1
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Gaul S, Shahzad K, Medert R, Gadi I, Maeder C, Schumacher D, Wirth A, Fatima S, Boeckel JN, Khawaja H, Brune M, Nawroth PP, Isermann B, Laufs U, Freichel M. A novel direct inducible nongenetic murine model of diabetes-aggravated atherosclerosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aims
Atherosclerosis, the main pathology underlying cardiovascular diseases is accelerated in diabetic patients (1,2). Genetic mouse models require breeding efforts which are time-consuming and costly. Our aim was to establish a new nongenetic model of inducible metabolic risk factors that mimics hyperlipidemia, hyperglycemia, or both and allows the detection of phenotypic differences dependent on the metabolic stressor(s) on any genetic background.
Methods and results
Wild type mice were injected with gain-of-function PCSK9D377Y (proprotein convertase subtilisin/kexin type 9) mutant adeno-associated viral particles (AAV) and streptozotocin (STZ) and fed either a high-fat diet (HFD) or high-cholesterol/high fat-diet (Paigen diet, PD) for 12 and 20 weeks. LDLR KO mice were used as reference control. Combined hyperlipidemic and hyperglycemic mice (HGHCi), but not hyperlipidemia (HCi) alone, displayed characteristic features of aggravated atherosclerosis characterized by larger and less stable plaques (necrotic core area in HGHCi HFD: 24% vs HCi HFD: 13% vs LDLR KO HFD: 18% area, at 20 weeks p<0.05; fibrous cap thickness in HGHCi: 13 μm vs HCi HFD: 23 μm vs LDLR KO HFD: 17 μm, at 20 weeks, p<0.05) which contained more macrophages (MOMA-2 in HGHCi HFD: 27% vs HCi HFD: 19% vs LDLR KO HFD: 46% area/plaque, at 20 weeks, p<0.05) and less smooth muscle cells (α-SMA in HGHCi HFD: 12% vs HCi HFD: 25% vs LDLR KO HFD: 18% area/plaque, at 20 weeks, p<0.05), on both HFD or PD diet. Diabetic atherosclerotic mice (HGHCi) fed a HFD showed 37% plaque area (of total lumen) compared to 16% plaque area in non-diabetic mice (HCi HFD) and 17% in LDLR KO HFD after 12 weeks; and 43% (HGHCi HFD) vs. 29% (HCi HFD) vs 39% plaque area (LDLR KO HFD) after 20 weeks (Figure 1A, B). Differences between the diabetic HGHCi and non-diabetic HCi HFD mice were confirmed using RNA-seq analysis of aortic tissue, revealing that significantly more genes were dysregulated in mice with combined hyperlipidemia and hyperglycemia than in the hyperlipidemia-only group. The HGHCi-associated genes were related to pathways regulating inflammation (increased Cd68, iNos, and Tnfa expression) and extracellular matrix degradation (Adamts4 and Mmp14) (Figure 1C). When comparing HFD with PD, the PD aggravated atherosclerosis to a greater extent in mice and showed plaque formation after 8 weeks (HGHCi PD: 48% plaque area vs. HCi PD: 30% plaque area), therefore, representing a direct inducible hyperglycemic atherosclerosis model compared with HFD-fed mice, in which atherosclerosis is severe by 8 weeks.
Conclusion
We established a nongenetic direct inducible mouse model of diabetes-aggravated atherosclerosis allowing comparative analyses of atherosclerosis in diabetic and non-diabetic conditions and its modification by diet, allowing analyses of multiple metabolic hits in mice.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Deutsche Forschungsgemeinschaft (DFG)
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Affiliation(s)
- S Gaul
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - K Shahzad
- University Hospital Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostic , Leipzig , Germany
| | - R Medert
- University of Heidelberg, Institute of Pharmacology , Heidelberg , Germany
| | - I Gadi
- University Hospital Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostic , Leipzig , Germany
| | - C Maeder
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - D Schumacher
- University of Heidelberg, Institute of Pharmacology , Heidelberg , Germany
| | - A Wirth
- University of Heidelberg, Institute of Pharmacology , Heidelberg , Germany
| | - S Fatima
- University Hospital Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostic , Leipzig , Germany
| | - J N Boeckel
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - H Khawaja
- University Hospital Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostic , Leipzig , Germany
| | - M Brune
- University of Heidelberg, Internal Medicine I and Clinical Chemistry , Heidelberg , Germany
| | - P P Nawroth
- University of Heidelberg, Internal Medicine I and Clinical Chemistry , Heidelberg , Germany
| | - B Isermann
- University Hospital Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostic , Leipzig , Germany
| | - U Laufs
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - M Freichel
- University of Heidelberg, Institute of Pharmacology , Heidelberg , Germany
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2
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Hemmer CJ, Bierhaus A, Riedesel JV, Gabat S, Liliensiek B, Pitronik P, Lin J, Grauer A, Amiral J, Ziegler R, Schieffer S, Kern P, Seitz R, Egbring R, Dietrich M, Nawroth PP. Elevated Thrombomodulin Plasma Levels as a Result of Endothelial Involvement in Plasmodium falciparum Malaria. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648889] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryWe used thrombomodulin (TM) to assess the participation of the vascular endothelium in human Plasmodium falciparum (P. F.) malaria. Before therapy TM plasma levels were elevated in P. F. malaria and fell to normal values during therapy. Parasitemia, TNFα, elastase and TAT levels correlated directly with TM. Elevated TM levels can not be explained by increased synthesis, since incubating HUVEC with pretherapy serum of patients with P. F. malaria, but not reconvalescence serum, suppressed TM transcription. This was partially prevented by adding a TNFα neutralizing antibody to patient serum before incubation with HUVEC. However, TNFα does not release TM from cultured HUVEC in vitro. Coincubation of HUVEC with pretherapy serum together with neutrophils resulted in endothelial cell destruction, which could be partly prevented by a TNFα neutralizing antibody. Hence the increase of TM during P. F. malaria might reflect the concerted action of cytokines and neutrophils on HUVEC.
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Affiliation(s)
- Christoph J Hemmer
- The Department of Medicine, Bernhard-Nocht-lnstitute for Tropical Medicine, Hamburg, Germany
| | - A Bierhaus
- Department of Medicine, University of Heidelberg, Germany
| | - J v Riedesel
- Department of Medicine, University of Heidelberg, Germany
| | - S Gabat
- Department of Medicine, University of Heidelberg, Germany
| | - B Liliensiek
- Department of Medicine, University of Heidelberg, Germany
| | - P Pitronik
- Department of Medicine, University of Heidelberg, Germany
| | - J Lin
- Department of Medicine, University of Heidelberg, Germany
| | - A Grauer
- Department of Medicine, University of Heidelberg, Germany
| | - J Amiral
- SERBIO Research Laboratories, Gennevilliers, France
| | - R Ziegler
- Department of Medicine, University of Heidelberg, Germany
| | - S Schieffer
- Infectious Diseases and Clinical Immunology Section, University of Ulm
| | - P Kern
- Infectious Diseases and Clinical Immunology Section, University of Ulm
| | - R Seitz
- Department of Hematology, Hemostaseology Section, University of Marburg, Germany
| | - R Egbring
- Department of Hematology, Hemostaseology Section, University of Marburg, Germany
| | - M Dietrich
- The Department of Medicine, Bernhard-Nocht-lnstitute for Tropical Medicine, Hamburg, Germany
| | - P P Nawroth
- Department of Medicine, University of Heidelberg, Germany
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3
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Bierhaus A, Hemmer CJ, Mackman N, Kutob R, Ziegler R, Dietrich M, Nawroth PP. Antiparasitic Treatment of Patients with P. falciparum Malaria Reduces the Ability of Patient Serum to Induce Tissue Factor by Decreasing NF-κB Activation. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1653723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummarySerum from patients with P. falciparum malaria at day 1 (pretherapy) induces tissue factor (TF) in cultured endothelial cells. TF induction depends on de novo transcription as shown in Nuclear Run On assays. Electrophoretic mobility shift assays demonstrated binding of AP-1 and NF- κB/Rel proteins to their recognition sites in the TF promotor. After therapy (day 28), stimulation of TF antigen by patient serum is reduced by 70%. When serum obtained before and after therapy was compared, a decrease of NF-κB activation was evident. Activation of NF-κB-like proteins was in part dependent on TNFα in patient serum, since a TNFα neutralizing antibody reduced induction of TF transcription and translation and induction of NF-κB-like proteins. Induction of TF activity was suppressed by pDTC, an inhibitor of NF-κB activation. When different promotor constructs of the TF gene were tested, induction was dependent upon the presence of the intact NF-κB-like binding site in the TF promotor. A mutant with deleted NF-κB, but intact AP-1 sites was not inducible. Mutation of the AP-1 sites did not prevent induction, but reduced inducibility by pretherapy serum. Therefore, NF-κB/Rel proteins are responsible for induction of TF transcription by pretherapy serum, but AP-1 is needed for highest inducibility. The effect of antiparasitic therapy on the induction of TF by serum from patients with complicated P. falciparum malaria is dependent on a therapy-mediated loss of activation of NF-κB-like proteins in post-treatment patient serum.
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Affiliation(s)
- A Bierhaus
- The Dept. of Medicine I, Univ. of Heidelberg, Germany
| | - Ch J Hemmer
- The Dept. of Medicine, Bernhard Nocht Inst. for Tropical Medicine, Hamburg, Germany
| | - N Mackman
- The Dept. of Immunol., Scripps Res. Clinic, La Jolla, USA
| | - R Kutob
- The Dept. of Medicine, Bernhard Nocht Inst. for Tropical Medicine, Hamburg, Germany
| | - R Ziegler
- The Dept. of Medicine I, Univ. of Heidelberg, Germany
| | - M Dietrich
- The Dept. of Medicine, Bernhard Nocht Inst. for Tropical Medicine, Hamburg, Germany
| | - P P Nawroth
- The Dept. of Medicine I, Univ. of Heidelberg, Germany
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4
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Groener JB, Jende J, Kurz F, Kender Z, Nawroth PP, Bendszus M, Kopf S. Der klinische Einfluss hyperintenser T2-Läsionen im MRT peripherer Nerven bei diabetischer Polyneuropathie. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- JB Groener
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - J Jende
- Neurologische Universitätsklinik Heidelberg, Abteilung für Neuroradiologie, Heidelberg, Germany
| | - F Kurz
- Neurologische Universitätsklinik Heidelberg, Abteilung für Neuroradiologie, Heidelberg, Germany
| | - Z Kender
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - PP Nawroth
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - M Bendszus
- Neurologische Universitätsklinik Heidelberg, Abteilung für Neuroradiologie, Heidelberg, Germany
| | - S Kopf
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
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5
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Kender Z, Groener JB, Masjkur JR, Bischoff S, Pflästerer A, Hagedorn-Dambuk A, Nawroth PP, Kopf S. Diabetische sensomotorische Neuropathie der Hände bei Patienten mit Diabetes mellitus Typ 2. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Z Kender
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - JB Groener
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - JR Masjkur
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - S Bischoff
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - A Pflästerer
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - A Hagedorn-Dambuk
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - PP Nawroth
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - S Kopf
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
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6
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Billeter AT, Scheurlen KM, Probst P, Eichel S, Nickel F, Kopf S, Fischer L, Diener MK, Nawroth PP, Müller-Stich BP. Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus. Br J Surg 2018; 105:168-181. [DOI: 10.1002/bjs.10724] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Abstract
Background
This study aimed to examine the effect of metabolic surgery on pre-existing and future microvascular complications in patients with type 2 diabetes mellitus (T2DM) in comparison with medical treatment. Although metabolic surgery is the most effective treatment for obese patients with T2DM regarding glycaemic control, it is unclear whether the incidence or severity of microvascular complications is reduced.
Methods
A systematic literature search was performed in MEDLINE, Embase, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) with no language restrictions, looking for RCTs, case–control trials and cohort studies that assessed the effect of metabolic surgery on the incidence of microvascular diabetic complications compared with medical treatment as control. The study was registered in the International prospective register of systematic reviews (CRD42016042994).
Results
The literature search yielded 1559 articles. Ten studies (3 RCTs, 7 controlled clinical trials) investigating 17 532 patients were included. Metabolic surgery reduced the incidence of microvascular complications (odds ratio 0·26, 95 per cent c.i. 0·16 to 0·42; P < 0·001) compared with medical treatment. Pre-existing diabetic nephropathy was strongly improved by metabolic surgery versus medical treatment (odds ratio 15·41, 1·28 to 185·46; P = 0·03).
Conclusion
In patients with T2DM, metabolic surgery prevented the development of microvascular complications better than medical treatment. Metabolic surgery improved pre-existing diabetic nephropathy compared with medical treatment.
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Affiliation(s)
- A T Billeter
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - K M Scheurlen
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - P Probst
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - S Eichel
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - F Nickel
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - S Kopf
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - L Fischer
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - M K Diener
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - P P Nawroth
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - B P Müller-Stich
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
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7
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Abstract
ZusammenfassungDie gleichzeitige Aktivierung der Immunantwort und des Gerinnungssystems nach Verletzung ist ein phylogenetisch altes, adaptives Prinzip, das bereits in frühen Entwicklungsstufen von Eukaryonten beobachtet wird. Die enge Verbindung von Gerinnung, Entzündung und Immunabwehr blieb während der Evolution erhalten und kann im Menschen bei zahlreichen physiologischen Reaktionen auf potenziell schädigende Einflüsse nachgewiesen werden.
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8
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Abstract
ZusammenfassungDie Verfügbarkeit von Mäusen mit genetischen Defekten des hämostatischen Systems (Knock-out- und transgene Mäuse) hat es ermöglicht, die Bedeutung des Gerinnungssystems für die Entwicklung des Embryos und der Plazenta zu charakterisieren. Dabei wurde die Funktion der Thrombozyten erst kürzlich experimental untersucht. Diese Studien haben neue Einblicke in die Funktion von Thrombozyten für die Reproduktion gegeben. Das Fehlen embryonaler Thrombozyten infolge einer genetischen Ablation des Transkriptionsfaktors NF-E2 führt zu einer embryonalen Wachstumsverzögerung und verminderten Vaskularisation der Plazenta. Ein maternaler Thrombozytenmangel ist mit Plazentablutungen assoziiert, die jedoch keinen Einfluss auf das Überleben des Embryos oder der Mutter haben. Thrombozyten oder thrombozytäre Mediatoren regulieren die invasiven Eigenschaften und den Phänotyp humaner extravillöser Trophoblastenzellen. Im Gegensatz hierzu sind Thrombozyten und Fibrinogen, und somit die Fähigkeit Thrombozyten-Fibrin-Aggregate zu bilden, für die embryonale Entwicklung nicht erforderlich. Diese Daten beweisen, dass Thrombozyten eine Funktion für die Plazentaentwicklung und/oder -funktion haben, wohingegen Thrombozyten nicht für die Entwicklung des Embryos selber erforderlich sind. Das bedeutet, dass die embryonale Letalität von Mäusen mit genetischen Gerinnungsdefekten nicht auf das Fehlen einer Thrombzyten-Fibrin-Interaktion zurückgeführt werden kann, und das Gerinnungssystem durch andere Mechanismen, z. B. Regulation der intrazellulären Signaltransduktion durch Protease-aktivierbare Rezeptoren (PARs), die Entwicklung des Embryos reguliert.
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9
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Nawroth PP, Bendszus M, Pham M, Jende J, Heiland S, Ries S, Schumann C, Schmelz M, Schuh-Hofer S, Treede RD, Kuner R, Oikonomou D, Groener JB, Kopf S. The Quest for more Research on Painful Diabetic Neuropathy. Neuroscience 2017; 387:28-37. [PMID: 28942323 DOI: 10.1016/j.neuroscience.2017.09.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/07/2017] [Accepted: 09/12/2017] [Indexed: 01/15/2023]
Abstract
A 62-year-old diabetologist diagnosed himself to have diabetes type-2, with an HbA1c of 9.5. Five months after lifestyle intervention and a multi-drug approach, HbA1c was 6.3, systolic blood pressure was below 135mmHg and BMI reduced to 27. But he suffered from severe painful diabetic neuropathy. Therefore he decided to visit his friend, a famous neuroscientist at an even more famous university. He asked him several plain questions: 1. What is the natural course of painful diabetic neuropathy? 2. Why do I have, despite almost normalizing HbA1c, more problems than before? 3. Are you sure my problems are due to diabetes or should we do a nerve biopsy? 4. Are there imaging techniques helpful for the diagnosis of this diabetic complication, starting in the distal nerve endings of the foot and slowly moving ahead? 5. Can you suggest any drug, specific and effective, for relieving painful diabetic neuropathy? This review will use the experts' answers to the questions of the diabetologist, not only to give a summary of the current knowledge, but even more to highlight areas of research needed for improving the fate of patients with painful diabetic neuropathy. Based on the unknowns, which exceed the knowns in diabetic neuropathy, a quest for more public support of research is made.
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Affiliation(s)
- P P Nawroth
- University Hospital Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany; German Center for Diabetes Research (DZD), Germany; Joint Heidelberg-IDC Translational Diabetes Program, Helmholtz-Zentrum, München, Germany.
| | - M Bendszus
- University Hospital Heidelberg, Department of Neuroradiology, Heidelberg, Germany
| | - M Pham
- University Hospital Würzburg, Department of Neuroradiology, Würzburg, Germany
| | - J Jende
- University Hospital Heidelberg, Department of Neuroradiology, Heidelberg, Germany
| | - S Heiland
- University Hospital Heidelberg, Department of Neuroradiology, Heidelberg, Germany
| | - S Ries
- Neuro Centrum Odenwald, Darmstadt, Germany
| | - C Schumann
- Neuro Centrum Odenwald, Darmstadt, Germany
| | - M Schmelz
- Department of Anesthesiology and Intensive Care Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - S Schuh-Hofer
- Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R D Treede
- Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R Kuner
- University of Heidelberg, Institute of Pharmacology, Heidelberg, Germany
| | - D Oikonomou
- University Hospital Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany
| | - J B Groener
- University Hospital Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany; German Center for Diabetes Research (DZD), Germany
| | - S Kopf
- University Hospital Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany; German Center for Diabetes Research (DZD), Germany
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10
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Wagner R, Machann J, Guthoff M, Nawroth PP, Nadalin S, Saleem MA, Heyne N, Königsrainer A, Fend F, Schick F, Fritsche A, Stefan N, Häring HU, Schleicher E, Siegel-Axel DI. The protective effect of human renal sinus fat on glomerular cells is reversed by the hepatokine fetuin-A. Sci Rep 2017; 7:2261. [PMID: 28536464 PMCID: PMC5442123 DOI: 10.1038/s41598-017-02210-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/06/2017] [Indexed: 02/06/2023] Open
Abstract
Renal sinus fat (RSF) is a perivascular fat compartment located around renal arteries. In this in vitro and in vivo study we hypothesized that the hepatokine fetuin-A may impair renal function in non alcoholic fatty liver disease (NAFLD) by altering inflammatory signalling in RSF. To study effects of the crosstalk between fetuin-A, RSF and kidney, human renal sinus fat cells (RSFC) were isolated and cocultured with human endothelial cells (EC) or podocytes (PO). RSFC caused downregulation of proinflammatory and upregulation of regenerative factors in cocultured EC and PO, indicating a protective influence of RFSC. However, fetuin-A inverted these benign effects of RSFC from an anti- to a proinflammatory status. RSF was quantified by magnetic resonance imaging and liver fat content by 1H-MR spectroscopy in 449 individuals at risk for type 2 diabetes. Impaired renal function was determined via urinary albumin/creatinine-ratio (uACR). RSF did not correlate with uACR in subjects without NAFLD (n = 212, p = 0.94), but correlated positively in subjects with NAFLD (n = 105, p = 0.0005). Estimated glomerular filtration rate (eGRF) was inversely correlated with RSF, suggesting lower eGFR for subjects with higher RSF (r = 0.24, p < 0.0001). In conclusion, our data suggest that in the presence of NAFLD elevated fetuin-A levels may impair renal function by RSF-induced proinflammatory signalling in glomerular cells.
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Affiliation(s)
- R Wagner
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - J Machann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany.,Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, University Hospital Tübingen, Tübingen, Germany
| | - M Guthoff
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
| | - P P Nawroth
- German Center for Diabetes Research (DZD), Neuherberg, Germany.,Department Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany
| | - M A Saleem
- Bristol Renal and Children's Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - N Heyne
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany
| | - F Fend
- Institute of Pathology and Neuropathology, University of Tübingen, Tübingen, Germany
| | - F Schick
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany.,Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, University Hospital Tübingen, Tübingen, Germany
| | - A Fritsche
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - N Stefan
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - H-U Häring
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - E Schleicher
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - D I Siegel-Axel
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany. .,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany. .,German Center for Diabetes Research (DZD), Neuherberg, Germany.
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Lodd E, She J, Fleming TH, Nawroth PP, Kroll J. Glo1-/- zebrafish mutants display differential susceptibility of vascular and renal systems. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- E Lodd
- Center for Biomedicine and Medical Technology Mannheim, Vascular Biology and Tumor Angiogenesis, Mannheim, Germany
| | - J She
- Center for Biomedicine and Medical Technology Mannheim, Vascular Biology and Tumor Angiogenesis, Mannheim, Germany
| | - TH Fleming
- Department of Medicine I and Clinical Chemistry, Heidelberg, Germany
| | - PP Nawroth
- Department of Medicine I and Clinical Chemistry, Heidelberg, Germany
| | - J Kroll
- Center for Biomedicine and Medical Technology Mannheim, Vascular Biology and Tumor Angiogenesis, Mannheim, Germany
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Groener JB, Cheko R, Kender Z, Oikonomou D, Kuner R, Magerl W, Treede RD, Jende J, Nawroth PP, Kopf S. Skin auto-fluorescence and impairment in thermal sensory testing in diabetes mellitus type 2. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- JB Groener
- Medizinische Klinik, Universitätsklinikum Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - R Cheko
- Medizinische Klinik, Universitätsklinikum Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - Z Kender
- Medizinische Klinik, Universitätsklinikum Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - D Oikonomou
- Medizinische Klinik, Universitätsklinikum Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - R Kuner
- Pharmakologisches Institut, Universität Heidelberg, Heidelberg, Germany
| | - W Magerl
- Centrum für Biomedizin und Medizintechnik, Medizinische Fakultät Mannheim, Neurophysiologie, Mannheim, Germany
| | - RD Treede
- Centrum für Biomedizin und Medizintechnik, Medizinische Fakultät Mannheim, Neurophysiologie, Mannheim, Germany
| | - J Jende
- Neurologische Klinik, Universitätsklinikum Heidelberg, Neuroradiologie, Heidelberg, Germany
| | - PP Nawroth
- Medizinische Klinik, Universitätsklinikum Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
| | - S Kopf
- Medizinische Klinik, Universitätsklinikum Heidelberg, Innere Medizin I Endokrinologie und Klinische Chemie, Heidelberg, Germany
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Kopf S, Höffgen M, Gröner JB, Cheko R, Kender Z, Kumar V, Kliemank E, Fleming T, Kreuter M, Nawroth PP. Renale und pulmonale Fibrose in Diabetes mellitus Typ 2 – chronische Inflammation und DNA-Schäden als gemeinsame Marker für Spätschäden. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S Kopf
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - M Höffgen
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - JB Gröner
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - R Cheko
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - Z Kender
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - V Kumar
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - E Kliemank
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - T Fleming
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
| | - M Kreuter
- Universitätsklinikum Heidelberg, Thoraxklinik, Heidelberg, Germany
| | - PP Nawroth
- Universtitätklinik Heidelberg/Medizinische Klinik, Heidelberg, Germany
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Jensen TM, Vistisen D, Fleming T, Nawroth PP, Rossing P, Jørgensen ME, Lauritzen T, Sandbaek A, Witte DR. Methylglyoxal is associated with changes in kidney function among individuals with screen-detected Type 2 diabetes mellitus. Diabet Med 2016; 33:1625-1631. [PMID: 27504739 DOI: 10.1111/dme.13201] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/26/2022]
Abstract
AIMS The glycolysis-derived metabolite methylglyoxal has been linked to clinical microvascular complications, including diabetic nephropathy. We aimed to further investigate the hypothesis that methylglyoxal is involved in decline in renal function by assessing the associations between measures of renal function during a 6-year follow-up in 1481 people with screen-detected Type 2 diabetes, as part of the Danish arm of the ADDITION-Europe trial (ADDITION-DK). METHODS Biobank serum samples collected at ADDITION-DK baseline (2001-2006) and follow-up (2009-2010) were used in the current analysis of methylglyoxal. We assessed cross-sectional baseline and longitudinal associations between methylglyoxal and urinary albumin-to-creatinine ratio (ACR) or estimated GFR (eGFR), and between methylglyoxal and categories of albuminuria or reduced eGFR. RESULTS Baseline methylglyoxal was positively associated with ACR at baseline (12% higher ACR per doubling in methylglyoxal levels), and change in methylglyoxal during 6 years of follow-up was inversely associated with change in eGFR (-1.6 ml/min/1.73 m2 per doubling in methylglyoxal change), in models adjusted for age, sex, HbA1c , systolic blood pressure, anti-hypertensive treatment, LDL-cholesterol, lipid-lowering treatment, C-reactive protein and smoking. CONCLUSIONS In a population of people with screen-detected Type 2 diabetes, we observed associations between methylglyoxal and markers of renal function: 6-year change in methylglyoxal was inversely associated with 6-year change in eGFR. Also, methylglyoxal at baseline was positively associated with ACR at baseline. Our study lends further support to a role for methylglyoxal in the pathogenesis of diabetic nephropathy.
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Affiliation(s)
- T M Jensen
- Steno Diabetes Center, Gentofte, Denmark
| | - D Vistisen
- Steno Diabetes Center, Gentofte, Denmark
| | - T Fleming
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - P P Nawroth
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - P Rossing
- Steno Diabetes Center, Gentofte, Denmark
| | - M E Jørgensen
- Steno Diabetes Center, Gentofte, Denmark
- National Institute of Public Health, Southern Denmark University, Odense, Denmark
| | - T Lauritzen
- Department of Public Health, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - A Sandbaek
- Department of Public Health, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - D R Witte
- Department of Public Health, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
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Wolter J, Schild L, Bock F, Hellwig A, Gadi I, Al-Dabet MM, Ranjan S, Rönicke R, Nawroth PP, Petersen KU, Mawrin C, Shahzad K, Isermann B. Thrombomodulin-dependent protein C activation is required for mitochondrial function and myelination in the central nervous system. J Thromb Haemost 2016; 14:2212-2226. [PMID: 27590316 DOI: 10.1111/jth.13494] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Indexed: 12/29/2022]
Abstract
Essentials The role of protein C (PC) activation in experimental autoimmune encephalitis (EAE) is unknown. PC activation is required for mitochondrial function in the central nervous system. Impaired PC activation aggravates EAE, which can be compensated for by soluble thrombomodulin. Protection of myelin by activated PC or solulin is partially independent of immune-modulation. SUMMARY Background Studies with human samples and in rodents established a function of coagulation proteases in neuro-inflammatory demyelinating diseases (e.g. in multiple sclerosis [MS] and experimental autoimmune encephalitis [EAE]). Surprisingly, approaches to increase activated protein C (aPC) plasma levels as well as antibody-mediated inhibition of PC/aPC ameliorated EAE in mice. Hence, the role of aPC generation in demyelinating diseases and potential mechanisms involved remain controversial. Furthermore, it is not known whether loss of aPC has pathological consequences at baseline (e.g. in the absence of disease). Objective To explore the role of thrombomodulin (TM)-dependent aPC generation at baseline and in immunological and non-immunological demyelinating disease models. Methods Myelination and reactive oxygen species (ROS) generation were evaluated in mice with genetically reduced TM-mediated protein C activation (TMPro/Pro ) and in wild-type (WT) mice under control conditions or following induction of EAE. Non-immunological demyelination was analyzed in the cuprizone-diet model. Results Impaired TM-dependent aPC generation already disturbs myelination and mitochondrial function at baseline. This basal phenotype is linked with increased mitochondrial ROS and aggravates EAE. Reducing mitochondrial ROS (p66Shc deficiency), restoring aPC plasma levels or injecting soluble TM (solulin) ameliorates EAE in TMPro/Pro mice. Soluble TM additionally conveyed protection in WT-EAE mice. Furthermore, soluble TM dampened demyelination in the cuprizone-diet model, demonstrating that its myelin-protective effect is partially independent of an immune-driven process. Conclusion These results uncover a novel physiological function of TM-dependent aPC generation within the CNS. Loss of TM-dependent aPC generation causes a neurological defect in healthy mice and aggravates EAE, which can be therapeutically corrected.
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Affiliation(s)
- J Wolter
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
| | - L Schild
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
| | - F Bock
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
- Internal Medicine I and Clinical Chemistry, German Diabetes Center (DZD), University of Heidelberg, Heidelberg, Germany
| | - A Hellwig
- Institute of Neurobiology, University of Heidelberg, Heidelberg, Germany
| | - I Gadi
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
| | - M M Al-Dabet
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
| | - S Ranjan
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
| | - R Rönicke
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
| | - P P Nawroth
- Internal Medicine I and Clinical Chemistry, German Diabetes Center (DZD), University of Heidelberg, Heidelberg, Germany
| | | | - C Mawrin
- Institute of Neuropathology, Otto-von-Guericke-University, Magdeburg, Germany
| | - K Shahzad
- University of Health Sciences, Lahore, Pakistan
| | - B Isermann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Magdeburg, Germany
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Morgenstern J, Fleming TH, Nawroth PP. Modifikation des Glyoxalasesystems und die Relevanz alternativer Entgiftungsmechanismen von Methylglyoxal im Rahmen der diabetischen Neuropathie. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schumacher D, Matka C, Sachdeva R, Dietrich N, Schlotterer A, Mathar I, Homberg S, Kriebs U, Stettner P, Nawroth PP, Gröne HJ, Hammes HP, Fleming T, Freichel M. Cation channels of the TRPC family contribute to development of nephropathy and retinopathy in the STZ model. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Deshpande DD, Fleming TH, Gans ROB, Nawroth PP. Impaired Pro-opiomelanocortin (Pomc) – Mu Opioid Receptor (MOR) axis contributes to painful diabetic neuropathy in Streptozotocin induced mice. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Morgenstern J, Fleming TH, Krebs J, Katz S, Backs J, Nawroth PP. Das Glyoxalasesystem unterliegt organ- und altersspezifischen Veränderungen im diabetischen Mausmodell (db/db). DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Riedinger C, Mendler M, Fleming TH, Okun JG, Nawroth PP. Hemmung der AICAR-Transformylase/Cyclohydrolase verhindert in C. elegans unter Hochglukosebedingungen AMP-K abhängig neuronale Schäden. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zemva J, Fleming T, Kaden S, Gröne HJ, Herpel E, Schmidt L, Bergheim BG, Nawroth PP, Tyedmers J. Komponenten eines neu identifizierten zellulären Schutzmechanismus gegen Methylglyoxal-induzierte Proteinschädigung liegen in der diabetischen Nephropathie hochreguliert vor. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Spanidis I, Hidmark A, Fleming T, Volk N, Eckstein V, Gröner JB, Kopf S, Nawroth PP, Oikonomou D. External muscle stimulation differentiates circulating hematopoietic stem cells in diabetes patients. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sharma K, Heckler K, Stoll S, Hillebrands JL, Kynast K, Herpel E, Porubsky S, Nawroth PP, Kroll J. Protective function of ELMO1 in renal development under diabetic conditions within zebrafish and in human diabetic nephropathy. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tsioga MN, Oikonomou D, Vittas S, Kalscheuer H, Roeder E, Wintgens KF, Nawroth PP, Wolfrum C, Rudofsky G. Plasma myostatin is only a weak predictor for weight maintenance in obese adults. Exp Clin Endocrinol Diabetes 2015; 123:466-72. [PMID: 26393401 DOI: 10.1055/s-0035-1559663] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Predicting an individual's success in a non-surgical weight loss approach is a demanding need since obesity is becoming an epidemic burden. A possible predictive marker is myostatin, a member of the transforming growth factor b superfamily, which has been shown to be an important regulator of muscle homeostasis. METHODS In the present study, we analyzed myostatin as a marker to predict weight loss of patients that participated in a 2 phased weight reduction program, comprising a weight loss period of 12 weeks and a weight stabilization period of 40 weeks. Therefore, 62 obese individuals with a mean BMI of 40.6 kg/m(2) were included. Plasma myostatin was measured with ELISA at the beginning (T0), after weight loss (T1) and at the end of the program (T2). RESULTS Although significant weight loss of -23.9±14.9 kg was achieved, myostatin did not change significantly during the program (T0>T1: p=0.46; T1>T2: p=0.70; T0>T2: p=0.57). Myostatin at baseline did neither negatively correlate with the achieved weight loss in the weight reduction phase (T0>T1: r=0.27, p=0.16) nor with weight loss during the whole program (T0>T2: r=0.20, p=0.29). Only a minor correlation with myostatin levels after weight loss with weight regain during maintenance period was detected. (T1>T2: r=-0.37, p=0.05). CONCLUSION Plasma myostatin might be suitable in predicting weight regain after marked weight loss, but no association with weight loss was observed in patients undergoing a non-surgical weight loss program. Therefore, myostatin does not seem to be a predictor for success in non-surgical weight loss approaches.
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Affiliation(s)
- M N Tsioga
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
| | - D Oikonomou
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
| | - S Vittas
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
| | - H Kalscheuer
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
| | - E Roeder
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
| | - K F Wintgens
- Immundiagnostik AG, Stubenwald-Allee 8a, Bensheim, Germany
| | - P P Nawroth
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
| | - C Wolfrum
- Swiss Federal Institute of Technology, Institute of Food Nutrition and Health, Schwerzenbach, Switzerland
| | - G Rudofsky
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
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Groener JB, Neus I, Kopf S, Hartmann M, Schanz J, Kliemank E, Wetekam B, Kihm L, Fleming T, Herzog W, Nawroth PP. Group Singing as a Therapy during Diabetes Training--A Randomized Controlled Pilot Study. Exp Clin Endocrinol Diabetes 2015; 123:617-21. [PMID: 26240957 DOI: 10.1055/s-0035-1555941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Comprehensive diabetes treatment has been shown to reduce quality of life in diabetic patients. However, there is evidence to suggest that group singing can have positive effects on quality of life in various clinical settings. In this randomized controlled pilot study, the effect of singing as a therapy to reduce stress and improve quality of life was investigated in insulin-dependent diabetic patients, undergoing a lifestyle intervention program. Patients from the singing group felt less discontented following treatment. This effect, however, was lost after 3 months. No effect on serum cortisol and plasma adrenocorticotropic hormone (ACTH) levels could be seen when comparing the singing group with the control group, although reduced levels of ACTH and cortisol 3 days after treatment could be found and were still present after 3 months within the group of patients who undertook singing as a therapy. Singing led to an increase in bodyweight, which interestingly had no effect on glucose control or methylglyoxal levels. Therefore, singing during a lifestyle intervention program for insulin-dependent diabetic patients had a short lasting and weak effect on patients' mood without affecting glucose control, but no significant effect on stress related hormones.
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Affiliation(s)
- J B Groener
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - I Neus
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - S Kopf
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - M Hartmann
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Germany
| | - J Schanz
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - E Kliemank
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - B Wetekam
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - L Kihm
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - T Fleming
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
| | - W Herzog
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Germany
| | - P P Nawroth
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Germany
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Billeter AT, Kopf S, Israel B, Schulte T, Knefeli P, Büchler MW, Nawroth PP, Müller BP. Gastric bypass improves subclinical nephropathy in non-severely obese patients (BMI < 35 kg/m2) with type 2 diabetes mellitus. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Brune M, Nillegoda N, Bukau B, Nawroth PP, Herzig S. Hepatic heat shock proteins in Diabetes and long term diabetic complications. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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28
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Volk N, Fleming TH, Kliemank E, Nawroth PP. Organ-specific affects of diabetes on mitochondrial function. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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Sulaj A, Bauer RV, Kopf S, Brune M, Mendler M, Nawroth PP, Fleming T. Effect of LDL-apheresis on the soluble form of Activated Leukocyte Cell Adhesion Molecule (ALCAM). DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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Pham M, Kollmer J, Oikonomou D, Bäumer P, Hornung B, Weiler M, Nawroth PP, Bendszus M, Heiland S. Protonendichte: Ein neuer Biomarker in der MR-Neurografie zur Diagnose und Charakterisierung der diabetischen Polyneuropathie. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Jörgens K, Lodd E, Schmöhl F, Stoll SJ, Fleming TH, Nawroth PP, Hammes HP, Kroll J. Zebrafish as a model organism for studying late diabetic complications. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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32
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Vittas S, Fleming TH, Hidmark A, Oikonomou D, Volk N, Kopf S, Nawroth PP. Pyruvate kinase isoenzyme M2 is increased in experimental diabetes and correlates with diabetic neuropathy in patients. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fleming T, Schleicher E, Häring HU, Nawroth PP. Overexpression of the glucose transporter 1 in renal mesangial cells protects against cellular stress via Nrf2/NQO1. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hofmann KP, Katz S, Herzig S, Nawroth PP, Kroll J, Peters V, Gröne HJ, Müller OJ, Backs J. Die Rolle oxidierter CaM Kinase II bei diabetischer Nephropathie. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bauer RV, Sulaj A, Kopf S, Gröne E, Gröne HJ, Hoffmann S, Schleicher E, Häring HU, Schwenger V, Herzig S, Nawroth PP, Fleming T. Loss of ALCAM/CD166 partially protects against diabetic nephropathy. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zemva J, Fleming T, Herpel E, Kaden S, Gröne HJ, Nawroth PP, Tyedmers J. Induktion von zellulären Schutzmechanismen gegen den Diabetes-relevanten reaktiven Metaboliten Methylglyoxal. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Billeter A, Vittas S, Israel B, Schulte T, Büchler MW, Hidmark A, Fleming TH, Müller BP, Nawroth PP. Gastric bypass improves glycemic control and reduces systemic inflammation in non-severely obese patients (BMI < 35 kg/m2) with type 2 diabetes mellitus. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Groener JB, Neus I, Hartmann M, Kopf S, Kliemank E, Schanz J, Wetekam B, Fleming T, Herzog W, Nawroth PP. Gruppensingen als Therapie im Rahmen einer Diabetesschulung – eine Randomisierte, Kontrollierte Studie. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hidmark A, Fleming T, Deshpande D, Vittas S, Nawroth PP. STZ treatment causes depletion of immune cells in sciatic nerve and dorsal root ganglion in mice. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Roser P, Lehnhoff D, Klein R, Gröner J, Nawroth PP, Schütt F, Rudofsky G. Retinopathiescreening in einer diabetologischen Abteilung – wie sinnvoll ist es? DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kopf S, Oikonomou D, Hartmann M, Herzog W, Humpert P, Nawroth PP. Stressreduktionstraining verbessert nachhaltig die kardiale autonome Funktion in Typ 2 Diabetes Patienten mit Mikroalbuminurie Ergebnisse der Heidelberger Diabetes und Stress Studie (HEIDIS). DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kopf S, Oikonomou D, Hartmann M, Herzog W, Humpert P, Nawroth PP. Ursachen von psychosozialem Stress und seine Assoziation mit dem kardiovaskulären Risiko bei Typ 2 Diabetes mellitus. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kopf S, Oikonomou D, Hartmann M, Feier F, Faude-Lang V, Morcos M, Häring HU, Herzog W, Bierhaus A, Humpert PM, Nawroth PP. Effects of stress reduction on cardiovascular risk factors in type 2 diabetes patients with early kidney disease - results of a randomized controlled trial (HEIDIS). Exp Clin Endocrinol Diabetes 2014; 122:341-9. [PMID: 24798861 DOI: 10.1055/s-0034-1372583] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Current guidelines for the treatment of type 2 diabetes focus on pharmacological treatment of glucose and cardio-vascular risk factors. The aim of this prospective randomized controlled intervention study was to examine the effects of a psychosocial intervention on clinical endpoints and risk factors in patients with type 2 diabetes and early diabetic kidney disease.110 patients were randomized to receive an 8-week mindfulness-based stress reduction (MBSR) training (n = 53) compared to standard care (n = 57). The study was carried out open-labelled and randomization was performed computer-generated in a 1:1 ratio. Primary outcome of the study was the change in urinary albumin excretion (albumin-creatinine-ratio, ACR); secondary outcomes were metabolic parameters, intima media thickness (IMT), psychosocial parameters and cardiovascular events.89 patients (42 in control group and 47 in intervention group) were analysed after 3 years of follow-up. After 1 year, the intervention group showed a reduction of ACR from 44 [16/80] to 39 [20/71] mg/g, while controls increased from 47 [16/120] to 59 [19/128] mg/g (p = 0.05). Parallel to the reduction of stress levels after 1 year, the intervention-group additionally showed reduced catecholamine levels (p < 0.05), improved 24 h-mean arterial (p < 0.05) and maximum systolic blood pressure (p < 0.01), as well as a reduction in IMT (p < 0.01). However, these effects were lost after 2 and 3 years of follow-up.This is the first study to show that a psychosocial intervention improves cardiovascular risk factors in high risk type 2 diabetes patients. Trial-Registration: NCT00263419 http://clinicaltrials.gov/ct2/show/NCT00263419 TRIAL REGISTRATION: clinicaltrials.gov-Identifier: NCT00263419.
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Affiliation(s)
- S Kopf
- Department of Medicine I and Clinical Chemistry; University of Heidelberg, Germany
| | - D Oikonomou
- Department of Medicine I and Clinical Chemistry; University of Heidelberg, Germany
| | - M Hartmann
- Department of Medicine II and Psychosomatics, University of Heidelberg, Germany
| | - F Feier
- Department of Medicine I and Clinical Chemistry; University of Heidelberg, Germany
| | - V Faude-Lang
- Department of Medicine II and Psychosomatics, University of Heidelberg, Germany
| | - M Morcos
- Department of Medicine I and Clinical Chemistry; University of Heidelberg, Germany
| | - H-U Häring
- Department of Medicine IV and Clinical Chemistry, University of Tübingen, Germany
| | - W Herzog
- Department of Medicine II and Psychosomatics, University of Heidelberg, Germany
| | - A Bierhaus
- Department of Medicine I and Clinical Chemistry; University of Heidelberg, Germany
| | - P M Humpert
- Department of Medicine I and Clinical Chemistry; University of Heidelberg, Germany
| | - P P Nawroth
- Department of Medicine I and Clinical Chemistry; University of Heidelberg, Germany
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Vanikar AV, Trivedi HL, Dave SD, Kute VB, Rawal MN, Patel HV, Gumber MR, Afghahi H, Pirouzifard M, Svensson AM, Eliasson B, Svensson MK, Dumann K, Horrmann B, Lammert A, Rheinberger M, Gorski M, Kramer BK, Heid IM, Boger CA, Demirtas L, Akbas EM, Timuroglu A, Ozcicek F, Turkmen K, Fernandez-Fernandez B, Sanchez-Nino MD, Martin-Cleary C, Izquierdo MC, Elewa U, Ortiz A, Petrica L, Vlad A, Gluhovschi G, Gadalean F, Dumitrascu V, Gluhovschi C, Velciov S, Bob F, Vlad D, Popescu R, Petrica M, Jianu DC, Milas O, Izvernari O, Ursoniu S, Makino Y, Konoshita T, Nyumura I, Babazono T, Yoshida N, Uchigata Y, Handisurya A, Kerscher C, Tura A, Werzowa J, Heinzl H, Ristl R, Kautzky-Willer A, Pacini G, Saemann M, Schmidt A, Halbesma N, Metcalfe W, Bulum T, Prka in I, Blaslov K, Zibar K, Duvnjak L, Idorn T, Knop FK, Jorgensen MB, Christensen M, Holst JJ, Hornum M, Feldt-Rasmussen B, Naess H, Hartmann A, Jenssen TG, Holdaas H, Horneland R, Grzyb K, Bitter J, Midtvedt K, Yoshida N, Babazono T, Uchigata Y, Timar R, Gluhovschi G, Gadalean F, Velciov S, Petrica L, Timar B, Gluhovschi C, Soro-Paavonen A, Fleming T, Forsblom C, Gordin D, Tolonen N, Harjutsalo V, Nawroth PP, Groop PH, Tsuda A, Ishimura E, Uedono H, Yasumoto M, Nakatani S, Ichii M, Ohno Y, Ochi A, Mori K, Fukumoto S, Emoto M, Inaba M, Rheinberger M, Hormann B, Lammert A, Dumann K, Gorski M, Heid IM, Kramer BK, Boger CA, Siddaramaiah NH, Tez DK, Linker NJ, Bilous M, Winship S, Marshall SM, Bilous RW, Lampropoulou IT, Papagianni A, Stangou M, Didangelos T, Iliadis F, Efstratiadis G, Esposito P, Debarbieri G, Mereu R, Ditoro A, Montagna F, Groop PH, Bernardi L, Dal Canton A, Garland JS, Holden R, Morton R, Ross R, Adams M, Pruss C, Akbas EM, Demirtas L, Timuroglu A, Ozcicek F, Turkmen K, Bulum T, Prka in I, Blaslov K, Zibar K, Duvnjak L, Theodoridis M, Panagoutsos S, Bounta T, Roumeliotis S, Kantartzi K, Pouloutidis G, Passadakis P, Polaina Rusillo M, Borrego Utiel FJ, Ortega Anguiano S, Liebana Canada A, Gaber EW, Abdel Rehim WM, Ibrahim NA, Mahmoud BF, Silva AP, Fragoso A, Tavares N, Silva C, Santos N, Camacho A, Neves P, Rodriguez R, Porrini E, Gonzalez-Rinne A, De Vries A, Torres A, Salido E, Kato S, Makino H, Uzu T, Koya D, Nishiyama A, Imai E, Ando M, Jorgensen MB, Knop FK, Idorn T, Holst JJ, Hornum M, Feldt-Rasmussen B, Vaduva C, Popa S, Mitrea A, Mota M, Mota E, Theodoridis M, Panagoutsos S, Roumeliotis S, Bounta T, Kriki P, Roumeliotis A, Passadakis P, Ogawa T, Okazaki S, Hatano M, Hara H, Inamura M, Kiba T, Iwashita T, Shimizu T, Tayama Y, Kanozawa K, Kato H, Matsuda A, Hasegawa H, Elewa U, Fernandez B, Egido J, Ortiz A, Rottembourg J, Guerin A, Diaconita M, Dansaert A, Chakraborty J, Prabhu R, Nagaraju SP, Bairy M, Satyamoorthy K, Kosuru S, Parthasarathy R, Tomilina N, Zhilinskaya T, Stolyarevich E, Silva AP, Fragoso A, Guilherme P, Silva C, Santos N, Rato F, Camacho A, Neves P, Pasko N, Strakosha A, Toti F, Dedej T, Marku N, Petrela E, Zekollari E, Kacorri V, Thereska N, Roumeliotis SK, Roumeliotis AK, Theodoridis M, Tavridou A, Panagoutsos S, Passadakis P, Vargemezis V, Kim IY, Lee SB, Lee DW, Kim MJ, Shin MJ, Rhee H, Yang BY, Song SH, Seong EY, Kwak IS, Celebi K, Sengul E, Cekmen MB, Yilmaz A, Sonikian M, Dona A, Skarakis J, Miha T, Trompouki S, Karaitianou A, Spiliopoulou C, Dimas GG, Iliadis FS, Tegos TJ, Spiroglou SG, Kanellos IE, Fotiadis SD, Didaggelos TP, Savopoulos CG, Hatzitolios AI, Grekas DM, Hsu YH, Huang MC, Chang HY, Shin SJ, Wahlqvist ML, Chang YL, Hsu KC, Hsu CC, Miarka P, Grabowska-Polanowska B, Faber J, Skowron M, Pietrzycka A, Walus-Miarka M, Sliwka I, Sulowicz W. DIABETES CLINICAL. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hidmark A, Fleming T, Vittas S, Mendler M, Deshpande D, Groener JB, Müller BP, Reeh PW, Sauer SK, Pham M, Muckenthaler MU, Bendszus M, Nawroth PP. A new paradigm to understand and treat diabetic neuropathy. Exp Clin Endocrinol Diabetes 2014; 122:201-7. [PMID: 24623503 DOI: 10.1055/s-0034-1367023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The clinical symptoms of diabetic neuropathy (DN) manifest in a time dependent manner as a positive symptoms (i. e. pain, hypersensitivity, tingling, cramps, cold feet etc.) during its early stages and by a loss of function (i. e. loss of sensory perception, delayed wound healing etc.) predominating in the later stages. Elevated blood glucose alone cannot explain the development and progression of DN and the lowering of blood glucose is insufficient in preventing and/or reversing neuropathy in patients with type 2 diabetes. Recently it has been shown that the endogenous reactive metabolite methylglyoxal (MG) can contribute to the gain of function via post-translational modification in DN of neuronal ion channels involved in chemosensing and action potential generation in nociceptive nerve endings. Dicarbonyls, such as MG, that are elevated in diabetic patients, modify DNA as well as extra- and intracellular proteins, leading to the formation of advanced glycation endproducts (AGEs). Increased formation of AGEs leads to increased cellular stress, dysfunction and ultimately cell death. The interaction of AGE-modified proteins through cell surface receptors, such as RAGE, can lead to increased cellular activation and sustained inflammatory responses, which are the molecular hallmarks of the later, degenerative, stages of DN. The direct and indirect effects of dicarbonyls on nerves or neuronal microvascular network provides a unifying mechanism for the development and progression of DN. Targeting the accumulation of MG and/or prevention of RAGE interactions may therefore provide new, more effective, therapeutic approaches for the treatment of DN.
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Affiliation(s)
- A Hidmark
- Department of Medicine I and Clinical Chemistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - T Fleming
- Department of Medicine I and Clinical Chemistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - S Vittas
- Department of Medicine I and Clinical Chemistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - M Mendler
- Department of Medicine I and Clinical Chemistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - D Deshpande
- Department of Medicine I and Clinical Chemistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - J B Groener
- Department of Medicine I and Clinical Chemistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - B P Müller
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - P W Reeh
- Institute of Physiology and Pathophysiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - S K Sauer
- Institute of Physiology and Pathophysiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - M Pham
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - M U Muckenthaler
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, University of Heidelberg, Heidelberg, Germany
| | - M Bendszus
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - P P Nawroth
- Department of Medicine I and Clinical Chemistry, University Hospital of Heidelberg, Heidelberg, Germany
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Oikonomou D, Kopf S, Gröner JB, Bauer RV, Vittas S, Sander A, Englert S, Humpert PM, Nawroth PP. Influence of insulin and glargine on mobilization and outgrowth of endothelial progenitor cells in patients with type 2 diabetes: a partially double-blind, randomized, three-arm unicenter study. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Groener JB, Blachutzik F, Oikonomou D, Kliemank E, Fleming T, Nawroth PP. Altered methylglyoxal metabolism identifies patients with late diabetic complications. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kopf S, Oikonomou D, Hartmann M, Humpert P, Herzog W, Nawroth PP. Mindfulness based stress reduction training was able to improve stress, depression and health status in patients with type 2 diabetes over 3 years. – Results of the Heidelberger Diabetes and Stress Study (HEIDIS). Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Spiegel R, Nawroth PP, Kasperk C. The effect of zoledronic acid on the fracture risk in men with osteoporosis. J Endocrinol Invest 2014; 37:229-32. [PMID: 24474679 DOI: 10.1007/s40618-013-0038-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 12/06/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prospective, placebo-controlled, double-blind, randomized studies on osteoporosis treatment with bisphosphonates in men are rare. This review focuses on a recent trial and compares the results with other studies. METHODS This review provides a summary of recent literature on fracture risk in men following treatment with zoledronic acid. According to a recent clinical study with 1,199 men, zoledronic acid was linked to a lower risk of vertebral fractures. In this manuscript, a re-analysis of the presented statistical data will be demonstrated by performing a Bonferroni-correction to adjust for type 1 error accumulation in multiple statistical tests. RESULTS It will be shown that the provided evidence linking zoledronic acid to a lower fracture risk in male osteoporosis is true, but less pronounced than originally assumed. CONCLUSION Comparative clinical studies are recommended, where the benefits of different bisphosphonates are compared to each other under the same experimental conditions.
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Groener JB, Reismann P, Fleming T, Kalscheuer H, Lehnhoff D, Hamann A, Roser P, Bierhaus A, Nawroth PP, Rudofsky G. C332C genotype of glyoxalase 1 and its association with late diabetic complications. Exp Clin Endocrinol Diabetes 2013; 121:436-9. [PMID: 23775136 DOI: 10.1055/s-0033-1345124] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIMS/INTRODUCTION Glyoxalase 1 catalyses the detoxification of methylglyoxal, a major precursor of advanced glycation end products associated with aging, neurodegenerative diseases, and microvascular complications of diabetes. Here, we examine a possible association of a single nucleotide polymorphism of glyoxalase 1 gene (Glo1 A332C, rs4746 or rs2736654) with the prevalence of microvascular diabetic complications in patients with type 1 and type 2 diabetes. MATERIALS AND METHODS Genotyping was performed in 209 patients with type 1 and 524 patients with type 2 diabetes using polymerase chain reaction and subsequent cleavage by restriction endonuclease Bsa I. RESULTS Frequencies of the glyoxalase 1 genotypes were different with respect to diabetes type with a significantly higher prevalence of A332A-genotype in type 1 diabetes (35.9% vs. 27.3%; p=0.03). In type 1 diabetes, there was no correlation of any genotype with diabetic retinopathy, nephropathy or neuropathy. In contrast, type 2 diabetic patients homozygous for the C332C allele showed a significantly increased prevalence of diabetic neuropathy (p=0.03; OR=1.49 [95%-CI: 1.04; 2.11]), while no association with diabetic nephropathy or retinopathy was found. However, the significance of this association was lost after correction for multiple testing. CONCLUSIONS Our data suggest a possible association of C332C-genotype of the glyoxalase 1 gene with diabetic neuropathy in type 2 diabetes, supporting the hypothesis that methylglyoxal might be an important mediator of diabetic neuropathy in type 2 diabetes.
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Affiliation(s)
- J B Groener
- Department of Medicine, Division of Endocrinology and Clinical Chemistry, University of Heidelberg, 69120 Heidelberg, Germany. - heidelberg.de
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