Albumin Oxidation and Albumin Glycation Discordance During Type 2 Diabetes Therapy: Biological and Clinical Implications.

Aims: Cys34 albumin redox modifications (reversible "cysteinylation" and irreversible "di/trioxidation"), besides being just oxidative stress biomarkers, may have primary pathogenetic roles to initiate and/or aggravate cell, tissue, and vascular damage in diabetes. In an exploratory "proof-of-concept" pilot study, we examined longitudinal changes in albumin oxidation during diabetes therapy. Methods: Mass spectrometric analysis was utilized to monitor changes in human serum albumin (HSA) post-translational modifications {glycation [glycated albumin (GA)], cysteinylation [cysteinylated albumin (CA) or human non-mercaptalbumin-1; reversible], di/trioxidation (di/trioxidized albumin or human non-mercaptalbumin-2; irreversible), and truncation (truncated albumin)} during ongoing therapy. Four informative groups of subjects were evaluated [type 1 diabetes (T1DM), type 2 diabetes (T2DM), prediabetes-obesity, and healthy controls] at baseline, and subjects with diabetes were followed for a period up to 280 days. Results: At baseline, T2DM was associated with relatively enhanced albumin cysteinylation (CA% total) compared with T1DM (P = 0.004), despite comparable mean hyperglycemia (P values: hemoglobin A1c = 0.09; GA = 0.09). T2DM, compared with T1DM, exhibited selectively and significantly higher elevations of all the "individual" glycated cum cysteinylated ("multimodified") albumin isoforms (P values: CysHSA+1G = 0.003; CysHSA+2G = 0.007; and CysHSA+3G = 0.001). Improvements in glycemic control and decreases in albumin glycation during diabetes therapy in T2DM were not always associated with concurrent reductions of albumin cysteinylation, and in some therapeutic situations, albumin cysteinylation worsened (glycation-cysteinylation discordance). Important differences were observed between the effects of sulfonylureas and metformin on albumin molecular modifications. Conclusions: T2DM was associated with higher oxidative (cysteinylation) and combined (cysteinylation plus glycation) albumin molecular modifications, which are not ameliorated by improved glucose control alone. Further studies are required to establish the clinical significance and optimal therapeutic strategies to address oxidative protein damage and resulting consequences in diabetes.

Differential Spectrum of Albumin Glycation, Oxidation, and Truncation in Type 2 and Type 1 Diabetes: Clinical and Biological Implications.

Background: Albumin, the most abundant and physiologically vital serum protein, accumulates a range of chemical modifications, as consequence of encounters with large number of reactive molecules whose concentrations increase in serum under pathological conditions. Methods: In a "proof of concept" study, mass spectrometric analysis was utilized to quantitate albumin post-translational modifications (glycation, oxidation, and truncation; individual isoforms and total) in four informative subject groups [type 1 diabetes (T1DM), type 2 diabetes (T2DM), prediabetes-obesity and healthy; all with estimated glomerular filtration rate ≥60 mL/(min·m2)]. Besides glycated albumin (GA/mass spectrometry), glycated serum protein (GSP/nitro blue tetrazolium colorimetry), and glycated hemoglobin (HbA1c/high-performance liquid chromatography) were also measured. Results: A wide spectrum of albumin molecular modifications was identified in diabetes, with significant differences between T2DM and T1DM. Albumin glycation: GA correlated more strongly with HbA1c in T1DM, compared to T2DM. Higher albumin glycation isoforms (human serum albumin +3G/2G) were more stable and discriminative markers of mean glycemia. Albumin oxidation: T2DM, in comparison with T1DM, showed enhanced oxidative and dual (glycation plus oxidation) modifications, representing extreme molecular pathology. Albumin truncation: There was dramatic reduction ("deficiency") of truncated albumin isoforms in T2DM, and significant reduction in T1DM. Albumin truncation negatively correlated with severity of albumin glycation (mean glycemia) and albumin oxidation (cysteinylation). Possible mechanisms of insulin resistance, with associated increased free fatty acids binding to albumin, in stimulating albumin oxidation and inhibiting albumin glycation ("metabolic cross talks") are reviewed. Conclusions: Albumin molecular modifications in diabetes, together with significant differences between T2DM and T1DM, suggest possible role for insulin resistance in their genesis and consequent cell, tissue, and vascular dysfunction/damage. Albumin molecular fingerprinting can provide valuable insights into pathogenesis, diagnosis, monitoring, and future therapies for diabetes. Identification of biomarker battery ("albuminomics," "diabetomics") driven diverse "healthy," prediabetes, obesity, and T2DM phenotypes represents additional novel step toward precision medicine in diabetes and related disorders.

Serum Creatinine Electrochemical Biosensor on Printed Electrodes Using Monoenzymatic Pathway to 1-Methylhydantoin Detection.

The rising prevalence of Chronic Kidney Disease (CKD) has necessitated efforts towards the development of cost-effective and accurate biosensors for serum creatinine, which is a potent biomarker reflecting kidney function. This work presents a novel and cost-effective technique to estimate serum creatinine without any sample preprocessing. The technique involves the conversion of creatinine by a monoenzymatic pathway to 1-methylhydantoin. The concentration of 1-methylhydantoin is then quantified by utilizing its innate ability to form a complex with transition metals such as cobalt. The complex formation has been validated using optical spectroscopy and the transmittance at 290 nm wavelength is used to identify the optimum concentration of cobalt chloride in sensing chemistry. This chemical assay is shown to be robust against interference from serum albumin, the abundant plasma protein that can potentially influence the sensor response. The electrochemical biosensor developed using screen-printed electrodes thus provides highly selective creatinine estimation over the range of 0.2-4 mg/dL in a sample volume of 300 µL with no preprocessing and hence can be easily translated into a viable point-of-care (POC) device.

Biochemical assay for serum creatinine detection through a 1-methylhydantoin and cobalt complex.

Creatinine is a reliable indicator of renal function and degradation of muscular metabolism. Current analytical techniques for its measurement are limited by their cost and requirement of sophisticated instruments. In this work, we report a highly sensitive amperometric biosensor for creatinine by utilizing the one-step selective conversion of creatinine by creatinine deiminase. The novelty of the proposed sensor relies on the measurement of N-methylhydantoin produced in the reaction. The sensing chemistry comprises of creatinine deiminase as the receptor for creatinine, cobalt chloride as the electrochemically active recognition element, and methylene blue as the redox mediator. The sensing chemistry is immobilized on the glassy carbon electrode surface by physisorption. We have been able to provide a standalone device that reliably quantifies creatinine in serum and even whole blood, without any sample pre-processing. It is possible to measure creatinine in the clinically relevant range from 0.8 to 4 mg dL-1 with this approach.

Identification of compounds for improved growth of Leptospira in culture and isolation.

Leptospirosis is a recurring global disease of severe illness involving pulmonary and renal involvement in cattle and humans that needs attention to cure. The major challenge in treating leptospirosis disease is the diagnosis of the disease. The culturing of an organism is a gold standard for confirmation of the disease. The growth and optimistic identification of an organism require at least 8 to 14 days because of its slow growth characteristics. We have investigated various media conditions that are prepared based on the wealth of information obtained from 'omic' studies and report a sustainable Leptospira growth medium comprising of serum equivalent elements and nutrients for pyrimidine biosynthesis, which allows a visible growth of organism within 2 days.

A novel mutation in the transglutaminase-1 gene in an autosomal recessive congenital ichthyosis patient.

Structure-function implication on a novel homozygous Trp250/Gly mutation of transglutaminase-1 (TGM1) observed in a patient of autosomal recessive congenital ichthyosis is invoked from a bioinformatics analysis. Structural consequences of this mutation are hypothesized in comparison to homologous enzyme human factor XIIIA accepted as valid in similar structural analysis and are projected as guidelines for future studies at an experimental level on TGM1 thus mutated.