The Effect of CYP2C9 Genotype Variants in Type 2 Diabetes on the Pharmacological Effectiveness of Sulfonylureas, Diabetic Retinopathy, and Nephropathy.

AIM: Type 2 diabetes (T2D), as a major cause of morbidity and mortality, is predicted to have a prevalence of 629 million by 2045. As diabetic patients show considerable inter-individual variation in response to antidiabetic treatment, this study aimed to investigate the gene polymorphism of cytochrome P450 as well as the effectiveness and safety of glibenclamide and gliclazide for different genotypes of CYP2C9. Besides, the chronic side effects of T2D including retinal microvasculature complications or retinopathy and renal dysfunction due to nephropathy in different genotypes were considered. PATIENTS AND METHODS: The participants including 80 T2D patients treated with glibenclamide or gliclazide were recruited from university hospitals of Ahvaz Jundishpur University of Medical Sciences, Ahvaz, in the southwest of Iran. Blood samples were collected from the patients at 2.5h after the morning dose of glibenclamide and 12h after the last dose of gliclazide. Genotyping from the extracted DNA was, then, performed using PCR-RFLP. The plasma level of glibenclamide and gliclazide was, in turn, measured by the reverse-phase high-pressure liquid chromatography. RESULTS: The results showed that the wild-type allele, i.e., CYP2C9*1, occurred in the highest frequency (0.8), while the frequency rates of the mutant allele, i.e., CYP2C9*2 and CYP2C9*3, were 0.15 and 0.05, respectively. Moreover, no significant association was found between any of the genotypes as well as the clinical and biochemical characteristics of the patients. The findings also showed that the plasma level of sulfonylureas (i.e., glibenclamide and gliclazide) was the highest in the patients with the CYP2C9*3 allele. It was also found that 75.9% of the patients with variant genotypes had experienced hypoglycemia events. Furthermore, in the absence of wild type allele, a significant increase was observed in retinopathy (p=0.039) and nephropathy (p=0.05). CONCLUSION: The findings can provide guidelines for the optimal management of the treatment protocols with sulfonylurea intended to control the T2D complications.

Magnetic iron oxide/phenylsulfonic acid: A novel, efficient and recoverable nanocatalyst for green synthesis of tetrahydrobenzo[b]pyrans under ultrasonic conditions.

A novel magnetic iron oxide supported phenylsulfonic acid (Fe3O4@Ph-SO3H) with core-shell structure is prepared, characterized and applied as efficient nanocatalyst for green synthesis of tetrahydrobenzo[b]pyrans. The Fe3O4@Ph-SO3H was prepared via modification of magnetic iron oxide cores with 1,4-bis(triethoxysilyl)benzene (BTEB) followed by sulfonation of aromatic rings. The Fe3O4@Ph-SO3H was characterized using FTIR, TGA, PXRD, SEM, TEM, VSM and EDX techniques. This was effectively applied for synthesis of tetrahydrobenzo[b]pyrans in water as green solvent at room temperature under ultrasonic conditions. The products were obtained in high to excellent yields at short times. The recoverability, reusability and durability of this nanocatalyst were studied under applied reaction conditions.

The effects of wet cupping on serum high-sensitivity C-reactive protein and heat shock protein 27 antibody titers in patients with metabolic syndrome.

INTRODUCTION: It has previously been reported that increased level of serum heat shock proteins (Hsps) antibody in patients with metabolic syndrome. It is possible that the expression of Hsp and inflammatory markers can be affected by cupping and traditional Chinese medicine. There is a little data investigating the effects of cupping on markers of inflammation and Hsp proteins, hence, the objective of this study was evaluation of the effects of wet cupping on serum high-sensitivity C-reactive protein (hs-CRP) and Hsp27 antibody titers in patients with metabolic syndrome. SUBJECTS AND METHODS: Serum Hs-CRP and Hsp27 antibody titers were assessed in samples from 126 patients with metabolic syndrome (18-65 years of age) at baseline, and after 6 and 12 weeks after treatment. One hundred and twenty-six patients were randomly divided into the experimental group treated with wet cupping combined with dietary advice, and the control group treated with dietary advice alone using a random number table. Eight patients in case group and five subjects in control groups were excluded from the study. Data were analyzed using SPSS 15.0 software and a repeated measure ANCOVA. RESULTS: Serum hs-CRP titers did not change significantly between groups (p>0.05) and times (p=0.27). The same result was found for Hsp27 titers (p>0.05). CONCLUSION: Wet-cupping on the interscapular region has no effect on serum hs-CRP and Hsp27 patients with metabolic syndrome.

The effects of wet cupping on coronary risk factors in patients with metabolic syndrome: a randomized controlled trial.

High serum cholesterol is an important risk factor for cardiovascular events. It has been reported that regular blood donation is associated with a reduction in serum cholesterol. This study aimed to determine the effects of wet cupping on lipid profiles and anthropometric characteristics of patients with metabolic syndrome. One hundred and thirty-six patients aged 18-65 years with metabolic syndrome were recruited to participate in this trial. Ten patients were excluded due to exclusion criteria. Patients (n = 126) were randomly assigned into the control (n = 63) and experimental (n = 63) groups. Patients in the experimental group were treated with wet cupping combined with dietary advice. The controls were given dietary advice only. Anthropometric and biochemical parameters were assessed at baseline and at six and 12 weeks after treatment. The significance of the data was analyzed using a repeated measure ANOVA. The lipid profile status did not differ significantly between the two groups (p > 0.05) whereas there was a significant difference between the two time points within each group (p < 0.05). In addition, several anthropometric parameters improved in both groups, but this did not differ significantly between subject groups. Wet cupping does not have a significant effect on anthropometric or biochemical indices compared to the effect of dietary advice alone.