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1.
Hum Genomics ; 18(1): 29, 2024 Mar 22.
Article in English | MEDLINE | ID: mdl-38520002

ABSTRACT

Chromosomal structural rearrangements consist of anomalies in genomic architecture that may or may not be associated with genetic material gain and loss. Evaluating the precise breakpoint is crucial from a diagnostic point of view, highlighting possible gene disruption and addressing to appropriate genotype-phenotype association. Structural rearrangements can either occur randomly within the genome or present with a recurrence, mainly due to peculiar genomic features of the surrounding regions. We report about three non-related individuals, harboring chromosomal structural rearrangements interrupting SETBP1, leading to gene haploinsufficiency. Two out of them resulted negative to Chromosomal Microarray Analysis (CMA), being the rearrangement balanced at a microarray resolution. The third one, presenting with a complex three-chromosome rearrangement, had been previously diagnosed with SETBP1 haploinsufficiency due to a partial gene deletion at one of the chromosomal breakpoints. We thoroughly characterized the rearrangements by means of Optical Genome Mapping (OGM) and Whole Genome Sequencing (WGS), providing details about the involved sequences and the underlying mechanisms. We propose structural variants as a recurrent event in SETBP1 haploinsufficiency, which may be overlooked by laboratory routine genomic analyses (CMA and Whole Exome Sequencing) or only partially determined when associated with genomic losses at breakpoints. We finally introduce a possible role of SETBP1 in a Noonan-like phenotype.


Subject(s)
Chromosome Aberrations , Haploinsufficiency , Humans , Haploinsufficiency/genetics , Gene Rearrangement , Chromosomes , Whole Genome Sequencing/methods , Carrier Proteins/genetics , Nuclear Proteins/genetics
2.
Eur J Med Genet ; 65(1): 104381, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34763108

ABSTRACT

The recurrent 2q13 deletion syndrome is a rare genetic disorder associated with developmental delay, cardiac and urogenital malformations, and minor facial anomalies. Congenital heart defects (CHDs) are the most frequent malformations associated with del2q13. Experimental studies in zebrafish suggest that two genes mapping within the 2q13 critical region (FBLN7 and TMEM87B) could confer susceptibility to congenital heart defects in affected individuals. We reviewed the cardiac characteristics in four patients with 2q13 deletion admitted to our hospitals, and in published patients. Two of our patients had congenital heart defects, consisting in partial anomalous pulmonary venous connection, ostium secundum atrial septal defect ostium secundum, and small muscular ventricular septal defect in one of them, and aortic valve insufficiency with partial fusion of two commissures (incomplete bicuspid aortic valve) and mitral valve insufficiency due to trivial mitral valve prolapse in the other. The anatomic types of CHD in del2q13 syndrome are highly variable and distributed widely, including laterality defects, complex atrioventricular septal defect, septal anomalies, and cardiomyopathies. Cardiac evaluation should be part of the clinical workup at diagnosis of 2q13 deletion.


Subject(s)
Chromosome Deletion , Chromosomes, Human, Pair 2 , Heart Defects, Congenital/genetics , Humans , Recurrence
3.
Acta Diabetol ; 55(6): 557-568, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29527621

ABSTRACT

AIMS: There is an unmet need among healthcare providers to identify subgroups of patients with type 2 diabetes who are most likely to respond to treatment. METHODS: Data were taken from electronic medical records of participants of an observational, retrospective study in Italy. We used logistic regression models to assess the odds of achieving glycated haemoglobin (HbA1c) reduction ≥ 1.0% point after 12-month treatment with liraglutide (primary endpoint), according to various patient-related factors. RECursive Partitioning and AMalgamation (RECPAM) analysis was used to identify distinct homogeneous patient subgroups with different odds of achieving the primary endpoint. RESULTS: Data from 1325 patients were included, of which 577 (43.5%) achieved HbA1c reduction ≥ 1.0% point (10.9 mmol/mol) after 12 months. Logistic regression showed that for each additional 1% HbA1c at baseline, the odds of reaching this endpoint were increased 3.5 times (95% CI: 2.90-4.32). By use of RECPAM analysis, five distinct responder subgroups were identified, with baseline HbA1c and diabetes duration as the two splitting variables. Patients in the most poorly controlled subgroup (RECPAM Class 1, mean baseline HbA1c > 9.1% [76 mmol/mol]) had a 28-fold higher odds of reaching the endpoint versus patients in the best-controlled group (mean baseline HbA1c ≤ 7.5% [58 mmol/mol]). Mean HbA1c reduction from baseline was as large as - 2.2% (24 mol/mol) in the former versus - 0.1% (1.1 mmol/mol) in the latter. Mean weight reduction ranged from 2.5 to 4.3 kg across RECPAM subgroups. CONCLUSIONS: Glycaemic response to liraglutide is largely driven by baseline HbA1c levels and, to a lesser extent, by diabetes duration.


Subject(s)
Biomarkers/analysis , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/therapeutic use , Liraglutide/therapeutic use , Aged , Blood Glucose/analysis , Databases, Factual , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Electronic Health Records/statistics & numerical data , Female , Glycated Hemoglobin/analysis , Humans , Italy/epidemiology , Longitudinal Studies , Male , Middle Aged , Prognosis , Retrospective Studies , Treatment Outcome , Weight Loss/drug effects
4.
Expert Rev Clin Pharmacol ; 10(7): 763-772, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28431476

ABSTRACT

INTRODUCTION: The present review developed a clinical consensus based on a Delphi method on Dapagliflozin, a selective inhibitor of the renal sodium-glucose co-transporter-2 (SGLT2-I) in the treatment of patients with Type 2 diabetes mellitus. Areas covered: Panel members, using a 5-point scale, were asked to rate 9 statements on pharmakodinamic, mode of action on glycaemic and extra-glycaemic effects, and safety of dapaglifozin, Members also aimed to identify the patient most susceptible to the treatment with dapagliflozin . Expert commentary: Dapagliflozin is effective in lowering the plasma glucose concentration with a good safety profile. Dapagliflozin can be utilized in combination with all other antihyperglycaemic agents at all stages of the disease: however, a reduced GFR limits its efficacy. As for the other drugs of the class, Dapagliflozin positively modifies other risk factors for CV disease: these effects will be tested in the so far largest cardiovascular outcome trial for the SGLT2 inhibitors so far, the DECLARE trial, which will communicate whether this class of drugs will be disease-modifier in patients with type 2 diabetes also in primary prevention.


Subject(s)
Benzhydryl Compounds/therapeutic use , Diabetes Mellitus, Type 2/drug therapy , Glucosides/therapeutic use , Hypoglycemic Agents/therapeutic use , Benzhydryl Compounds/adverse effects , Benzhydryl Compounds/pharmacology , Blood Glucose/drug effects , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Consensus , Delphi Technique , Diabetes Mellitus, Type 2/physiopathology , Glomerular Filtration Rate , Glucosides/adverse effects , Glucosides/pharmacology , Humans , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/pharmacology , Risk Factors , Sodium-Glucose Transporter 2 Inhibitors
5.
Nutr Metab Cardiovasc Dis ; 26(10): 893-8, 2016 10.
Article in English | MEDLINE | ID: mdl-27480449

ABSTRACT

BACKGROUND AND AIMS: Literature data suggest an association between Helicobacter pylori infection and glucose homeostasis. However, a causative link between them has not been demonstrated yet. The aim of this study is to investigate the effect of H. pylori eradication on glucose homeostasis in patients with type 2 diabetes. METHODS AND RESULTS: A randomized, double-blind, placebo-controlled trial was conducted to investigate the effect of H. pylori eradication on glucose homeostasis in 154 patients with type 2 diabetes and who tested positive for H. pylori infection (mean age (SD), 63.1 (8.1) years). Subjects were assigned to H. pylori eradication treatment or placebo. Metabolic and inflammatory parameters were measured in all subjects at baseline and 4 weeks after the treatment. H. pylori eradication led to an improvement in glucose homeostasis, measured by HOMA-IR (p < 0.001) and KITT (0 = 0.041), due to the decrease in fasting insulin levels (p = 0.004). The results also showed that lower levels of inflammatory parameters were present after eradication. CONCLUSION: To our knowledge this is the first randomized, double blind, controlled study where the effect of H. pylori eradication on glucose homeostasis in subjects with type 2 diabetes has been investigated. Our findings demonstrate that H. pylori eradication improves glucose homeostasis in patients with type 2 diabetes through a decrease in pro-inflammatory factors. TRIAL REGISTRATION NUMBER: ACTRN12609000255280 (https://www.anzctr.org.au/).


Subject(s)
Amoxicillin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Blood Glucose/metabolism , Clarithromycin/administration & dosage , Diabetes Mellitus, Type 2/blood , Esomeprazole/administration & dosage , Helicobacter Infections/drug therapy , Helicobacter pylori/drug effects , Proton Pump Inhibitors/administration & dosage , Aged , Amoxicillin/adverse effects , Anti-Bacterial Agents/adverse effects , Biomarkers/blood , Clarithromycin/adverse effects , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/microbiology , Double-Blind Method , Drug Administration Schedule , Drug Therapy, Combination , Esomeprazole/adverse effects , Female , Helicobacter Infections/blood , Helicobacter Infections/diagnosis , Helicobacter Infections/microbiology , Helicobacter pylori/pathogenicity , Homeostasis , Host-Pathogen Interactions , Humans , Inflammation Mediators/blood , Insulin/blood , Insulin Resistance , Italy , Male , Middle Aged , Proton Pump Inhibitors/adverse effects , Time Factors , Treatment Outcome
6.
Diabetes Obes Metab ; 18(9): 855-67, 2016 09.
Article in English | MEDLINE | ID: mdl-27161301

ABSTRACT

Type 2 diabetes mellitus (T2DM) is a major cause of cardiovascular (CV) disease. Several large clinical trials have shown that the risk for patients with diabetes of developing CV complications is only partially reduced by early, intensive glycaemic control and lifestyle interventions, and that such complications result from changes in complex, not fully explored networks that contribute to the maintenance of endothelial function. The accumulation of senescent cells and the low-grade, systemic, inflammatory status that accompanies aging (inflammaging) are involved in the development of endothelial dysfunction. Such phenomena are modulated by epigenetic mechanisms, including microRNAs (miRNAs). MiRNAs can modulate virtually all gene transcripts. They can be secreted by living cells and taken up in active form by recipient cells, providing a new communication tool between tissues and organs. MiRNA deregulation has been associated with the development and progression of a number of age-related diseases, including the enduring gene expression changes seen in patients with diabetes. We review recent evidence on miRNA changes in T2DM, focusing on the ability of diabetes-associated miRNAs to modulate endothelial function, inflammaging and cellular senescence. We also discuss the hypothesis that miRNA-containing extracellular vesicles (i.e. exosomes and microvesicles) could be harnessed to restore a 'physiological' signature capable of preventing or delaying the harmful systemic effects of T2DM.


Subject(s)
Aging/metabolism , Diabetes Mellitus, Type 2/metabolism , Diabetic Angiopathies/metabolism , Endothelium, Vascular/metabolism , Extracellular Vesicles/metabolism , MicroRNAs/metabolism , Cellular Senescence , Diabetes Mellitus, Type 2/drug therapy , Diabetic Angiopathies/physiopathology , Endothelium, Vascular/physiopathology , Epigenesis, Genetic , Humans , Hyperglycemia/metabolism , Hypoglycemic Agents/therapeutic use , Inflammation
7.
Nutr Metab Cardiovasc Dis ; 26(4): 285-92, 2016 Apr.
Article in English | MEDLINE | ID: mdl-27036849

ABSTRACT

AIMS: The possible link between hyperglycaemia-induced oxidative stress (OxS) and diabetic complications is suggested by many in vitro studies. However, not much attention has been paid to the clinical evidence supporting this hypothesis, as well as to their possible therapeutic implications. DATA SYNTHESIS: Some prospective studies show a direct correlation between an increase in OxS biomarkers and the appearance of diabetes complications. This is consistent with the evidence that any acute increase of glycaemia, particularly post-prandial, and hypoglycaemia causes endothelial dysfunction and inflammation, through the generation of an OxS. However, the detection of free radicals is difficult as they are highly reactive molecules with a short half-life. Instead, the metabolites of OxS are measured. Interventional trials with supplemented antioxidants have failed to show any beneficial effects. Conversely, natural foods show very promising results. CONCLUSIONS: The "new antioxidant" approach includes the possibility of controlling free radical production and increasing intracellular antioxidant defence, a concept different from the old one, when antioxidant activities implied scavenging the free radicals already produced. A synergistic action in this respect could convincingly be obtained with a balanced 'Mediterranean Diet' (MedD) type. Early intensive glucose control is still the best strategy to avoid OxS and its associated diabetes complications.


Subject(s)
Antioxidants/pharmacology , Cardiovascular Diseases/drug therapy , Diabetic Angiopathies/drug therapy , Hypoglycemic Agents/pharmacology , Oxidative Stress , Biomarkers/blood , Cardiovascular Diseases/blood , Diabetic Angiopathies/blood , Diet, Mediterranean , Drug Synergism , Endothelium, Vascular/physiopathology , Humans , Randomized Controlled Trials as Topic , Reactive Oxygen Species/metabolism
8.
Mar Environ Res ; 115: 65-77, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26895386

ABSTRACT

Trophic ecology of adults of European sardine (Sardina pilchardus) and anchovy (Engraulis encrasicolus) was examined and compared among various regions of central Mediterranean Sea. Carbon and nitrogen stable isotope analyses (δ(13)C and δ(15)N) were adopted as a tool to determine changes in feeding behaviour of adults of sardines and anchovies. In the study period (summer) a clear geographical pattern was recognized in the isotopic composition of both species, with an increasing trend northward. The highest variations in isotopic signal were linked to the geographical positions of the samples and, especially, between pairs of areas: South Sicily/South Campania and Gulf of Gaeta/South Elba. Higher isotope values were found in the anchovies and sardines caught in northern Tyrrhenian Sea, while lower values were mostly estimated in the southern region. Higher carbon and nitrogen isotopes may reflect a more coastal behaviour of both species, being (13)C-enriched source from benthic primary producers in addition to phytoplankton. Variations in the nitrogen isotope ratio may reflect not only differences in the trophic level of prey species, but also variations in the baseline level of food webs. Our results support the hypothesis that feeding behaviour of both species is directly or indirectly influenced by local factors, or by resource partitioning based on zooplankton size. Findings can supply knowledge needed for improving fish stock management and promoting plans able to take into account also local ecosystem analysis.


Subject(s)
Ecosystem , Feeding Behavior , Fishes/physiology , Animals , Carbon Isotopes/analysis , Food Chain , Mediterranean Sea , Nitrogen Isotopes/analysis
9.
Diabetes Res Clin Pract ; 113: 179-86, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26803356

ABSTRACT

AIMS: To compare metabolic control under lispro and recombinant regular human insulin (RHI) in people with diet-unresponsive type 2 diabetes mellitus (T2DM) and compensated non-alcoholic liver disease (CLD). METHODS: 108 people with T2DM and CLD were randomly allocated to RHI or lispro according to a 12+12 week cross-over protocol. A 1-week continuous glucose monitoring (CGM) session was performed at the end of each treatment period followed by a standard meal test with a 12IU lispro or RHI shot ahead. RESULTS: CGM showed higher glycemic excursions under RHI than under lispro (p<0.01) with lower glucose levels in the late post-absorption phase (p<0.05) and even more during the night (p<0.01). Post-challenge incremental areas under the curve (ΔAUC) were undistinguishable for insulin but lower for glucose, while insulin peaked higher and earlier and glycemic excursions were lower with lispro than with RHI (0.05

Subject(s)
Blood Glucose/drug effects , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin Lispro/therapeutic use , Insulin, Regular, Human/therapeutic use , Liver Cirrhosis/complications , Cross-Over Studies , Diabetes Mellitus, Type 2/complications , Female , Humans , Hyperglycemia/drug therapy , Insulin/therapeutic use , Insulin Lispro/pharmacology , Insulin, Regular, Human/pharmacology , Male , Middle Aged , Postprandial Period
10.
Nurse Educ ; 40(1): 41-5, 2015.
Article in English | MEDLINE | ID: mdl-25350049

ABSTRACT

The number of international applicants to US nursing graduate programs is increasing. Modifying standard admission criteria, such as RN licensure, graduate record examination, validation of BSN degree, criminal background check, letters of recommendation, and personal statements, is necessary because of unique complexities. Addressing admission requirements unique to international students, such as English proficiency, visas, and proof of financial resources, is critical. Managing complexities of admitting international students is necessary to facilitate their success.


Subject(s)
Education, Nursing, Graduate/organization & administration , Faculty, Nursing , International Educational Exchange , School Admission Criteria , Humans , Nursing Education Research , United States
11.
Lett Appl Microbiol ; 59(1): 43-8, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24597562

ABSTRACT

UNLABELLED: Aloe barbadensis Miller (Aloe vera) is a herbal remedy widely used for a variety of illnesses; A. vera leaf extracts have been promoted for detoxification, cure constipation, help flush out toxins and wastes from the body, promote digestion and are used in the treatment of peptic ulcer for cytoprotective action. The aim of this study was to evaluate the antibacterial activity of A. vera inner gel against both susceptible and resistant Helicobacter pylori strains isolated in Abruzzo region, Italy. The inner gel of leaves of a 5-year-old plant of A. vera was extracted, homogenized and tested from 800 to 1.56 mg ml(-1) against 14 clinical strains and one reference strain of H. pylori using the broth microdilution methodology. Furthermore, the sample of A. vera was investigated for the chemical fingerprint of anthraquinones. The inhibitory concentrations of A. vera inner gel were similar to the bactericidal ones, with values ranging from 6.25 to 800 mg ml(-1) . Fifty per cent of the detected strains, independently of their susceptibility profile, were inhibited in their growth at 100 mg ml(-1) . Aloe vera inner gel expresses antibacterial properties against H. pylori and, therefore, in combination with antibiotics, could represent a novel strategy for the treatment of the infection of H. pylori, especially in cases of multiresistance. SIGNIFICANCE AND IMPACT OF THE STUDY: The study demonstrates that the Aloe vera inner gel expresses antibacterial properties against both susceptible and resistant Helicobacter pylori strains. These findings may impact on the antimicrobial resistance phenomenon of H. pylori, proposing the A. vera inner gel as a novel effective natural agent for combination with antibiotics for the treatment of H. pylori gastric infection.


Subject(s)
Aloe/chemistry , Anti-Bacterial Agents/pharmacology , Helicobacter pylori/drug effects , Plant Extracts/pharmacology , Amoxicillin/pharmacology , Drug Resistance, Bacterial , Gels , Helicobacter Infections/drug therapy , Humans , Microbial Sensitivity Tests , Plant Leaves/chemistry
12.
Nutr Metab Cardiovasc Dis ; 24(2): 116-23, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24094827

ABSTRACT

BACKGROUND AND AIMS: Hypoglycemia produces thrombosis activation, but little attention has been paid to the effects of hyperglycemia following recovery from hypoglycemia on thrombosis activation. METHODS AND RESULTS: In both twenty-two healthy subjects and twenty-one matched persons with type 1 diabetes, recovery from a 2-h induced hypoglycemia was obtained by reaching normo-glycemia or hyperglycemia for another 2 h. After this, normal glycemia was maintained for the following 6 h. Hyperglycemia after hypoglycemia was also repeated with the concomitant infusion of vitamin C. In both controls and people with diabetes, the recovery with normo-glycemia was accompanied by a significant improvement of Von Willebrand factor (vWF), prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin III-complexes (TAT), P-selectin, plasminogen activator inhibitor-1 (PAI-1), nitrotyrosine and 8-iso-prostaglandin F2α (8-iso-PGF2α) (p < 0.01 vs hypoglycemia for all the parameters), all directly affected by hypoglycemia itself (p < 0.01 vs baseline for all the parameters). On the contrary, the recovery with hyperglycemia after hypoglycemia worsens all these parameters (p < 0.01 vs normoglycemia for all the parameters), an effect persisting even after the additional 6 h of normo-glycemia. The effect of hyperglycemia following hypoglycemia was partially counterbalanced when vitamin C was infused (p < 0.01 vs hyperglycemia alone for all the parameters), suggesting that hyperglycemia following hypoglycemia may activate thrombosis through the oxidative stress production. CONCLUSION: This study shows that, in type 1 diabetes as well as in controls, the way in which recovery from hypoglycemia takes place could play an important role in favoring the activation of thrombosis and oxidative stress, widely recognized cardiovascular risk factors.


Subject(s)
Diabetes Mellitus, Type 1/therapy , Endothelium, Vascular/pathology , Hyperglycemia/drug therapy , Hypoglycemia/therapy , Thrombosis/pathology , Adult , Antithrombin III/metabolism , Ascorbic Acid/administration & dosage , Blood Glucose/metabolism , Dinoprost/analogs & derivatives , Dinoprost/metabolism , Female , Healthy Volunteers , Humans , Hyperglycemia/etiology , Hypoglycemia/complications , Male , Oxidative Stress/physiology , P-Selectin/metabolism , Peptide Fragments/metabolism , Peptide Hydrolases/metabolism , Plasminogen Activator Inhibitor 1/metabolism , Protein Precursors/metabolism , Prothrombin/metabolism , Thrombosis/etiology , Young Adult , von Willebrand Factor/metabolism
13.
Diabetes Obes Metab ; 15(10): 938-53, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23594109

ABSTRACT

AIM: Cardiovascular safety of sulfonylurea has been questioned by some authors. This article aims at collecting all available data on this issue from randomized trials. METHODS: A meta-analysis was performed including all trials with a duration of at least 6 months, comparing a sulfonylurea with a non-sulfonylurea agent in type 2 diabetes. Major cardiovascular events (MACE) and mortality were retrieved and combined to calculate Mantel-Haenzel odds ratio (MH-OR). RESULTS: Of the 115 selected trials, 62 reported information on MACE, and 30 reported at least one event. MH-OR for sulfonylurea was 1.08 [0.86-1.36], p = 0.52 (1.85 [1.20-2.87], p = 0.005, in the five trials vs. DPP4 inhibitors, no significant differences vs. other comparators). The MH-OR for myocardial infarction and stroke was 0.88 [0.75-1.04], p = 0.13 and 1.28 [1.03-1.60], p = 0.026, respectively. Mortality was significantly increased with sulfonylureas (MH-OR: 1.22 [1.01-1.49], p = 0.047). CONCLUSIONS: In type 2 diabetes, the use of sulfonylureas is associated with increased mortality and a higher risk of stroke, whereas the overall incidence of MACE appears to be unaffected. Significant differences in cardiovascular risk could be present in direct comparisons with specific classes of glucose-lowering agents, such as DPP4 inhibitors, but this hypothesis needs to be confirmed in long-term cardiovascular outcomes trials. The results of this meta-analysis need to be interpreted with caution, mainly because of limitations in trial quality and under-reporting of information on cardiovascular events and mortality. However, the cardiovascular safety of sulfonylureas cannot be considered established unless it is evaluated in long-term cardiovascular outcomes trials.


Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Diabetic Angiopathies/chemically induced , Myocardial Infarction/chemically induced , Stroke/chemically induced , Sulfonylurea Compounds/adverse effects , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/mortality , Diabetic Angiopathies/blood , Diabetic Angiopathies/mortality , Female , Humans , Incidence , Male , Myocardial Infarction/blood , Myocardial Infarction/mortality , Randomized Controlled Trials as Topic , Risk Factors , Stroke/blood , Stroke/mortality , Sulfonylurea Compounds/administration & dosage
14.
J Endocrinol Invest ; 36(8): 606-16, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23511244

ABSTRACT

BACKGROUND: Previous evidence indicates that pioglitazone may improve dyslipidemia in patients with Type 2 diabetes mellitus (T2DM). AIM: The primary objective of this study was to evaluate the effect of either pioglitazone or placebo with metformin on levels of serum HDL cholesterol (HDL-C) in patients with T2DM. A secondary objective evaluated changes in metabolic syndrome (MS)-specific parameters. SUBJECTS AND METHODS: This multicenter, double-blind, randomized study was performed in patients with T2DM treated with metformin and hemoglobin A1c (HbA1c) levels between 6-8%, central obesity and reduced HDL-C. MS was evaluated from global changes in parameter values and expressed as a single factorial score following multivariate analysis of each parameter. 213 patients (110 in the pioglitazone group and 103 in the placebo group) were available for intention-to-treat analysis. RESULTS: Pioglitazone-treated patients showed a significant increase in HDL-C compared to placebo group (6.3 mg/dl vs 3.0 mg/dl; p<0.01) in addition to a greater reduction in the extent of MS (-13.2 vs -4.9; p=0.0055). Upon study completion, patients treated with pioglitazone had lower levels of HbA1c (6.41±0.65 vs 6.96±0.74%; p<0.001) and homeostasis model assessment-insulin resistance (HOMA-IR) (2.88±1.95 vs 4.68±3.63; p=0.013) and a reduction of the atherogenic LDL subfraction (pattern B) (-5.7%). CONCLUSIONS: The beneficial effects observed in pioglitazone-treated patients in the present study, (i.e. the increase in HDL-C and the reduction of insulin resistance and atherogenic LDL subfractions), support findings from the PROactive trial, where pioglitazone showed pleiotropic effects and reduced death, fatal myocardial infarction (MI) and non-fatal MI in T2DM patients with MS. Furthermore, medication used in this study showed good tolerability.


Subject(s)
Cholesterol, HDL/blood , Diabetes Mellitus, Type 2/drug therapy , Metabolic Syndrome/drug therapy , Metformin/administration & dosage , Thiazolidinediones/administration & dosage , Adult , Aged , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/metabolism , Double-Blind Method , Drug Combinations , Female , Glycated Hemoglobin/metabolism , Homeostasis , Humans , Insulin Resistance , Male , Metabolic Syndrome/metabolism , Middle Aged , Models, Biological , Pioglitazone , Placebos
15.
Food Chem ; 136(2): 335-41, 2013 Jan 15.
Article in English | MEDLINE | ID: mdl-23122067

ABSTRACT

The quantity of phenols, as well as antioxidant and antimicrobial activities, were investigated in bark of Rhamnus alaternus L., R. fallax Boiss., R. intermedia Steud. et Hochst., and R. pumila Turra from natural stands in Croatia. The most abundant anthraquinones in the investigated extracts were chrysophanol in R. alaternus (3.14 mg/g), emodin in R. pumila (0.339 mg/g), and physcion in R. fallax (2.70 mg/g) and R. intermedia (0.285 mg/g). The species exhibiting the highest antioxidant activity were R. fallax and R. pumila. A positive correlation was observed between total phenolic and flavonoid levels of the extracts and antioxidant activity in some of the assays. All species showed antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans, Aspergillus niger and Microsporum gypseum with minimal inhibitory concentrations equal to or below 2.500 mg/mL. The results indicate that the investigated Rhamnus species are a source of anthraquinones and other phenols, which act as multifunctional antioxidants with antimicrobial activity.


Subject(s)
Anthraquinones/chemistry , Anti-Infective Agents/chemistry , Antioxidants/chemistry , Plant Bark/chemistry , Plant Extracts/chemistry , Rhamnus/chemistry , Anthraquinones/pharmacology , Anti-Infective Agents/pharmacology , Antioxidants/pharmacology , Bacteria/drug effects , Fungi/drug effects , Plant Extracts/pharmacology , Rhamnus/classification
16.
Oral Dis ; 18(1): 32-9, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21851508

ABSTRACT

Licorice, the name given to the roots and stolons of Glycyrrhiza species, has been used since ancient times as a traditional herbal remedy. Licorice contains several classes of secondary metabolites with which numerous human health benefits have been associated. Recent research suggests that licorice and its bioactive ingredients such as glycyrrhizin, glabridin, licochalcone A, licoricidin, and licorisoflavan A possess potential beneficial effects in oral diseases. This paper reviews the effects of licorice and licorice constituents on both the oral microbial pathogens and the host immune response involved in common ora-dental diseases (dental caries, periodontitis, candidiasis, and recurrent aphthous ulcers). It also summarizes results of clinical trials that investigated the potential beneficial effects of licorice and its constituents for preventing/treating oro-dental diseases.


Subject(s)
Candidiasis, Oral/drug therapy , Dental Caries/drug therapy , Glycyrrhiza , Periodontitis/drug therapy , Phytotherapy , Plant Extracts/therapeutic use , Stomatitis, Aphthous/drug therapy , Animals , Candida albicans/drug effects , Humans , Plant Extracts/pharmacology , Plant Roots , Streptococcus mutans/drug effects
17.
J Fish Dis ; 34(11): 853-60, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21988357

ABSTRACT

The effects of different stressors on the atretic degeneration of ovarian vitellogenic follicles, as well as on the ovarian mass, were examined in female Atlantic bluefin tuna, Thunnus thynnus (L.), from the Mediterranean Sea. The stressors taken into consideration were short-term starvation (up to 14 days), long-term cage rearing (1 year) and crowding-induced severe panic frenzy. Wild-caught individuals were used as a control group. Fish subjected to either severe panic frenzy or starvation exhibited a decrease in gonad mass and had significantly higher intensity of α atresia in the vitellogenic follicles (means: 78% and 58%, respectively; range: 36-100%) than either wild or long-term caged individuals (means: 32% and 30%, respectively; range: 19-44%). The extensive atresia in fish stressed by severe panic frenzy was observed as early as 24 h after the stressing event. The present study represents the first evidence of the extreme susceptibility of Atlantic bluefin tuna to severe acute stress during vitellogenesis; it also shows that starvation is associated with progressive reabsorption of vitellogenic oocytes.


Subject(s)
Follicular Atresia , Starvation/veterinary , Stress, Physiological , Tuna/physiology , Animals , Female , Organ Size , Ovarian Follicle/anatomy & histology , Ovarian Follicle/pathology , Ovary/anatomy & histology , Tuna/anatomy & histology
18.
Phytomedicine ; 18(7): 586-91, 2011 May 15.
Article in English | MEDLINE | ID: mdl-21112752

ABSTRACT

Previous studies demonstrated that natural prenyloxyphenylpropanoid derivatives have potent biological properties like anti-cancer effects in vitro and in vivo. Additionally they are extremely safe and associated with low toxicity, making them excellent candidates as chemopreventive agents. However, so far only little is known about possible interactions with isoforms of cytochrome P450 (CYPs) being involved in the metabolism of xenobiotics and representing a major site for drug-drug interactions. The aim of this study was to evaluate the effects of selected natural prenyloxyphenylpropanoids (prenyloxycinnamic acids) on expression and activity of some major CYPs and on the activity of the major drug efflux transporter P-glycoprotein (P-gp). Inhibition of CYP3A4, CYP2C19, and CYP2D6 was quantified using commercially available kits. P-gp inhibtion was quantified by calcein assay. Induction of CYP mRNA (CYP3A4, CYP2C19, CYP2C9, and CYP2B6) was measured in LS180 cells by quantitative real-time reverse transcriptase polymerase chain reaction using the LightCycler technology. Only boropinic acid revealed substantial inhibition of CYPs, especially of CYP2C19 (IC50 = 31±5µM). This compound also had the most pronounced effect on CYP mRNA expression among the prenyloxycinnamic acids tested. However all but 4'-isopentenyloxy-p-coumaric acid revealed inducing effects on CYPs with different induction profiles. P-gp was only significantly inhibited by 4'-geranyloxyferulic acid. This was the first study demonstrating modulating effects of prenyloxycinnamic acids on CYP activity and expression and on P-gp activity. The results suggest that boropinic acid is most prone to drug-drug interactions at the level of CYPs, whereas 4'-isopentenyloxy-p-coumaric acid does not modulate CYP activity and expression.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Cinnamates/pharmacology , Cytochrome P-450 Enzyme System/metabolism , Enzyme Inhibitors/pharmacology , ATP Binding Cassette Transporter, Subfamily B, Member 1/antagonists & inhibitors , Cell Line, Tumor , Cytochrome P-450 Enzyme Inhibitors , Cytochrome P-450 Enzyme System/genetics , Drug Interactions , Enzyme Induction/drug effects , Gene Expression Regulation, Enzymologic , Humans , Isoenzymes/metabolism , RNA, Messenger/genetics , Reverse Transcriptase Polymerase Chain Reaction , Up-Regulation/genetics
19.
Int J Immunopathol Pharmacol ; 23(2): 601-10, 2010.
Article in English | MEDLINE | ID: mdl-20646355

ABSTRACT

Artichoke, dandelion, turmeric extracts and rosemary essential oil are commonly used as ingredients in many herbal preparations to treat hepatic and gallbladder disorders. In the present work we compare the activity of each single extract with a commercial mixture for antiproliferative, antiradical and protective effects against induced oxidant stress effect. In ABTS and DPPH tests, turmeric extract is the most active, followed by artichoke and dandelion. All samples exhibited antiproliferative activity in a dose-dependent manner against HepG2 cells. In the same cell lines, the protective effect of pre-treatment with the extracts were detected by evaluating the prostaglandin E2 release, a marker of oxidative stress induced by hydrogen peroxide. The treatments with the extracts were efficient in reducing the release of PGE2 induced by oxidative stimulus. The positive results of the cell viability test, together with the protective and antiradical activity confirm the rationale for the use of these ingredients in commercial formulations as a health aid tool in modern phytotherapy.


Subject(s)
Antioxidants/pharmacology , Curcuma , Cynara scolymus , Plant Extracts/pharmacology , Protective Agents/pharmacology , Rosmarinus , Taraxacum , Benzothiazoles , Biphenyl Compounds/metabolism , Cell Proliferation/drug effects , Dinoprostone/biosynthesis , Hep G2 Cells , Humans , Hydrogen Peroxide/pharmacology , Phytotherapy , Picrates/metabolism , Sulfonic Acids/metabolism , Thiazoles/metabolism
20.
J Pharm Biomed Anal ; 53(2): 212-4, 2010 Oct 10.
Article in English | MEDLINE | ID: mdl-20172682

ABSTRACT

Oxyprenylated natural products (isopentenyloxy-, geranyloxy- and the less spread farnesyloxy-compounds and their biosynthetic derivatives) represent a family of secondary metabolites that have been consider for years merely as biosynthetic intermediates of the most abundant C-prenylated derivatives. Many of the isolated oxyprenylated natural products were shown to exert in vitro and in vivo remarkable anti-cancer and anti-inflammatory effects. 4'-Geranyloxyferulic acid [3-(4'-geranyloxy-3'-methoxyphenyl)-2-trans-propenoic] has been discovered as a valuable chemopreventive agent of several types of cancer. After development of a high yield and "eco-friendly" synthetic scheme of this secondary metabolite, starting from cheap and non-toxic reagents and substrates, we developed a new HPLC-DAD method for its quantification in grapefruit skin extract. A preliminary study on C18 column showed the separation between GOFA and boropinic acid (having the same core but with an isopentenyloxy side chain), used as internal standard. The tested column were thermostated at 28+/-1 degrees C and the separation was achieved in gradient condition at a flow rate of 1 mL/min with a starting mobile phase of H(2)O:methanol (40:60, v/v, 1% formic acid). The limit of detection (LOD, S/N=3) was 0.5 microg/mL and the limit of quantification (LOQ, S/N=10) was 1 microg/mL. Matrix-matched standard curves showed linearity up to 75 microg/mL. In the analytical range the precision (RSD%) values were

Subject(s)
Antineoplastic Agents/analysis , Chromatography, High Pressure Liquid/methods , Coumaric Acids/analysis , Citrus paradisi/chemistry , Limit of Detection , Plant Extracts/chemistry
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