We report on a systematic review of the efficacy of turmeric derivatives for the in vivo treatment of peripheral neuropathies. Our review protocol followed the PRISMA Statement. The Medline (PubMed), Web of Science, Scopus, and Scielo databases were used. The search strategy was ("neuropathy" OR "neuropathies" OR "nerve injury" OR "nerve injuries") AND ("curcumin" OR "turmeric yellow" OR "yellow, turmeric" OR "diferuloylmethane"). Eligibility criteria were in vivo animal models, published in English, Portuguese, Spanish, or French, evaluating the efficacy of turmeric derivatives in the treatment of peripheral neuropathies. We have included 30 papers, and all consisted of pre-clinical trials with good methodological quality. Animals treated with turmeric derivatives (i.e., curcumin, curcumin by-products and curcumin loaded delivery systems) demonstrated remarkable amelioration in the injuries caused by diabetic and sciatic neuropathy, as well as for vincristine, cisplatin, and alcohol-induced neuropathy, especially with regards to the functional recovery of the affected nerve. Turmeric has great potential for the treatment of peripheral neuropathies, including those associated with diabetes mellitus. Clinical trials still need to be performed to assess the feasibility of human treatment as an alternative or adjuvant to existing pharmacological therapy.
Curcumin , Peripheral Nervous System Diseases , Animals , Curcuma , Curcumin/therapeutic use , Models, Animal , Peripheral Nervous System Diseases/drug therapy , Disease Models, Animal
ABSTRACT Objective: Conduct a survey on the interference of drugs in laboratory tests. Methodology: To identify the interference of each medication in laboratory tests, the Municipal List of Essential Medicines (Remume) of a medium-sized municipality in the state of Minas Gerais was used along with the following sources of information: Dynamed, Micromedex® and Nursing Reference Center. Results: We observed that the majority (67.7%) of Remume drugs can interfere in one or more laboratory tests; among them, the main classes of drugs are diuretics, beta blockers, ß-lactams, sulfonamides, macrolides, tricyclic antidepressants and selective serotonin reuptake inhibitors antidepressants. Conclusion: It is extremely important to disseminate knowledge about these interferences so that health professionals are alert and know how to identify the possible changes, reducing analytical errors and subsequently misdiagnosis and erroneous monitoring. Continued education on drug interference in laboratory tests is equally important.
RESUMEN Objetivo: Llevar a cabo una encuesta acerca de la interferencia de los medicamentos en las pruebas de laboratorio. Métodos: Usamos la Relación Municipal de Medicamentos Esenciales (Remume) de una municipalidad mediana en el estado de Minas Gerais y las siguientes fuentes de información: Dynamed, Micromedex® y Nursing Reference Center. Resultados: Observamos que la mayor parte (67,7%) de los medicamentos de Remume puede interferir en una o más pruebas de laboratorio; entre ellos, las principales clases son los diuréticos, beta bloqueadores, betalactámicos, sulfonamidas, macrólidos, antidepresivos tricíclicos y antidepresivos inhibidores selectivos de la recaptación de serotonina. Conclusión: Es muy importante divulgar el conocimiento respecto a esas interferencias para que los profesionales de la salud puedan identificar las posibles alteraciones en las pruebas, reduciendo errores analíticos y diagnósticos y monitoreos equivocados. Por lo tanto, es necesaria una educación continuada acerca de las interferencias de medicamentos en las pruebas de laboratorio.
RESUMO Objetivo: Realizar um levantamento sobre a interferência dos medicamentos nos exames laboratoriais. Métodos: Utilizamos a Relação Municipal dos Medicamentos Essenciais (Remune) de um município de médio porte do estado de Minas Gerais e as seguintes fontes de informações: Dynamed, Micromedex® e Nursing Reference Center. Resultados: Observamos que a maioria (67,7%) dos medicamentos da Remune pode interferir em um ou mais exames laboratoriais; entre eles, as principais classes de medicamentos são os diuréticos, betabloqueadores, betalactâmicos, sulfonamidas, macrolídeos, antidepressivos tricíclicos e antidepressivos inibidores seletivos da recaptação de serotonina. Conclusão: É muito importante divulgar o conhecimento a respeito dessas interferências para que os profissionais da área da saúde possam identificar as possíveis alterações nos exames, reduzindo erros analíticos e diagnósticos e monitoramentos equivocados. Portanto, faz-se necessária a educação continuada sobre as interferências de medicamentos nos exames laboratoriais.
ABSTRACT Introduction: The use of oral contraceptives increases women's risk of developing cardiovascular and thromboembolic diseases, due to alterations in hemostatic and lipid profile. Objectives: Analyze the association between the use of different types of oral contraceptives with lipid profile and levels of serum high-sensitivity C-reactive protein (hsCRP) and plasma D-dimer. Methods: One hundred fifty-four participants were divided into the following groups: control nonusers (n = 41), medium-dose users (n= 32), third-generation low-dose users (n = 40), and fourth-generation low-dose users (n = 41). Triglycerides and total cholesterol serum levels were determined by colorimetric enzymatic method; high-density lipoprotein (HDL) cholesterol levels, by precipitation method; low-density lipoprotein (LDL) cholesterol levels, by Friedewald equation; hsCRP levels, by immunoturbidimetric method; and D-dimer levels, by fluorescence immunoassay. Results: Oral contraceptive users had higher serum levels of triglycerides, total cholesterol, HDL cholesterol (HDL-C), HDL/LDL index and hsCRP compared to controls. Medium-dose users had higher D-dimer plasma levels than controls and higher triglycerides serum levels than low-dose users. Triglycerides, hsCRP and D-dimer were positively correlated to each other. Conclusion: The use of combined oral contraceptives was associated with an unfavorable lipid profile and a chronic subclinical inflammation, with atherogenic potential. Furthermore, medium-dose contraceptives induced a higher thrombogenic potential, since they were associated with increased D-dimer levels in comparison to low-dose ones.
RESUMO Introdução: O uso de anticoncepcionais orais aumenta o risco de desenvolvimento de doenças cardiovasculares e tromboembólicas devido a alterações no perfil lipídico e hemostático. Objetivo: Analisar a associação entre o uso de diferentes tipos de anticoncepcionais orais com o perfil lipídico e os níveis da proteína C reativa ultrassensível (PCRus) e do dímero D. Métodos: Cento e quarenta e cinco participantes foram divididas em: não usuárias (n = 41), usuárias de média dose (n = 32), usuárias de terceira geração de baixa dose (n = 40) e usuárias de quarta geração de baixa dose (n = 41). Níveis de triglicerídeos e colesterol total foram determinados pelo método enzimático colorimétrico; colesterol da lipoproteína de alta densidade (HDL), pelo método de precipitação; colesterol da lipoproteína de baixa densidade (LDL), pela equação de Friedewald; PCRus, por imunoturbidimetria; e dímero D, por imunoensaio fluorescente. Resultados: As usuárias de anticoncepcionais orais apresentaram maiores níveis de triglicerídeos, colesterol total, HDL, índice HDL/LDL e PCRus do que as não usuárias. As usuárias de anticoncepcionais de média dose apresentaram maiores níveis de dímero D do que as não usuárias, e maiores níveis de triglicerídeos do que as usuárias de anticoncepcionais de baixa dose. Triglicerídeos, PCRus e dímero D apresentaram correlação positiva uns com os outros. Conclusão: O uso de anticoncepcionais orais combinados está associado ao perfil lipídico desfavorável e à inflamação crônica subclínica, com potencial aterogênico. Além disso, os anticoncepcionais orais de média dose induziram maior potencial trombogênico, já que foram relacionados com níveis maiores de dímero D em comparação com os de baixa dose.
ABSTRACT Introduction: Diabetes mellitus is one of the greatest public health problems in the world; the numerous complications of this disease are the focus of great concern, as they are related to high morbidity and mortality. Among the complications of diabetes, diabetic retinopathy is the most common microvascular complication. Objectives: Evaluate the association of plasma levels of inflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ), and anti-inflammatory cytokine interleukin-10 (IL-10) with diabetic retinopathy and the correlation of plasma levels of these cytokines together. Material and method: 125 patients with type 1 diabetes mellitus were included in this study - 55 with retinopathy and 70 without retinopathy. Cytokines IL-6, TNF-α, IFN-γ and IL-10 were determined by flow cytometry. Results and discussion: A significant association of the levels of cytokines IL-6, TNF-α, IFN-γ and IL-10 with retinopathy was not observed, possibly because measurements were performed on plasma samples, but not on vitreous humor. However, a positive correlation of cytokines among themselves (p < 0.001) was observed. Conclusion: Cytokines IL-6, TNF-α, IFN-γ and IL-10 presented a positive correlation among themselves, what suggests that they may act together in the development and progression of vascular complications in diabetes patients.
RESUMO Introdução: O diabetes mellitus é considerado um dos maiores problemas de saúde pública no mundo; as numerosas complicações decorrentes dessa patologia são foco de grande preocupação, pois estão relacionadas com elevadas morbidade e mortalidade. Entre as complicações decorrentes do diabetes, a retinopatia diabética é considerada a complicação microvascular mais comum. Objetivos: Avaliar a associação dos níveis plasmáticos das citocinas inflamatórias interleucina 6 (IL-6), fator de necrose tumoral alfa (TNF-α) e interferon gama (IFN-γ) e da citocina anti-inflamatória interleucina 10 (IL-10) com a retinopatia diabética, bem como a correlação dos níveis plasmáticos dessas citocinas entre si. Material e método: Foram incluídos no estudo 125 pacientes diabéticos tipo 1, sendo 55 portadores de retinopatia e 70 sem retinopatia. As citocinas IL-6, TNF-α, IFN-γ e IL-10 foram determinadas pelo método de citometria de fluxo. Resultados e discussão: Não foi observada associação significativa dos níveis das citocinas IL-6, TNF-α, IFN-γ e IL-10 com a retinopatia, possivelmente devido às dosagens terem sido realizadas em amostras de plasma e não de humor vítreo/aquoso. Porém, foi observada correlação positiva das citocinas entre si (p < 0,001). Conclusão: As citocinas IL-6, TNF-α, IFN-γ e IL-10 apresentaram correlação positiva entre si, o que sugere que elas podem atuar em conjunto no desenvolvimento e na progressão das complicações vasculares nos pacientes diabéticos.
The aim of the present study was to investigate the association between the presence of albuminuria and cytokines profile with biomarkers of endothelial damage and oxidative stress in patients with type 1 diabetes mellitus (DM1). The sample was composed by 35 healthy individuals, 63 DM1 patients with normoalbuminuria (<30 mg of albumin/g of creatinine) and 62 DM1 patients with micro- and macroalbuminuria (≥30 mg of albumin/g of creatinine). Plasma and urinary cytokines (TNF-α, IL-6 and IL-10) and thrombomodulin levels were determined by ELISA. Oxidative status was evaluated using the TBARS and MTT assays. Diabetic patients were characterized by elevated levels of urinary cytokines TNF-α, IL-6 and IL-10. Those with macroalbuminuria presented significantly higher TNF-α and IL-10 urinary levels when compared to other groups. Urinary and plasmatic levels of TNF-α were positively correlated with plasma levels of cystatin C, creatinine, urea and albuminuria, while they were negatively correlated with estimated glomerular filtration rate. Urinary IL-10 levels proved positive correlation with fasting glucose, HbA1c, thrombomodulin and TBARS, while IL-6 plasma levels were positively correlated with HbA1c and albuminuria. Only urinary TNF-α levels were associated with the presence and severity of macroalbuminuria, after logistic regression analysis. This finding suggests that measurement of urinary TNF-α level may be helpful to evaluate progression to nephropathy in DM1 patients.
Biomarkers/urine , Diabetes Mellitus, Type 1/immunology , Endothelium/metabolism , Kidney/metabolism , Tumor Necrosis Factor-alpha/urine , Adult , Albuminuria , Biomarkers/blood , Cystatin C/metabolism , Diabetes Mellitus, Type 1/diagnosis , Disease Progression , Female , Glomerular Filtration Rate , Humans , Interleukin-10/blood , Interleukin-10/urine , Interleukin-6/blood , Interleukin-6/urine , Kidney/pathology , Male , Middle Aged , Oxidative Stress , Tumor Necrosis Factor-alpha/blood , Young Adult
