Sodium-glucose co-transporter-2 inhibitor use and dietary carbohydrate intake in Japanese individuals with type 2 diabetes: A randomized, open-label, 3-arm parallel comparative, exploratory study.

This study investigated the safety and efficacy of the sodium-glucose co-transporter-2 (SGLT2) inhibitor luseogliflozin with differing carbohydrate intakes in Japanese individuals with type 2 diabetes (T2D). Participants were randomly assigned to 3 carbohydrate-adjusted meals for 14 days (days 1-14; a high carbohydrate [HC; 55% total energy carbohydrate] and high glycaemic index [HGI] meal; an HC [55% total energy carbohydrate] and low glycaemic index [LGI] meal; or a low carbohydrate [LC; 40% total energy carbohydrate] and HGI meal). All participants received luseogliflozin for the last 7 days (days 8-14), continuous glucose monitoring (CGM) before and after luseogliflozin treatment (days 5-8 and days 12-15) and blood tests on days 1, 8 and 15. Luseogliflozin significantly decreased the area under the curve and mean of CGM values in all 3 groups similarly. Fasting plasma glucose, insulin and glucagon were similar at all time points. Ketone bodies on day 15 were significantly higher in the LC-HGI group compared with the HC-HGI and HC-LGI groups. In conclusion, luseogliflozin has similar efficacy and safety in Japanese people with T2D when meals contain 40% to 55% total energy carbohydrate, but a strict LC diet on this class of drug should be avoided to prevent SGLT2 inhibitor-associated diabetic ketoacidosis.

Pharmacokinetic interaction study of sulphasalazine in healthy subjects and the impact of curcumin as an in vivo inhibitor of BCRP.

BACKGROUND AND PURPOSE An ATP-binding cassette (ABC) transporter, breast cancer resistance protein (BCRP)/ABCG2, limits oral bioavailability of sulphasalazine. Here we examined the effect of curcumin, the principal curcuminoid of turmeric, on oral bioavailability of microdoses and therapeutic doses of sulphasalazine in humans. EXPERIMENTAL APPROACH Effects of curcumin were measured on the ATP-dependent sulphasalazine uptake by hBCRP-expressing membrane vesicles and on oral bioavailability of sulphasalazine in wild-type and Bcrp(-/-) mice. Eight healthy Japanese subjects received an oral dose of sulphasalazine suspension (100 µg) or tablets (2 g) alone or after curcumin tablets (2 g). Uptake of sulphasalazine was studied in HEK293 cells transfected with the influx transporter (OATP)2B1. KEY RESULTS Curcumin was a potent hBCRP inhibitor in vitro (K(i) 0.70 ± 0.41 µM). Curcumin increased the area under the curve (AUC)(0-8) of plasma sulphasalazine eightfold in wild-type mice at 300 and 400 mg·kg(-1), but not in Bcrp(-/-) mice. Curcumin increased AUC(0-24) of plasma sulphasalazine 2.0-fold at microdoses and 3.2-fold at therapeutic doses in humans. Non-linearity of the dose-exposure relationship was observed between microdoses and therapeutic doses of sulphasalazine. Sulphasalazine was a substrate for OATP2B1 (K(m) 1.7 ± 0.3 µM). Its linear index (dose/K(m)) at the therapeutic dose was high and may saturate OATP2B1. CONCLUSIONS AND IMPLICATIONS Curcumin can be used to investigate effects of BCRP on oral bioavailability of drugs in humans. Besides the limited dissolution, OATP2B1 saturation is a possible mechanism underlying non-linearity in the dose-exposure relationship of sulphasalazine.

Effects of growth hormone on the differentiation of mouse B-lymphoid precursors.

Growth hormone (GH) has been known to enhance immune responses directly or through insulin-like growth factor-I (IGF-I). The present study aimed to clarify the roles of GH in the differentiation of B-lineage precursors. In short-term bone marrow cultures, which contained stem cells and early B-lineage cells, GH (10 mug/L) treatment for one day decreased the percentages of stem cells (0.5-fold) and increased those of B-lineage cells (1.4-fold). Furthermore, GH changed the expressions of transcription factors for B cell progenitors differentiation such as paired box gene-5 (Pax-5), immunoglobulin-associated-alpha (Ig-alpha)/CD79a, Ig-beta/CD79b, and IGF-I. Thus, a physiological concentration of GH stimulated the differentiation of B-lymphoid precursors from bone marrow stem cells. Since mRNAs of both GH and GH receptor were present in stem cells and B-cell precursors in bone marrow, GH may modulate B-lymphoid precursors development in an autocrine or paracrine manner in bone marrows.

Expression and roles of Cl- channel ClC-5 in cell cycles of myeloid cells.

ClC-5 is a chloride channel known to be expressed in the kidney. We previously reported that ClC-5 mRNA was also strongly expressed in immature human myeloid cell line (HL-60), but weakly expressed in mature neutrophils. To clarify the underlying mechanisms, we examined the relationship between ClC-5 expression and cell cycle. Dimethyl sulfoxide treatment of HL-60 that causes differentiation with G0/G1 cell cycle arrest decreased the expression of ClC-5 mRNA. Cell sorting and synchronization experiments revealed that ClC-5 mRNA expression was high in S and G2/M phases and low in G0/G1 phase. ClC-5 antisense oligonucleotide suppressed proliferation of HL-60 cells with a decrease in ClC-5 protein expression, probably due to G2 arrest. These results suggest that cell cycle-dependent expression of ClC-5 has a role in cell cycle progression in myeloid cells.