Man Lu, Xiao-Wen Guo, Fang-Fang Zhang, Dan-Hong Wu, Di Xie, Feng-Qin Luo
Background: Diabetes is often associated with gastrointestinal dysfunctions, which can lead to hypoglycemia. Dexmedetomidine (DEX) is a commonly used sedative in perioperative diabetic patients and may affect gastrointestinal function.
Aim: To investigate whether sedative doses of DEX alleviate diabetes-caused intestinal dysfunction.
Methods: Sedation/anesthesia scores and vital signs of streptozotocin (STZ)-induced diabetic mice under DEX sedation were observed. Diabetic mice were divided into saline and DEX groups. After injecting sedatives intraperitoneally, tight junctions (TJs) and apoptotic levels were evaluated 24 hours later to assess the intestinal barrier function. The role of DEX was validated using Villin-MMP23B flox/flox mice with intestinal epithelial deletion. In vitro, high glucose and hyperosmolarity were used to culture Caco-2 monolayer cells with STZ inter-vention. Immunofluorescence techniques were used to monitor the barrier and mitochondrial functions.
Results: MMP23B protein levels in the intestinal tissue of STZ-induced diabetic mice were significantly higher than those in the intestinal tissue of control mice, with the DEX group displaying decreased MMP23B levels. Diabetes-mediated TJ dis-ruption, increased intestinal mucosal permeability, and systemic inflammation in wild-type mice might be reversed by DEX. In Caco-2 cells, MMP23B was associated with increased reactive oxygen species accumulation, mitochondrial membrane potential depolarization, and TJ disruption.
Conclusion: DEX reduces MMP23B, which may potentially contribute to STZ-induced intestinal barrier dysfunction, affecting TJ modification through mitochondrial dysfunction.
{"title":"Dexmedetomidine ameliorates diabetic intestinal injury by promoting the polarization of M2 macrophages through the MMP23B pathway.","authors":"Man Lu, Xiao-Wen Guo, Fang-Fang Zhang, Dan-Hong Wu, Di Xie, Feng-Qin Luo","doi":"10.4239/wjd.v15.i9.1962","DOIUrl":"https://doi.org/10.4239/wjd.v15.i9.1962","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is often associated with gastrointestinal dysfunctions, which can lead to hypoglycemia. Dexmedetomidine (DEX) is a commonly used sedative in perioperative diabetic patients and may affect gastrointestinal function.</p><p><strong>Aim: </strong>To investigate whether sedative doses of DEX alleviate diabetes-caused intestinal dysfunction.</p><p><strong>Methods: </strong>Sedation/anesthesia scores and vital signs of streptozotocin (STZ)-induced diabetic mice under DEX sedation were observed. Diabetic mice were divided into saline and DEX groups. After injecting sedatives intraperitoneally, tight junctions (TJs) and apoptotic levels were evaluated 24 hours later to assess the intestinal barrier function. The role of DEX was validated using Villin-MMP23B flox/flox mice with intestinal epithelial deletion. <i>In vitro</i>, high glucose and hyperosmolarity were used to culture Caco-2 monolayer cells with STZ inter-vention. Immunofluorescence techniques were used to monitor the barrier and mitochondrial functions.</p><p><strong>Results: </strong>MMP23B protein levels in the intestinal tissue of STZ-induced diabetic mice were significantly higher than those in the intestinal tissue of control mice, with the DEX group displaying decreased MMP23B levels. Diabetes-mediated TJ dis-ruption, increased intestinal mucosal permeability, and systemic inflammation in wild-type mice might be reversed by DEX. In Caco-2 cells, MMP23B was associated with increased reactive oxygen species accumulation, mitochondrial membrane potential depolarization, and TJ disruption.</p><p><strong>Conclusion: </strong>DEX reduces MMP23B, which may potentially contribute to STZ-induced intestinal barrier dysfunction, affecting TJ modification through mitochondrial dysfunction.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Carlos Tatmatsu-Rocha, Luan Santos Mendes-Costa
Inflammatory markers and mediators that affect the development of car-diovascular diseases have been the focus of recent scientific work. Thus, the purpose of this editorial is to promote a critical debate about the article titled "Nε-carboxymethyl-lysine and inflammatory cytokines, markers, and mediators of coronary artery disease progression in diabetes", published in the World Journal of Diabetes in 2024. This work directs us to reflect on the role of advanced glycation end products, which are pro-inflammatory products arising from the metabolism of fatty acids and sugars whose main marker in tissues is Nε-carboxymethyl-lysine (NML). Recent studies have linked high levels of pro-inflammatory agents with the development of coronary artery disease (CAD), especially tumor necrosis factor alpha, interleukins, and C-reactive protein. These inflammatory agents increase the production of reactive oxygen species (ROS), of which people with diabetes are known to have an increased production. The increase in ROS promotes lipid peroxidation, which causes damage to myocytes, promoting myocardial damage. Furthermore, oxidative stress induces the binding of NML to its receptor RAGE, which in turn activates the nuclear factor-kB, and conse-quently, inflammatory cytokines. These inflammatory cytokines induce endo-thelial dysfunction, with increased expression of adhesion molecules, changes in endothelial permeability and changes in the expression of nitric oxide. In this sense, the therapeutic use of monoclonal antibodies (inflammatory reducers such as statins and sodium-glucose transport inhibitors) has demonstrated positive results in the regression of atherogenic plaques and consequently CAD. On the other hand, many studies have demonstrated a relationship between mito-chondrial dynamics, diabetes, and cardiovascular diseases. This link occurs since ROS have their origin in the imbalance in glucose metabolism that occurs in the mitochondrial matrix, and this imbalance can have its origin in inadequate diet as well as some pathologies. Photobiomodulation (PBM) has recently been considered a possible therapeutic agent for cardiovascular diseases due to its effects on mitochondrial dynamics and oxidative stress. In this sense, therapies such as PBM that act on pro-inflammatory mediators and mitochondrial modulation could benefit those with cardiovascular diseases.
{"title":"Inflammatory markers, oxidative stress, and mitochondrial dynamics: Repercussions on coronary artery disease in diabetes.","authors":"José Carlos Tatmatsu-Rocha, Luan Santos Mendes-Costa","doi":"10.4239/wjd.v15.i9.1853","DOIUrl":"https://doi.org/10.4239/wjd.v15.i9.1853","url":null,"abstract":"<p><p>Inflammatory markers and mediators that affect the development of car-diovascular diseases have been the focus of recent scientific work. Thus, the purpose of this editorial is to promote a critical debate about the article titled \"Nε-carboxymethyl-lysine and inflammatory cytokines, markers, and mediators of coronary artery disease progression in diabetes\", published in the <i>World Journal of Diabetes</i> in 2024. This work directs us to reflect on the role of advanced glycation end products, which are pro-inflammatory products arising from the metabolism of fatty acids and sugars whose main marker in tissues is Nε-carboxymethyl-lysine (NML). Recent studies have linked high levels of pro-inflammatory agents with the development of coronary artery disease (CAD), especially tumor necrosis factor alpha, interleukins, and C-reactive protein. These inflammatory agents increase the production of reactive oxygen species (ROS), of which people with diabetes are known to have an increased production. The increase in ROS promotes lipid peroxidation, which causes damage to myocytes, promoting myocardial damage. Furthermore, oxidative stress induces the binding of NML to its receptor RAGE, which in turn activates the nuclear factor-kB, and conse-quently, inflammatory cytokines. These inflammatory cytokines induce endo-thelial dysfunction, with increased expression of adhesion molecules, changes in endothelial permeability and changes in the expression of nitric oxide. In this sense, the therapeutic use of monoclonal antibodies (inflammatory reducers such as statins and sodium-glucose transport inhibitors) has demonstrated positive results in the regression of atherogenic plaques and consequently CAD. On the other hand, many studies have demonstrated a relationship between mito-chondrial dynamics, diabetes, and cardiovascular diseases. This link occurs since ROS have their origin in the imbalance in glucose metabolism that occurs in the mitochondrial matrix, and this imbalance can have its origin in inadequate diet as well as some pathologies. Photobiomodulation (PBM) has recently been considered a possible therapeutic agent for cardiovascular diseases due to its effects on mitochondrial dynamics and oxidative stress. In this sense, therapies such as PBM that act on pro-inflammatory mediators and mitochondrial modulation could benefit those with cardiovascular diseases.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The bidirectional relationship between periodontitis and type 2 diabetes mellitus has been well-established. However, the underlying molecular mechanisms remain unclear. Diabetic retinopathy (DR) is an important complication of diabetes, but there are few studies on the relationship between DR and periodontitis, especially on the intrinsic inflammatory pathway mechanism. This article reviews the latest clinical data on how diabetes promotes susceptibility to periodontitis from the epidemiological and molecular perspectives, with a special focus on the key roles of systemic inflammation and endothelial dysfunction in the interplay between DR and periodontitis. Comprehension of the intertwined pathogenesis of DR and periodontitis can better guide the development of comprehensive management strategies for glycemic control and periodontal health, with the aim of mitigating the progression of DR and enhancing overall well-being.
牙周炎与 2 型糖尿病之间的双向关系已得到证实。然而,其潜在的分子机制仍不清楚。糖尿病视网膜病变(DR)是糖尿病的一个重要并发症,但关于糖尿病视网膜病变与牙周炎之间关系的研究很少,尤其是关于内在炎症通路机制的研究。本文从流行病学和分子角度回顾了糖尿病如何促进牙周炎易感性的最新临床数据,并特别关注了全身炎症和内皮功能障碍在 DR 与牙周炎相互作用中的关键作用。了解糖尿病肾病和牙周炎相互交织的发病机制可以更好地指导血糖控制和牙周健康综合管理策略的制定,从而缓解糖尿病肾病的进展,提高整体健康水平。
{"title":"Link between periodontitis and diabetic retinopathy: Inflammatory pathways and clinical implications.","authors":"Yu Zhao, Quan-Quan Shen","doi":"10.4239/wjd.v15.i9.1842","DOIUrl":"https://doi.org/10.4239/wjd.v15.i9.1842","url":null,"abstract":"<p><p>The bidirectional relationship between periodontitis and type 2 diabetes mellitus has been well-established. However, the underlying molecular mechanisms remain unclear. Diabetic retinopathy (DR) is an important complication of diabetes, but there are few studies on the relationship between DR and periodontitis, especially on the intrinsic inflammatory pathway mechanism. This article reviews the latest clinical data on how diabetes promotes susceptibility to periodontitis from the epidemiological and molecular perspectives, with a special focus on the key roles of systemic inflammation and endothelial dysfunction in the interplay between DR and periodontitis. Comprehension of the intertwined pathogenesis of DR and periodontitis can better guide the development of comprehensive management strategies for glycemic control and periodontal health, with the aim of mitigating the progression of DR and enhancing overall well-being.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monogenic diabetes is caused by one or even more genetic variations, which may be uncommon yet have a significant influence and cause diabetes at an early age. Monogenic diabetes affects 1% to 5% of children, and early detection and genetically focused treatment of neonatal diabetes and maturity-onset diabetes of the young can significantly improve long-term health and well-being. The etiology of monogenic diabetes in childhood is primarily attributed to genetic variations affecting the regulatory genes responsible for beta-cell activity. In rare instances, mutations leading to severe insulin resistance can also result in the development of diabetes. Individuals diagnosed with specific types of monogenic diabetes, which are commonly found, can transition from insulin therapy to sulfonylureas, provided they maintain consistent regulation of their blood glucose levels. Scientists have successfully devised materials and methodologies to distinguish individuals with type 1 or 2 diabetes from those more prone to monogenic diabetes. Genetic screening with appropriate findings and interpretations is essential to establish a prognosis and to guide the choice of therapies and management of these interrelated ailments. This review aims to design a comprehensive literature summarizing genetic insights into monogenetic diabetes in children and adolescents as well as summarizing their diagnosis and management.
{"title":"Exploring the genetic basis of childhood monogenic diabetes.","authors":"Debmalya Sanyal","doi":"10.4239/wjd.v15.i9.1829","DOIUrl":"https://doi.org/10.4239/wjd.v15.i9.1829","url":null,"abstract":"<p><p>Monogenic diabetes is caused by one or even more genetic variations, which may be uncommon yet have a significant influence and cause diabetes at an early age. Monogenic diabetes affects 1% to 5% of children, and early detection and genetically focused treatment of neonatal diabetes and maturity-onset diabetes of the young can significantly improve long-term health and well-being. The etiology of monogenic diabetes in childhood is primarily attributed to genetic variations affecting the regulatory genes responsible for beta-cell activity. In rare instances, mutations leading to severe insulin resistance can also result in the development of diabetes. Individuals diagnosed with specific types of monogenic diabetes, which are commonly found, can transition from insulin therapy to sulfonylureas, provided they maintain consistent regulation of their blood glucose levels. Scientists have successfully devised materials and methodologies to distinguish individuals with type 1 or 2 diabetes from those more prone to monogenic diabetes. Genetic screening with appropriate findings and interpretations is essential to establish a prognosis and to guide the choice of therapies and management of these interrelated ailments. This review aims to design a comprehensive literature summarizing genetic insights into monogenetic diabetes in children and adolescents as well as summarizing their diagnosis and management.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This editorial introduces the potential of targeting macrophage function for diabetic cardiomyopathy (DCM) treatment by dipeptidyl peptidase-4 (DPP-4) inhibitors. Zhang et al studied teneligliptin, a DPP-4 inhibitor used for diabetes management, and its potential cardioprotective effects in a diabetic mouse model. They suggested teneligliptin administration may reverse established markers of DCM, including cardiac hypertrophy and compromised function. It also inhibited the NLRP3 inflammasome and reduced inflammatory cytokine production in diabetic mice. Macrophages play crucial roles in DCM pathogenesis. Chronic hyperglycemia disturbs the balance between pro-inflammatory (M1) and anti-inflammatory (M2) macrophages, favoring a pro-inflammatory state contributing to heart damage. Here, we highlight the potential of DPP-4 inhibitors to modulate macrophage function and promote an anti-inflammatory environment. These compounds may achieve this by elevating glucagon-like peptide-1 levels and potentially inhibiting the NLRP3 inflammasome. Further studies on teneligliptin in combination with other therapies targeting different aspects of DCM could be suggested for developing more effective treatment strategies to improve cardiovascular health in diabetic patients.
{"title":"Macrophage modulation with dipeptidyl peptidase-4 inhibitors: A new frontier for treating diabetic cardiomyopathy?","authors":"Saeed Mohammadi, Ahmed Al-Harrasi","doi":"10.4239/wjd.v15.i9.1847","DOIUrl":"https://doi.org/10.4239/wjd.v15.i9.1847","url":null,"abstract":"<p><p>This editorial introduces the potential of targeting macrophage function for diabetic cardiomyopathy (DCM) treatment by dipeptidyl peptidase-4 (DPP-4) inhibitors. Zhang <i>et al</i> studied teneligliptin, a DPP-4 inhibitor used for diabetes management, and its potential cardioprotective effects in a diabetic mouse model. They suggested teneligliptin administration may reverse established markers of DCM, including cardiac hypertrophy and compromised function. It also inhibited the NLRP3 inflammasome and reduced inflammatory cytokine production in diabetic mice. Macrophages play crucial roles in DCM pathogenesis. Chronic hyperglycemia disturbs the balance between pro-inflammatory (M1) and anti-inflammatory (M2) macrophages, favoring a pro-inflammatory state contributing to heart damage. Here, we highlight the potential of DPP-4 inhibitors to modulate macrophage function and promote an anti-inflammatory environment. These compounds may achieve this by elevating glucagon-like peptide-1 levels and potentially inhibiting the NLRP3 inflammasome. Further studies on teneligliptin in combination with other therapies targeting different aspects of DCM could be suggested for developing more effective treatment strategies to improve cardiovascular health in diabetic patients.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yi-Fan Yang, Ling Yuan, Xiang-Yang Li, Qian Liu, Wen-Jie Jiang, Tai-Qiang Jiao, Jia-Qing Li, Meng-Yi Ye, Yang Niu, Yi Nan
<p><strong>Background: </strong>Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus. Its blindness rate is high; therefore, finding a reasonable and safe treatment plan to prevent and control DR is crucial. Currently, there are abundant and diverse research results on the treatment of DR by Chinese medicine Traditional Chinese medicine compounds are potentially advantageous for DR prevention and treatment because of its safe and effective therapeutic effects.</p><p><strong>Aim: </strong>To investigate the effects of Buqing granule (BQKL) on DR and its mechanism from a systemic perspective and at the molecular level by combining network pharmacology and <i>in vivo</i> experiments.</p><p><strong>Methods: </strong>This study collected information on the drug targets of BQKL and the therapeutic targets of DR for intersecting target gene analysis and protein-protein interactions (PPI), identified various biological pathways related to DR treatment by BQKL through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses, and preliminarily validated the screened core targets by molecular docking. Furthermore, we constructed a diabetic rat model with a high-fat and high-sugar diet and intraperitoneal streptozotocin injection, and administered the appropriate drugs for 12 weeks after the model was successfully induced. Body mass and fasting blood glucose and lipid levels were measured, and pathological changes in retinal tissue were detected by hematoxylin and eosin staining. ELISA was used to detect the oxidative stress index expression in serum and retinal tissue, and immunohistochemistry, real-time quantitative reverse transcription PCR, and western blotting were used to verify the changes in the expression of core targets.</p><p><strong>Results: </strong>Six potential therapeutic targets of BQKL for DR treatment, including Caspase-3, c-Jun, TP53, AKT1, MAPK1, and MAPK3, were screened using PPI. Enrichment analysis indicated that the MAPK signaling pathway might be the core target pathway of BQKL in DR treatment. Molecular docking prediction indicated that BQKL stably bound to these core targets. <i>In vivo</i> experiments have shown that compared with those in the Control group, rats in the Model group had statistically significant (<i>P</i> < 0.05) severe retinal histopathological damage; elevated blood glucose, lipid, and malondialdehyde (MDA) levels; increased Caspase-3, c-Jun, and TP53 protein expression; and reduced superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, ganglion cell number, AKT1, MAPK1, and MAPK3 protein expression. Compared with the Model group, BQKL group had reduced histopathological retinal damage and the expression of blood glucose and lipids, MDA level, Caspase-3, c-Jun and TP53 proteins were reduced, while the expression of SOD, GSH-Px level, the number of ganglion cells, AKT1, MAPK1, and MAPK3 proteins were elevated. These differences were statistical
背景:糖尿病视网膜病变(DR)是糖尿病常见的微血管并发症:糖尿病视网膜病变(DR)是糖尿病常见的微血管并发症。其致盲率很高,因此,寻找合理、安全的治疗方案来预防和控制 DR 至关重要。目的:通过网络药理学和体内实验相结合的方法,从系统角度和分子水平研究布庆颗粒(BQKL)对 DR 的作用及其机制:本研究通过基因本体和京都基因组百科全书的富集分析,收集BQKL的药物靶点信息和DR的治疗靶点信息,进行交叉靶基因分析和蛋白相互作用(PPI)分析,确定了BQKL治疗DR的相关生物学通路,并通过分子对接初步验证了筛选出的核心靶点。此外,我们还通过高脂高糖饮食和腹腔注射链脲佐菌素构建了糖尿病大鼠模型,并在模型诱导成功后给予相应药物治疗 12 周。测量体重、空腹血糖和血脂水平,并通过苏木精和伊红染色检测视网膜组织的病理变化。用ELISA检测血清和视网膜组织中氧化应激指数的表达,用免疫组化、实时定量逆转录PCR和Western印迹验证核心靶点表达的变化:结果:利用PPI筛选出了BQKL治疗DR的六个潜在靶点,包括Caspase-3、c-Jun、TP53、AKT1、MAPK1和MAPK3。富集分析表明,MAPK 信号通路可能是 BQKL 治疗 DR 的核心靶点通路。分子对接预测表明,BQKL能与这些核心靶点稳定结合。体内实验表明,与对照组相比,模型组大鼠视网膜组织病理学损伤严重,血糖、血脂和丙二醛(MDA)水平升高,Caspase-3、c-Jun和TP53蛋白表达增加,超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)水平、神经节细胞数量、AKT1、MAPK1和MAPK3蛋白表达降低,差异有统计学意义(P<0.05)。与模型组相比,BQKL 组视网膜组织病理学损伤减轻,血糖和血脂、MDA 水平、Caspase-3、c-Jun 和 TP53 蛋白表达降低,而 SOD、GSH-Px 水平、神经节细胞数量、AKT1、MAPK1 和 MAPK3 蛋白表达升高。这些差异具有统计学意义(P < 0.05):结论:BQKL 可通过减轻氧化应激和炎症反应,调节 MAPK 信号通路介导的 Caspase-3、c-Jun、TP53、AKT1、MAPK1 和 MAPK3 蛋白,从而延缓 DR 的发生和发展。
{"title":"Molecular mechanisms of Buqing granule for the treatment of diabetic retinopathy: Network pharmacology analysis and experimental validation.","authors":"Yi-Fan Yang, Ling Yuan, Xiang-Yang Li, Qian Liu, Wen-Jie Jiang, Tai-Qiang Jiao, Jia-Qing Li, Meng-Yi Ye, Yang Niu, Yi Nan","doi":"10.4239/wjd.v15.i9.1942","DOIUrl":"https://doi.org/10.4239/wjd.v15.i9.1942","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus. Its blindness rate is high; therefore, finding a reasonable and safe treatment plan to prevent and control DR is crucial. Currently, there are abundant and diverse research results on the treatment of DR by Chinese medicine Traditional Chinese medicine compounds are potentially advantageous for DR prevention and treatment because of its safe and effective therapeutic effects.</p><p><strong>Aim: </strong>To investigate the effects of Buqing granule (BQKL) on DR and its mechanism from a systemic perspective and at the molecular level by combining network pharmacology and <i>in vivo</i> experiments.</p><p><strong>Methods: </strong>This study collected information on the drug targets of BQKL and the therapeutic targets of DR for intersecting target gene analysis and protein-protein interactions (PPI), identified various biological pathways related to DR treatment by BQKL through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses, and preliminarily validated the screened core targets by molecular docking. Furthermore, we constructed a diabetic rat model with a high-fat and high-sugar diet and intraperitoneal streptozotocin injection, and administered the appropriate drugs for 12 weeks after the model was successfully induced. Body mass and fasting blood glucose and lipid levels were measured, and pathological changes in retinal tissue were detected by hematoxylin and eosin staining. ELISA was used to detect the oxidative stress index expression in serum and retinal tissue, and immunohistochemistry, real-time quantitative reverse transcription PCR, and western blotting were used to verify the changes in the expression of core targets.</p><p><strong>Results: </strong>Six potential therapeutic targets of BQKL for DR treatment, including Caspase-3, c-Jun, TP53, AKT1, MAPK1, and MAPK3, were screened using PPI. Enrichment analysis indicated that the MAPK signaling pathway might be the core target pathway of BQKL in DR treatment. Molecular docking prediction indicated that BQKL stably bound to these core targets. <i>In vivo</i> experiments have shown that compared with those in the Control group, rats in the Model group had statistically significant (<i>P</i> < 0.05) severe retinal histopathological damage; elevated blood glucose, lipid, and malondialdehyde (MDA) levels; increased Caspase-3, c-Jun, and TP53 protein expression; and reduced superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, ganglion cell number, AKT1, MAPK1, and MAPK3 protein expression. Compared with the Model group, BQKL group had reduced histopathological retinal damage and the expression of blood glucose and lipids, MDA level, Caspase-3, c-Jun and TP53 proteins were reduced, while the expression of SOD, GSH-Px level, the number of ganglion cells, AKT1, MAPK1, and MAPK3 proteins were elevated. These differences were statistical","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Monserrat Lomelí Martínez, Irán Cortés Trujillo, Melissa Martínez Nieto, Ana Esther Mercado González
The global increase in the prevalence of type 2 diabetes mellitus (T2DM) and its complications presents significant challenges to public health. Recently, per-iodontal disease (PD) was recognized as a factor that is likely to influence the progression of T2DM and its complications due to its potential to exacerbate systemic inflammation and oxidative stress. In this editorial, we comment on the article published by Thazhe Poyil et al in the very recent issue of the World Journal of Diabetes in 2024, which investigated the correlation between PD and diabetic retinopathy (DR) in T2DM patients, with emphasis on the association between periodontal swollen surface area, glycated hemoglobin (HbA1c), interleukin-6 (IL-6), and lipoprotein (a). The findings by Thazhe Poyil et al are significant as they demonstrate a strong link between PD and DR in T2DM patients. This correlation highlights the importance of addressing periodontal health in diabetes management to potentially reduce the risk and severity of DR, a complication of diabetes. The integration of periodontal evaluation and treatment into diabetes care protocols may lead to improved glycemic control and better overall outcomes for T2DM patients . A few studies have established an interconnection between PD and diabetic complication, specifically DR, in T2DM patients, which we aim to highlight in this editorial. Emphasis was placed on the different mechanisms that suggest a bidirectional relationship between PD and T2DM, where the presence of periodontal inflammation negatively influenced glycemic control and contributed to the development and progression of DR through shared inflammatory and vascular mechanisms. This article highlights the importance of collaboration amongst diabetes specialists, ophthalmologists, periodontists, and public health professionals to advance the prevention, early detection, and treatment of PD and DR. This will improve the health and quality of life of T2DM patients. Moreover, the editorial highlights the need for further research on the specific molecular and immunological mechanisms that underlie the link between periodontitis and DR, with identification of common inflammatory biomarkers and signaling pathways. This is expected to facilitate effective direction of therapeutic objectives, thereby improving the management of diabetes and its complications through integrated care that incorporates oral health.
全球 2 型糖尿病(T2DM)及其并发症发病率的上升给公共卫生带来了重大挑战。最近,牙周病(PD)被认为是可能影响 T2DM 及其并发症发展的一个因素,因为它有可能加剧全身炎症和氧化应激。在这篇社论中,我们对 Thazhe Poyil 等人发表在最近一期《世界糖尿病杂志》(World Journal of Diabetes)上的文章(2024 年)进行了评论,该文章研究了 T2DM 患者牙周病与糖尿病视网膜病变(DR)之间的相关性,重点关注了牙周肿胀表面积、糖化血红蛋白(HbA1c)、白细胞介素-6(IL-6)和脂蛋白(a)之间的关联。Thazhe Poyil 等人的研究结果意义重大,因为他们证明了 T2DM 患者的牙周病与 DR 之间存在密切联系。这种相关性凸显了在糖尿病管理中解决牙周健康问题的重要性,从而有可能降低糖尿病并发症 DR 的风险和严重程度。将牙周评估和治疗纳入糖尿病护理方案可能会改善 T2DM 患者的血糖控制和总体疗效。有几项研究证实了 T2DM 患者的牙周病与糖尿病并发症(尤其是 DR)之间的相互联系,我们希望在这篇社论中强调这一点。文章强调了牙周病与 T2DM 之间存在双向关系的不同机制,即牙周炎症的存在会对血糖控制产生负面影响,并通过共同的炎症和血管机制促进 DR 的发生和发展。这篇文章强调了糖尿病专家、眼科专家、牙周病专家和公共卫生专业人员之间合作的重要性,以促进预防、早期发现和治疗糖尿病和慢性阻塞性肺病。这将改善 T2DM 患者的健康和生活质量。此外,社论还强调了进一步研究牙周炎与 DR 之间联系的特定分子和免疫学机制的必要性,并确定了常见的炎症生物标志物和信号通路。这将有助于有效指导治疗目标,从而通过结合口腔健康的综合护理改善糖尿病及其并发症的管理。
{"title":"Periodontal disease: A silent factor in the development and progression of diabetic retinopathy.","authors":"Sarah Monserrat Lomelí Martínez, Irán Cortés Trujillo, Melissa Martínez Nieto, Ana Esther Mercado González","doi":"10.4239/wjd.v15.i8.1672","DOIUrl":"10.4239/wjd.v15.i8.1672","url":null,"abstract":"<p><p>The global increase in the prevalence of type 2 diabetes mellitus (T2DM) and its complications presents significant challenges to public health. Recently, per-iodontal disease (PD) was recognized as a factor that is likely to influence the progression of T2DM and its complications due to its potential to exacerbate systemic inflammation and oxidative stress. In this editorial, we comment on the article published by Thazhe Poyil <i>et al</i> in the very recent issue of the <i>World Journal of Diabetes</i> in 2024, which investigated the correlation between PD and diabetic retinopathy (DR) in T2DM patients, with emphasis on the association between periodontal swollen surface area, glycated hemoglobin (HbA1c), interleukin-6 (IL-6), and lipoprotein (a). The findings by Thazhe Poyil <i>et al</i> are significant as they demonstrate a strong link between PD and DR in T2DM patients. This correlation highlights the importance of addressing periodontal health in diabetes management to potentially reduce the risk and severity of DR, a complication of diabetes. The integration of periodontal evaluation and treatment into diabetes care protocols may lead to improved glycemic control and better overall outcomes for T2DM patients . A few studies have established an interconnection between PD and diabetic complication, specifically DR, in T2DM patients, which we aim to highlight in this editorial. Emphasis was placed on the different mechanisms that suggest a bidirectional relationship between PD and T2DM, where the presence of periodontal inflammation negatively influenced glycemic control and contributed to the development and progression of DR through shared inflammatory and vascular mechanisms. This article highlights the importance of collaboration amongst diabetes specialists, ophthalmologists, periodontists, and public health professionals to advance the prevention, early detection, and treatment of PD and DR. This will improve the health and quality of life of T2DM patients. Moreover, the editorial highlights the need for further research on the specific molecular and immunological mechanisms that underlie the link between periodontitis and DR, with identification of common inflammatory biomarkers and signaling pathways. This is expected to facilitate effective direction of therapeutic objectives, thereby improving the management of diabetes and its complications through integrated care that incorporates oral health.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this editorial, we comment on the article by Zhang et al. Diabetes mellitus is a chronic disorder associated with several complications like cardiomyopathy, neuropathy, and retinopathy. Diabetes prevalence is increasing worldwide. Multiple diabetes medications are prescribed based on individual patients' needs. However, the exact mechanisms by which many of these drugs exert their pro-tective effects remain unclear. Zhang et al elucidates molecular mechanisms undelaying cardioprotective effect of the dipeptidyl peptidase-IV inhibitor, teneligliptin. Briefly, teneligliptin alleviates the activation of NOD-like receptor protein 3 inflammasome, a multiprotein complex that plays a pivotal role in regulating the innate immune system and inflammatory signaling. Suppression of NOD-like receptor protein 3 inflammasome activity reduces the expression of cytokines, oxygen radicals and inflammation. These findings highlight teneligliptin as an anti-diabetic cardioprotective reagent.
{"title":"Teneligliptin: A potential therapeutic approach for diabetic cardiomyopathy.","authors":"Ashraf Al Madhoun","doi":"10.4239/wjd.v15.i8.1654","DOIUrl":"10.4239/wjd.v15.i8.1654","url":null,"abstract":"<p><p>In this editorial, we comment on the article by Zhang <i>et al</i>. Diabetes mellitus is a chronic disorder associated with several complications like cardiomyopathy, neuropathy, and retinopathy. Diabetes prevalence is increasing worldwide. Multiple diabetes medications are prescribed based on individual patients' needs. However, the exact mechanisms by which many of these drugs exert their pro-tective effects remain unclear. Zhang <i>et al</i> elucidates molecular mechanisms undelaying cardioprotective effect of the dipeptidyl peptidase-IV inhibitor, teneligliptin. Briefly, teneligliptin alleviates the activation of NOD-like receptor protein 3 inflammasome, a multiprotein complex that plays a pivotal role in regulating the innate immune system and inflammatory signaling. Suppression of NOD-like receptor protein 3 inflammasome activity reduces the expression of cytokines, oxygen radicals and inflammation. These findings highlight teneligliptin as an anti-diabetic cardioprotective reagent.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Transient neonatal diabetes mellitus (TNDM) is a rare form of diabetes mellitus that usually presents within the first 6 mo of life. Patients often enter remission within several months, although relapse can occur later in life. Mutations in the ABCC8 gene, which encodes the sulfonylurea receptor 1 of the ATP-sensitive potassium channel in pancreatic beta cells, are associated with TNDM and permanent neonatal diabetes. This study describes a novel de novo c.3880C>T heterozygous ABCC8 variant that causes TNDM and can be treated with sulf-onylurea therapy.
Case summary: We retrospectively analyzed 2 Chinese patients with TNDM who were diagnosed, treated, or referred for follow-up between September 2017 and September 2023. The patients were tested for mutations using targeted next-generation sequencing. Patients with neonatal diabetes mellitus caused by a c.3880C>T heterozygous missense variant in the ABCC8 gene have not been reported before. Both children had an onset of post-infectious diabetic ketoacidosis, which is worth noting. At a follow-up visit after discontinuing insulin injection, oral glyburide was found to be effective with no adverse reactions.
Conclusion: Early genetic testing of neonatal diabetes mellitus aids in accurate diagnosis and treatment and helps avoid daily insulin injections that may cause pain.
背景:一过性新生儿糖尿病(TNDM)是一种罕见的糖尿病,通常在出生后 6 个月内发病。患者通常在数月内病情得到缓解,但也可能在出生后复发。ABCC8 基因编码胰岛β细胞中 ATP 敏感钾通道的磺脲受体 1,该基因的突变与 TNDM 和永久性新生儿糖尿病有关。本研究描述了一种新发的c.3880C>T杂合ABCC8变异,该变异可导致TNDM,并可通过磺脲类药物治疗。病例摘要:我们对2017年9月至2023年9月期间诊断、治疗或转诊随访的2例中国TNDM患者进行了回顾性分析。采用靶向新一代测序技术对患者进行了基因突变检测。由ABCC8基因c.3880C>T杂合子错义变异引起的新生儿糖尿病患者此前尚未见报道。值得注意的是,两名患儿均在感染后出现糖尿病酮症酸中毒。在停用胰岛素注射后的随访中发现,口服甘舒霖效果良好,且无不良反应:结论:对新生儿糖尿病进行早期基因检测有助于准确诊断和治疗,也有助于避免每天注射胰岛素带来的痛苦。
{"title":"Transient diabetes mellitus with ABCC8 variant successfully treated with sulfonylurea: Two case reports and review of literature.","authors":"Ling-Hua Shen, Yan Cui, Dong-Xia Fu, Wei Yang, Sheng-Nan Wu, Hui-Zhen Wang, Hai-Hua Yang, Yong-Xing Chen, Hai-Yan Wei","doi":"10.4239/wjd.v15.i8.1811","DOIUrl":"10.4239/wjd.v15.i8.1811","url":null,"abstract":"<p><strong>Background: </strong>Transient neonatal diabetes mellitus (TNDM) is a rare form of diabetes mellitus that usually presents within the first 6 mo of life. Patients often enter remission within several months, although relapse can occur later in life. Mutations in the <i>ABCC8</i> gene, which encodes the sulfonylurea receptor 1 of the ATP-sensitive potassium channel in pancreatic beta cells, are associated with TNDM and permanent neonatal diabetes. This study describes a novel <i>de novo</i> c.3880C>T heterozygous <i>ABCC8</i> variant that causes TNDM and can be treated with sulf-onylurea therapy.</p><p><strong>Case summary: </strong>We retrospectively analyzed 2 Chinese patients with TNDM who were diagnosed, treated, or referred for follow-up between September 2017 and September 2023. The patients were tested for mutations using targeted next-generation sequencing. Patients with neonatal diabetes mellitus caused by a c.3880C>T heterozygous missense variant in the <i>ABCC8</i> gene have not been reported before. Both children had an onset of post-infectious diabetic ketoacidosis, which is worth noting. At a follow-up visit after discontinuing insulin injection, oral glyburide was found to be effective with no adverse reactions.</p><p><strong>Conclusion: </strong>Early genetic testing of neonatal diabetes mellitus aids in accurate diagnosis and treatment and helps avoid daily insulin injections that may cause pain.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ye-Yao Li, Rui-Qian Guan, Zhi-Bo Hong, Yao-Lei Wang, Li-Min Pan
Diabetic peripheral neuropathy (DPN) is one of the strongest risk factors for diabetic foot ulcers (neuropathic ulcerations) and the existing ulcers may further deteriorate due to the damage to sensory neurons. Moreover, the resulting numbness in the limbs causes difficulty in discovering these ulcerations in a short time. DPN is associated with gut microbiota dysbiosis. Traditional Chinese medicine (TCM) compounds such as Shenqi Dihuang Decoction, Huangkui Capsules and Qidi Tangshen Granules can reduce the clinical symptoms of diabetic nephropathy by modulating gut microbiota. The current review discusses whether TCM compounds can reduce the risk of DPN by improving gut mic-robiota.
{"title":"Advances in the treatment of diabetic peripheral neuropathy by modulating gut microbiota with traditional Chinese medicine.","authors":"Ye-Yao Li, Rui-Qian Guan, Zhi-Bo Hong, Yao-Lei Wang, Li-Min Pan","doi":"10.4239/wjd.v15.i8.1712","DOIUrl":"10.4239/wjd.v15.i8.1712","url":null,"abstract":"<p><p>Diabetic peripheral neuropathy (DPN) is one of the strongest risk factors for diabetic foot ulcers (neuropathic ulcerations) and the existing ulcers may further deteriorate due to the damage to sensory neurons. Moreover, the resulting numbness in the limbs causes difficulty in discovering these ulcerations in a short time. DPN is associated with gut microbiota dysbiosis. Traditional Chinese medicine (TCM) compounds such as Shenqi Dihuang Decoction, Huangkui Capsules and Qidi Tangshen Granules can reduce the clinical symptoms of diabetic nephropathy by modulating gut microbiota. The current review discusses whether TCM compounds can reduce the risk of DPN by improving gut mic-robiota.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}