, rapid metabolism and fast systemic elimination. To apprehend these limitations, we propose to use highly bioavailable curcumin loaded solid lipid nanoparticles (C-SLNs) for the treatment of RA.

METHODS

In the present study, the protective effect of curcumin and its SLNs was evaluated in complete Freund's adjuvant (CFA)-induced arthritis in rats.

RESULTS

Arthritic rats exhibited marked decrease in paw withdrawal threshold in Randall-Selitto and von Frey hair test along with decreased reaction time in hot plate. Arthritic rats also showed significant joint hyperalgesia, joint stiffness and increased paw volume along with marked decrease in mobility score. Arthritic rats showed a significant increase in blood leukocyte count, oxidative-nitrosative stress, tumour necrosis factor-α, C-reactive protein, cyclic citrullinated peptide antibody levels and radiological alterations in tibiotarsal joint. C-SLN administration (10 and 30 mg/kg), when compared with free curcumin (10 and 30 mg/kg), significantly and dose dependently ameliorated various symptoms of arthritis in rats, improved biochemical markers and preserved radiological alterations in joints of arthritic rats.

CONCLUSIONS

The current findings suggest the protective potential of curcumin-SLNs in ameliorating CFA-induced arthritis in rats through attenuation of oxido-inflammatory and immunomodulatory cascade. Further, the results emphasize that SLNs are a novel approach to deliver curcumin into the inflamed joints and improve its biopharmaceutical performance.

Effect of sesamol on the pathophysiological changes induced by surgical menopause in rodents

OBJECTIVE

Estrogen deprivation after menopause is associated with increased oxidative stress. The present study was designed to study the role of sesamol (3,4-methylenedioxyphenol), a phenolic antioxidant and anti-inflammatory molecule, in oxidative stress-induced changes in three major affected organ systems, the central nervous system, the cardiovascular system and the skeletal system in ovariectomized rats, a widely used animal model of menopause.

DESIGN

Animals were divided into eight different groups (n = 6-8). Five groups underwent ovariectomy; starting from the 2nd day of ovariectomy, three of these groups received sesamol (2, 4, 8 mg/kg) and the fourth group was administered α-tocopherol (100 mg/kg) orally for 7 weeks. The fifth ovariectomized group did not receive any drug treatment. Rats in the naïve (non-operated) and sham-operated groups did not receive any drug treatment, while the eighth group consisted of naïve animals which were treated for 7 weeks with only sesamol 8 mg/kg orally daily. After 7 weeks, animals were subjected to testing of behavioral paradigms (elevated plus maze and Morris water maze for assessment of anxiety and memory, respectively) 24 h after the last dose. After behavioral studies, animals were sacrificed for various biochemical estimations.

RESULT

Administration of sesamol (2, 4, 8 mg/kg orally) to ovariectomized rats for 7 weeks significantly and dose-dependently improved memory, attenuated anxiety, decreased oxidative stress in brain, improved the serum lipid profile and reduced serum tumor necrosis factor-α levels when compared with ovariectomized control rats. Similar protective effects were observed in the case of the skeletal system studies. Sesamol increased the bone ash content and the mechanical stress parameters in treated groups.

CONCLUSION

The results emphasize the involvement of oxidative stress and inflammation in the development of ovariectomy-induced pathophysiological changes and point towards the therapeutic potential of sesamol in menopausal pathologies.

Role of Lactobacillus acidophilus loaded floating beads in chronic fatigue syndrome: behavioral and biochemical evidences

BACKGROUND

  In recent years the interface between neuropsychiatry and gastroenterology has converged in to a new discipline referred to as enteric neuroscience. Implications of brain-gut communication in the pathogenesis of psychiatric disorders indicate a possible role of suitably packaged/delivered probiotics as newer therapeutic options. In the present study probable role of per-oral administration of free Lactobacillus acidophilus (LAB) and LAB loaded alginate beads in attenuation of the symptoms associated with chronic fatigue syndrome (CFS) were evaluated.

METHODS

  Chronic fatigue syndrome following physical fatigue was induced in rats by forcing them to swim (forced swim test; FST) in water till exhaustion, after weighing them down with 10% their body weight, daily for 28 days. Immobility (I) and postswim fatigue time (PSF) were taken as suitable markers. Free LAB and LAB loaded floating beads (FBs) were administered, from 21 to 28 days.

KEY RESULTS

  Immobility and PSF were found to increase considerably in FST rats (665 ± 22 s and 196 ± 6 s) as compared with the naïve (32 ± 7 s and 22 ± 2 s) at 20 days, establishing severe fatigue like behavior. FST control group exhibited significant (P < 0.05) hypertrophy of spleen, hypotrophy of thymus, and increased oxido-nitrosative stress in brain and tumor necrosis factor-α (TNF-α) levels in serum. Treatment with LAB and LAB FBs significantly decreased I and PSF and attenuated (P < 0.05) oxido-nitrosative stress and TNF-α levels. Spleen and thymus were also restored to their original size in this group.

CONCLUSIONS & INFERENCES

  The findings suggest a valuable therapeutic role of LAB especially when incorporated into alginate beads for the treatment of CFS.

Curcumin ameliorates reserpine-induced pain-depression dyad: behavioural, biochemical, neurochemical and molecular evidences

An apparent clinical relationship between pain and depression has long been recognized. Depression and pain are often diagnosed in the same patients. The emerging concept for pain-depression pathogenesis is the dysfunction of biogenic amine-mediated pain-depression control and the possible involvement of nitrodative stress-induced neurogenic inflammation. The present study was designed to investigate the effect of curcumin on reserpine-induced pain-depression dyad in rats. Administration of reserpine (1mg/kg subcutaneous daily for three consecutive days) led to a significant decrease in nociceptive threshold as evident from reduced paw withdrawal threshold in Randall Sellitto and von-Frey hair test as well as significant increase in immobility time in forced swim test. This behavioural deficit was integrated with decrease in the biogenic amine (dopamine, norepinephrine and serotonin) levels along with increased substance P concentration, nitrodative stress, inflammatory cytokines, NF-κβ and caspase-3 levels in different brain regions (cortex and hippocampus) of the reserpinised rats. Curcumin (100, 200, 300mg/kg; ip) dose dependently ameliorated the behavioural deficits associated with pain and depression by restoring behavioural, biochemical, neurochemical and molecular alterations against reserpine-induced pain-depression dyad in rats.

Hyperglycemia-induced alterations in synaptosomal membrane fluidity and activity of membrane bound enzymes: beneficial effect of N-acetylcysteine supplementation

Diabetic encephalopathy is characterized by impaired cognitive functions that appear to underlie neuronal damage triggered by glucose driven oxidative stress. Hyperglycemia-induced oxidative stress in diabetic brain may initiate structural and functional changes in synaptosomal membranes. The objective of the present study was to examine the neuroprotective role of N-acetylcysteine (NAC) in hyperglycemia-induced alterations in lipid composition and activity of membrane bound enzymes (Na(+),K(+)-ATPase and Ca(2+)-ATPase) in the rodent model of type 1 diabetes. Male Wistar rats weighing between 180 and 200 g were rendered diabetic by a single injection of streptozotocin (50 mg/kg body weight, i.p.). The diabetic animals were administered NAC (1.4-1.5 g/kg body weight) for eight weeks and lipid composition along with membrane fluidity were determined. A significant increase in lipid peroxidation was observed in cerebral cortex of diabetic rats. NAC administration on the other hand lowered the hyperglycemia-induced lipid peroxidation to near control levels. The increased lipid peroxidation following chronic hyperglycemia was accompanied by a significant increase in the total lipids which can be attributed to increase in the levels of cholesterol, triglycerides and glycolipids. On the contrary phospholipid and ganglioside levels were decreased. Hyperglycemia-induced increase in cholesterol to phospholipid ratio reflected decrease in membrane fluidity. Fluorescence polarization (p) with DPH also confirmed decrease in synaptosomal membrane fluidity that influenced the activity of membrane bound enzymes. An inverse correlation was found between fluorescence polarization with the activities of Na(+),K(+)-ATPase (r(2)=0.416, P<0.05) and Ca(2+) ATPase (r(2)=0.604, P<0.05). NAC was found to significantly improve lipid composition, restore membrane fluidity and activity of membrane bound enzymes. Our results clearly suggest perturbations in lipid composition and membrane fluidity as a major factor in the development of diabetic encephalopathy. Furthermore, NAC administration ameliorated the effect of hyperglycemia on oxidative stress and alterations in lipid composition thereby restoring membrane fluidity and activity of membrane bound enzymes.

Medical therapy for rheumatic heart disease: is it time to be proactive rather than reactive?

Rheumatic Heart Disease (RHD) is well known to be an active inflammatory process which develops progressive calcification and leaflet thickening over time. The potential for statin therapy in slowing the progression of valvular heart disease is still controversial. Retrospective studies have shown that medical therapy is beneficial for patients with calcific aortic stenosis and recently for rheumatic valve disease. However, the prospective randomized clinical trials have been negative to date. This article discusses the epidemiologic risk factors, basic science, retrospective and prospective studies in valvular heart disease and a future clinical trial to target RHD with statin therapy to slow the progression of this disease. Recent epidemiological studies have revealed the risk factors associated with valvular disease include male gender, smoking, hypertension and elevated serum cholesterol and are similar to the risk factors for vascular atherosclerosis. An increasing number of models of experimental hypercholesterolemia demonstrate features of atherosclerosis in the aortic valve (AV), which are similar to the early stages of vascular atherosclerotic lesions. Calcification, the end stage process of the disease, must be understood as a prognostic indicator in the modification of this cellular process before it is too late. This is important in calcific aortic stenosis as well as in rheumatic valve disease. There are a growing number of studies that describe similar pathophysiologic molecular markers in the development of rheumatic valve disease as in calcific aortic stenosis. In summary, these findings suggest that medical therapies may have a potential role in patients in the early stages of this disease process to slow the progression of RHD affecting the valves. This review will summarize the potential for statin therapy for this patient population.

Possible role of male factors in recurrent pregnancy loss

To evaluate various causes possibly contributing towards recurrent pregnancy loss (RPL), particularly male factors. Prospective study of 75 couples with history of RPL who were investigated for genetic, anatomic, immunological, infective and systemic causes in both partners. Functional sperm capacity was assessed by the Hypo-osmotic swelling test (HOS), Acrosomal Reaction (AR), Nuclear condensation-decondensation test (NCD) and Seminal Total Leukocyte Count (TLC) along with semen analysis. Twenty male volunteers with recently proven fertility were also included for detailed sperm morphology and sperm functions test as controls. Amongst male partners 3 (4%) had varicocele, 23 (30.6%) had infection, 1 (1.3%) immunological and 1 (1.3%) had genetic abnormality. Sperm motility, viability and sperm function tests were significantly lower in the RPL group as compared to the control group (P = 0.000). Male factor might be a possible contributing factor towards RPL. Both the partners should be evaluated and treated simultaneously in order to achieve desirable outcome.

Neurochemical changes associated with chronic administration of typical antipsychotics and its relationship with tardive dyskinesia

The therapeutic success of atypical antipsychotics has focused the attention on the role of receptor systems other than dopaminergic system in the pathophysiology of neuroleptic-associated extrapyramidal side effects such as tardive dyskinesia. In the present study we planned to study time-dependent changes in extracellular levels of norepinephrine, dopamine and serotonin in cortical and subcortical (including striatum) regions of brain and tried to correlate them with hyperkinetic motor activities (vacuous chewing movements [VCMs], tongue protrusions and facial jerking) in rats treated chronically with typical neuroleptics (haloperidol and chlorpromazine). Chronic administration of haloperidol (1 mg/kg) and chlorpromazine (5 mg/kg) resulted in a time-dependent increase in orofacial hyperkinetic movements. There were also significant changes in the extracellular levels of different neurotransmitters in different brain regions (cortical and subcortical regions) as measured by high-performance liquid chromatography/electrochemical detection (HPLC/ED). Both haloperidol and chlorpromazine produced time-dependent decreases in the levels of these neurotransmitters.

Assessment of the variation in menopausal symptoms with age, education and working/non-working status in north-Indian sub population using menopause rating scale (MRS)

OBJECTIVE

To study the variation of the menopause rating scale (MRS) scores with age, working/non-working and educated/uneducated status in a cohort of north-Indian subpopulation and to look for the possible reasons for the incurred variations. MRS is a well-known and validated instrument for assessing the frequency and intensity of menopausal symptoms.

METHOD

A menopause clinic was organized in collaboration with a primary care centre (under the guidance of a gynecologist). A random sample of 208 women aged 35-65 years participated in the study. The MRS scale, a self-administered standardized questionnaire was applied with additional patient related information (age at menopause, level of education, working/non-working and exercising or not).

RESULTS

The results were evaluated for psychological (P), somatic (S), and urogenital (U) symptoms. The average age at which menopause set in, in the cohort was found to be 48.7+/-2.3 years (46.4-51 years). Based on the average age at the menopause, the cohort was divided into peri (35-45), menopausal/early menopause (46-51) and the postmenopausal (52-65) groups. A significantly higher % of perimenopausal women (36%) showed a P score of > or =7; while a higher % of postmenopausal showed S score and U score > or =7 (>40%; p< or =0.001). Working women seem to suffer more from psychological symptoms whereas non-working women showed a greater incidence of somatic symptoms. Educated women showed a lower incidence of psychological and somatic symptoms.

CONCLUSIONS

Present study indicates that age, level of education and working/non-working status (in a group of women with same socio-cultural background) may also contribute to significant variations in menopausal symptoms.

Resveratrol and curcumin suppress immune response through CD28/CTLA-4 and CD80 co-stimulatory pathway

The role of resveratrol and curcumin is well documented in cancer, inflammation, diabetes and various other diseases. However, their immunosuppressive action on T cells, B cells and macrophages is not well documented. In the present study, we have ascertained the effect of resveratrol and curcumin on T and B cells and macrophages. The most striking findings were that both resveratrol and curcumin suppressed the activity of T and B cells and macrophages, as evidenced by significant inhibition in proliferation, antibody production and lymphokine secretion. Interestingly, curcumin imparted immunosuppression by mainly down-regulating the expression of CD28 and CD80 and up-regulating CTLA-4. Resveratrol also functioned by decreasing the expression of CD28 and CD80, as well as by augmenting the production of interleukin (IL)-10.

Inhibition of oxidative stress and cytokine activity by curcumin in amelioration of endotoxin-induced experimental hepatoxicity in rodents

The present study is aimed at investigating the effect of curcumin (CMN) in salvaging endotoxin-induced hepatic dysfunction and oxidative stress in the liver of rodents. Hepatotoxicity was induced by administering lipopolysaccharide (LPS) in a single dose of 1 mg/kg intraperitoneally to the animals, which were being treated with CMN daily for 7 days. Liver enzymes serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST) and alkaline phosphatase (ALP), total bilirubin and total protein were estimated in serum. Oxidative stress in liver tissue homogenates was estimated by measuring thiobarbituric acid reactive substances (TBARS), glutathione (GSH) content and superoxide dismutase (SOD) activity. Serum and tissue nitrite was estimated using Greiss reagent and served as an indicator of NO production. A separate set of experiments was performed to estimate the effect of CMN on cytokine levels in mouse serum after LPS challenge. LPS induced a marked hepatic dysfunction evident by rise in serum levels of ALT, AST, ALP and total bilirubin (P < 0.05). TBARS levels were significantly increased, whereas GSH and SOD levels decreased in the liver homogenates of LPS-challenged rats. CMN administration attenuated these effects of LPS successfully. Further CMN treatment also regressed various structural changes induced by LPS in the livers of rats and decreased the levels of tumour necrosis factor-alpha and interleukin-6 in mouse plasma. In conclusion, these findings suggest that CMN attenuates LPS-induced hepatotoxicity possibly by preventing cytotoxic effects of NO, oxygen free radicals and cytokines.

Rhabdomyolysis

Rhabdomyolysis is a condition caused by skeletal muscle injury and release of muscle cell contents into the circulation. It may result in myoglobinuria, the filtration of myoglobin into the urine, and is often associated with acute renal failure (ARF). Rhabdomyolysis may complicate many disease states. In some, such as crush injury, muscle injury is obvious; in others, such as drug overdose, it may never be apparent. It may occur in the setting of an altered mental status, and even in the conscious patient, it may occur with minimal symptoms or physical findings. Therefore, diagnosis requires a high level of suspicion and appropriate sensitivity to abnormal laboratory values. Many insults can precipitate rhabdomyolysis and myoglobinuria. Disruption of the muscle cell membrane may result from a direct mechanical or toxic insult to the membrane or an inability to maintain ionic gradients across the membrane (as in ischemia or extreme exertion). This article reviews the etiology, pathogenesis, clinical features, complications, and management of rhabdomyolysis, particularly crush injuries in the setting of a major disaster.

Evidence of the role of angiotensin AT1 receptors in remote renal preconditioning of myocardium

The underlying mechanisms of myocardial preconditioning after a brief period of renal ischemia-reperfusion are unknown. The phenomenon itself and the involvement of AT(1) angiotensin receptors was therefore investigated using an in vivo rat model of acute myocardial infarction. Anesthetized rats underwent a left thoracotomy and pericardiotomy. A laparotomy was performed to expose the left renal artery. Animals were then preconditioned with four episodes, each consisting of 5 min of renal artery occlusion followed by 10 min of reperfusion, or underwent a 60 min sham period of anesthesia. Subsequently, the left coronary artery was occluded for 30 min and reperfused for 2 h. Area at risk and infarct size was estimated along with hemodynamic and temperature data recording. The infarct-to-risk ratio was limited from 56.36 +/- 2.36 and 50.65 +/- 4.71 in control to 12.0 +/- 0.48 and 12.57 +/- 0.44 in preconditioned hearts, by volume and weight methods. The protective effect of renal preconditioning on the myocardium was not abolished by losartan 1 mg/kg (10.11 +/- 0.12 and 11.2 +/- 1.4) pretreatment whereas it was completely attenuated by losartan 5 mg/kg (46.5 +/- 1.0 and 47.8 +/- 1.4) administration. Thus we can infer that angiotensin AT(1) receptors participate in renal preconditioning of the myocardium in in vivo rat hearts.