RESUMEN
Ischemia is a stimulus for production of angiogenic cytokines that activate local vascular cells and mobilize angiogenic cells to the circulation. These responses are impaired in elderly patients with peripheral arterial disease. Hypoxia-inducible factor (HIF)-1 mediates adaptive responses to ischemia, including production of angiogenic cytokines. In this study, we demonstrate that aging and HIF-1 loss-of-function impair the expression of multiple angiogenic cytokines, mobilization of angiogenic cells, maintenance of tissue viability, and recovery of limb perfusion following femoral artery ligation. We show that HIF-1 directly activates transcription of the gene encoding stem cell factor and that mice lacking the cognate receptor C-KIT have impaired recovery from ischemia. Administration of AdCA5, an adenovirus encoding a constitutively active form of HIF-1alpha, improved the recovery of perfusion in older mice to levels similar to those in young mice. Injection of AdCA5 into nonischemic limb was sufficient to increase the number of circulating angiogenic cells. These results indicate that HIF-1 activity is necessary and sufficient for the mobilization of angiogenic cells and that HIF-1alpha gene therapy can counteract the pathological effects of aging in a mouse model of limb ischemia.
Asunto(s)
Envejecimiento/metabolismo , Movimiento Celular/fisiología , Factor 1 Inducible por Hipoxia/metabolismo , Isquemia/genética , Isquemia/terapia , Extremidad Inferior/irrigación sanguínea , Neovascularización Patológica/genética , Neovascularización Patológica/terapia , Envejecimiento/genética , Envejecimiento/patología , Animales , Movimiento Celular/genética , Células Cultivadas , Factor 1 Inducible por Hipoxia/genética , Factor 1 Inducible por Hipoxia/uso terapéutico , Isquemia/metabolismo , Isquemia/patología , Extremidad Inferior/fisiología , Masculino , Ratones , Ratones Noqueados , Ratones Transgénicos , Neovascularización Patológica/metabolismo , Reperfusión/métodosRESUMEN
OBJECTIVE: To evaluate the impacts of using SMS on improving laboratory test levels and Knowledge, Attitude, Practice (KAP) and Self Efficacy (SE) of patients with type 2 diabetes mellitus (DM) in Iran. MATERIALS AND METHODS: In this randomized controlled trial study, a total of 81 type 2 diabetes patients were randomly assigned into two groups exp. group (n = 43) and cont. group (n = 38). Only exp. group received 4 messages weekly consisted of diet, exercise, medication taking and. The researchers provided the intervention for 12 weeks. Data were collected with results of laboratory tests and KAP, SE reliable and valid questionnaires and demographic characteristics list. Data gathering at the baseline of the study and after 3 months intervention and was analyzed by SPSS11.5 software using descriptive and inferential statistics methods. RESULTS: The results of this study showed that exp. group compared with cont. group improved significantly in HbA1C (p = 0.024), LDL (p = 0.019), cholesterol (p = 0.002), BUN (p ≤ 0.001), micro albumin (p ≤ 0.001), knowledge (p ≤ 0.001), practice (p ≤ 0.001) and self efficacy (p ≤ 0.001). CONCLUSION: The finding of this study demonstrate the effectiveness of intervention using SMS via mobile phone in the management of type 2 diabetes mellitus (DM). Thus, further studies are recommended for wide usage of distance education with mobile phone utilization.