[Fixed ratio combinations GLP-1RA and basal insulin: literature review].

The progressive nature of type 2 diabetes mellitus leads to the need for insulin therapy in a significant proportion of patients. Very often start of insulin therapy in type 2 diabetes mellitus (T2DM) is associated with weight gain and a significant increase of hypoglycemia's risk. However, innovative options, such as fixed ratio combinations of glucagon-like peptide 1 receptor agonists (GLP-1RA) and basal insulin, minimize weight gain and hypoglycemia risks and allow a greater proportion of patients to achieve individual glycemic control goals without compromising safety parameters. This review includes a description of the randomized clinical trials, as well as the results of real clinical practice of the use of two currently existing fixed ration combinations of GLP-1RA and basal insulin - iDegLira and iGlarLixi.

Expression of Beclin-1 and LAMP-2 in Rat Hippocampus under Conditions of Simulated Gravity Overload in the Caudocranial Vector.

Structural changes in the rat hippocampus in response to chronic cerebrovascular disorders induced by gravity exposure in the caudocranial vector were studied. Qualitative and quantitative morphological analysis detected significant cytoarchitectonic changes in the pyramidal layer: spongiosis, manifest pericellular and perivascular edema, and a drastic increase in the counts of pyramidal neurons with signs of impairment in all hippocampal zones. The density of perikarya in the pyramidal layer decreased. Immunohistochemical study detected high expression of Beclin-1 in CA1 field. High expression of LAMP-2 was detected in CA4 field. Field CA2 was characterized by the maximum counts of damaged cells and high expression of Beclin-1 and LAMP-2.

[Focal cerebral ischemia in rats with estrogen deficiency and endothelial dysfunction]. / Fokal'naia ishemiia golovnogo mozga u krys na fone nedostatochnosti éstrogenov i éndotelial'noi disfunktsii.

AIM: To assess an effect of ovariectomy (OE) on the cerebral blood flow, endothelium-dependent vasodilation, neurological, cognitive and locomotor deficit as markers of brain damage after focal ischemia in rats. MATERIAL AND METHODS: The study was conducted in 48 female Wistar rats. Ovariectomy was performed with ovaries and uterine body extirpation, cerebral ischemia was performed by middle cerebral artery occlusion (MCAO) in rats. To assess brain damage, Combs and Garcia scores, 'open field' test (OFT), 'extrapolatory escape test' (EET), 'passive avoidance test' (PAT), 'beam-walking test' were used. Cerebral blood flow was measured using ultrasonic flowmetry. RESULTS AND CONCLUSION: After 7 days of MCAO, the cerebral blood flow in ovarioectomized animals was reduced by 20% compared to sham-ovariectomized animals. Ovariectomized animals with MCAO showed a three-fold endothelium-dependent vasodilation reduction (the reaction of cerebral vessels to the introduction of acetylcholine and N-L-arginine), indicating the presence of severe endothelial dysfunction. In ovarioectomized animals, the cerebral blood flow was reduced by 34% compared to sham-operated animals. MCAO and OE taken together resulted in more than 2-fold increase in neurological, motor disturbances, 3-fold decrease in motor activity of the animals in the OP test. Focal ischemia in ovarioectomized animals with endothelial dysfunction led to memory decrease by 1/5 fold in PAT and by 2-fold in EET.

[Cerebroprotective activity of metformin, gosogliptin, citicoline and a novel GPR119 agonist in cerebral ischemia under experimental diabetes mellitus]. / Sravnitel'naia tserebroprotektivnaia aktivnost' metformina, gosogliptina, tsitikolina i novogo agonista GPR119 pri éksperimental'noi ishemii golovnogo mozga na fone sakharnogo diabeta.

Hypoglycemic agents of some groups: sodium-glucose cotransporter type 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists reduce the risk and/or severity of cardiovascular diseases. Studies of such properties are currently focused on metformin and dipeptidyl peptidase-4 (DPP-4) inhibitors. Agonists of GPR119 receptor, increasing the secretion of GLP-1 and insulin, are also actively studied as hypoglycemic drugs with endothelial and cerebroprotective potential. AIM: To evaluate the cerebroprotective activity of metformin, gosogliptin, citicoline and an agonist of GPR119 (ZB-16) in middle cerebral artery occlusion (MCAO) in animals with 4-week streptozotocin-nicotinamide-induced diabetes. MATERIAL AND METHODS: A study included 73 male rats. Hypoglycemic agents and ZB-16 were administered on the first day of diabetes and citicoline was administered after MCAO. Cerebroprotective effect was evaluated using Garcia, Combs and D'Alecy score test, 'Rotarod' and 'open field' test, as well as the infarct volume and severity of brain edema measurement. RESULTS AND CONCLUSION: Preventive administration of metformin resulted in the pronounced hypoglycemic activity without a significant cerebroprotective effect in subsequent brain ischemia modelling. Administration of substances with incretin activity (gosogliptin and, in particular, ZB-16) in addition to the hypoglycemic action promoted a significant reduction of infarct volume, brain edema and severity of neurologic deficit of the surviving animals. At the same time, the introduction of citicoline without proper glycemic control didn't reduce the brain ischemia severity.

[HYPOLIPIDEMIC, ANTIOXIDANT, AND ENDOTHELIAL PROTECTIVE EFFECT OF COMPOUND ZB-16 (NOVEL GPR119 RECEPTOR AGONIST) IN RATS WITH EXPERIMENTAL TYPE 2 DIABETES.]

The effect of compound ZB-16 (a new GPR1 19 receptor agonist) after two-week administration on the endothelial function, glucose and lipid metabolism (total cholesterol, LDL, HDL and triglycerides), lipid peroxidation, and antioxidant system status in rats with experimental type-2 diabetes mellitus (T2DM) has been studied. It was found that the untreated control group of animals exhibited, in addition to sustained hyperglycemia, a decrease in endothelium-dependent vaso- dilation and antioxidant system activity, and increase in the content of LDL and the dyslipidemic index. Administration of ZB-16 (1 mg/kg, p.o.) in rats with T2DM model resulted in reduction of the endothelial dysfunction (improved endothelium-dependent vasodilation by 83% as compared to the control group, p < 0.05). ZB-16 also produced a moderate antioxidant effect of reducing the content of TBA-active products (by 30% as compared to the untreated control, p <0.05) and favored normalization of lipid metabolism indicators.

[COMPARATIVE CEREBROPROTECTIVE EFFECT OF PREVENTIVE ADMINISTRATION OF MAGNESIUM HYDROXYBUTYRATE VERSUS MAGNESIUM SULFATE AND CAVINTON IN RATS WITH COMMON CAROTID ARTERY OCCLUSION].

Dose-dependent cerebroprotective effect of magnesium hydroxybutyrate (MHB) on common carotid artery occlusion model in rats was established. Administration of 150 mg/kg MHB led to significant decrease in animal mortality (up to 9.3 times) in comparison to control (p < 0.05). This MHB dose also produced significant decrease of neurological deficit on the McGraw scale in comparison to control and magnesium sulfate (50% and 20%, respectively). The MHB treated animals also showed improved locomotor and exploratory performance in the open-field test and retained memory performance in the passive avoidance test and extrapolation escape task test. The administration of 150 mg/kg MHB produced three-fold (p < 0.05) decrease of brain edema in animals with cerebral blood flow impairment in comparison to animals treated with magnesium sulfate and cavinton.

NEUROPROTECTIVE ACTION OF PHENIBUT AND NEUROGLUTAM IN EXPERIMENTAL CEREBRAL ISCHEMIA ON THE BACKGROUND OF ALTERED IMMUNOREACTIVITY.

Cerebroprotective activity of phenyl derivatives of GABA (phenibut, 25 mg/kg) and L-glutamic acid (neuroglutam, 26 mg/kg) in rats with cerebral ischemia was studied on the background of intact and altered immunoreactivity. Tested compounds were administered intraperitoneally for 7 days after two phase ligation of common carotid arteries (second artery was ligated 3 days after ligation of the first artery). Immunosuppression caused by cyclosporin (daily dose 5 mg/kg, p.o., for 13 days) worsened brain ischemia outcome, as manifested by increased mortality, more severe neurological marker score, increased levels of brain damage markers (NSE and MBP) in the blood serum, decrease in muscle strength and locomotor activity, and impairment of orientation and research activity as compared to animals with brain ischemia and intact immunity. Activation of immune system was caused by lipopolysaccharide (10 mg/kg, i.p., 7 injections every second day). Upon activation of the immune system, brain ischemia produced lower mortality, while the survived rats exhibited more favorable outcome of ischemia than animals with suppression of immune system: lover neurological marker score, lower blood serum NSE and MBP levels (-35% on average,p < 0.05), and much higher level of performance in motor coordination, muscular strength, and locomotor activity (+90% on average, p < 0.05). The state of immune system significantly influenced the neuroprotective activity of drugs tested. Neuroglutam administration produced positive effect both in animals with intact immunity and on the background of altered immunoreactivity. However, most positive outcome after neuroglutam administration in ischemic rats was observed in animals with suppression of immune system, with significant increase in the cerebral blood flow level (+56%), decrease in NSE and MBP blood serum levels (57 and 76%, respectively) after 7-day treatment as compared to the control group. The therapeutic potential of phenibut was somewhat lower than that of neuroglutam, and it was more pronounced in rats with activated immune system, whereas the drug effectiveness in rats with suppressed immune system was less pronounced.

[COMPARATIVE MORPHOFUNCTIONAL CHARACTERISTICS OF ADULT AND OLD RAT VENTRAL HIPPOCAMPUS TO COMBINED STRESS INFLUENCE].

Animals were subjected to seven days combined stress in a special chamber (6 isolated compartments of equal area) with removable multi-modal stressors (noise, vibration, pulsating bright light) every 5 minutes on the stochastic scheme with restraint and temperature rise in the chamber during 30-minute stressing time sessions. After exposure to combined stress in the ventral hippocampus of old rats (24 months) compared with adult animals (12 months) following changes were revealed: marked dystrophic changes and increased inducible nitric oxide synthase expression in pyramidal neurons of CA3 field, signs of impaired hemodynamic disorders in the microvasculature, perivascular edema, decreased endothelial nitric oxide synthase expression in microvascular endothelial cells, as well as decreased expression of serine racemase in the neuropil of the radial layer of CA1 field.

[The influence of the immunity activation and suppression on the outcome of brain ischemia]. / Ishemiia golovnogo mozga na fone podavleniia i aktivatsii immuniteta.

AIM: To explore the influence of the immunity activation and suppression on the outcome of brain ischemia in experimental animals. MATERIAL AND METHODS: Brain ischemia has been modulated by irreversible staged bilateral common carotid arteries occlusion. Suppression of the immune system has been conducted by administration of cyclosporin A (5 mg/kg, per os). Activation of the immune system has been conducted by administration of lipopolysaccharide (10 mkg/kg, i.p.). RESULTS: Authors have established that in animals with immunosuppression there is an increase in the concentration of the neuron specific proteins in blood serum (NSE and MBP), mortality (by 20%) and severity of neurological deficit (by 33%). Rats with immunosuppression have reduced general locomotor activity (by 44%), exploratory behavior in the Open Field Test (by 43%) and decrease in the motor activity in the Rotarod Test (by 19%) compared to the group of rats with brain ischemia and intact immune systems. During the immunity activation after brain ischemia injury, the decrease in NSE and MBP levels, mortality (by 15%) and severity of neurological deficit (by 13%) as well as higher concentrations of neurotrophins BDNF and NGF and higher general locomotor activity of animals (by 34%) and physical endurance (by 55%) in the Open Field and Rotarod Tests, respectively, were observed. CONCLUSION: Immunosupression negatively affected the outcome of brain ischemia.

[GLIATILIN CORRECTION OF WORKING AND REFERENCE SPATIAL MEMORY IMPAIRMENT IN AGED RATS].

This work was aimed at evaluating the influence of gliatilin administration on the spatial memory in aged rats. Cognitive function and spatial memory in animals was evaluated using radial (8-beam) maze test. Errors of working spatial memory and reference memory were used as indicators of impaired cognitive function. It was found that aged (24-month) rats compared with younger (6-months) age group exhibited cognitive impairment, as manifested by deterioration of short- and long-term memory processes. Course administration of gliatilin in rats of the older age group at a dose of 100 mg/kg resulted in significant improvement of the working and reference spatial memory in aged rats.

Neuroprotective and Antioxidant Effects of Neuroglutam in Cerebral Ischemia.

We studied in vitro and in vivo neuroprotective and antioxidant properties of neuroglutam, a new glutamic acid derivative. In experiments on immortalized mouse hippocampal cell line HT22, neuroglutam exhibited a neuroprotective effect in the model of oxidative stress after its introduction, both before and after H2O2. In vivo study on animals treated with neuroglutam against the background of cerebral ischemia modeled by irreversible occlusion of the common carotid arteries showed that plasma level of TBA-active products was significantly lower and activities of cell antioxidant enzymes (superoxide dismutase and catalase) were higher than in control animals receiving saline under the same conditions.

[GPR119 Receptor Agonists: Characteristics, Physiological Role, Prospects of Use in the Treatment of Diabetes Mellitus Type 2 and Metabolic Syndrome].

Last decade GPR119 receptor attracted great attention of many researchers groups worldwide. This receptor is expressed in enteroendocrine L- and K-intestinal cells and pancreas beta cells. First endogenous ligands for GPR119 was found in 2005: fatty acid metabolites, some phospholipids and fatty acid amides derivatives. GPR119 receptor is involved in the glucose metabolism regulation: glucose-dependent insulin secretion, glucose-independent incretin secretion, appetite control, gastric emptying, as well as beta cell proliferation. Thus, GPR119 is a "sensor" of some fatty acid derivatives and-GPR119 is a promising new pharmacological target for the treatment of type 2 diabetes.

[Studying the neuroprotective effect of the novel glutamic acid derivative neiroglutam on focal cerebral ischemia in rats].

We have studied the neuroprotective effect of the novel glutamic acid derivative neiroglutam on reversible focal cerebral ischemia in rats. The neuroprotective drug action was assessed by the ability to reduce the severity of neurological deficit (1, 2, 3, 5 and 7 days), forelimb fine-motor disorders (in the ladder test), hind limb motor activity (beam-walking test), and volume of the infarct zone upon 7-day pathologic exposure. It was found that the therapeutic administration of neiroglutam (26 mg/kg, i.p., for 7 days) reduces the volume of necrosis of cerebral tissues in case of focal brain ischemia in animals (on the average by 38%, (p < 0.05) and decreases the severity of motor disorders, which indicates the presence of neuroprotective effect of this compound.

[Neuroprotective effect of neuroglutam under conditions of activated free radical oxidation].

The neuroprotective properties of the novel glutamic acid derivative neiroglutam have been studied in vitro and in vivo. Neiroglutam demonstrated the protective action on 6-OH-dopamine neurotoxicity model in vitro, where free radical oxidation is a basic part of pathogenesis. In control rats, focal brain ischemia caused significant increase in thiobarbituric acid reactive species (TBARS) level and decrease in superoxide dismutase (SOD) enzyme activity. In two-year-old rats, preventive administration of the neiroglutam caused a significant reduction in the TBARS plasma concentration (34.5%, p < 0.05), increased SOD activity, and increased the time of acid-induced hemolysis of erythrocytes (40%, p < 0.05).

[Comparative analysis of action of beta-phenyl derivatives of glutamic and gamma-aminobutyric acid on cerebral blood flow and cerebrovascular endothelium after irreversible occlusion of the common carotid artery].

A comparative analysis of the effect of phenyl derivatives of glutamic (RGPU-135) and gamma-aminobutyric acid (Phenibut) on cerebral blood flow, vasodilatory endothelial function and the number of circulating endothelial cells desquamated in animals after irreversible occlusion of the common carotid arteries. It was found that animals treated prophylactically by RGPU-135, after occlusion of the common carotid arteries have higher cerebral blood flow and lower the severity of endothelial dysfunction than in animals treated with Phenibut.

[Endothelial protection drugs--a new class of pharmacological agents].

This review considers issues dealing with the role of nitric oxide and endothelial function/dysfunction in providing a number of physiological and pathophysiological processes and various body systems functioning. It also covers in details the possible ways of pharmacological management of endothelial dysfunction (ED) using drugs of different pharmacological groups (classes). Diverse pharmacological effects which have various degree of intensity and presented at various stages of ED pathogenesis are discussed. The value and urgency of search and development of agents with endothelial protection potential are studied in available experimental and clinical works on the considerable role of endothelial system in cardiovascular diseases and lack of specific means for prevention and treatment of endothelial dysfunction. Integrated morphological-functional approach to assessment of ED and endothelial protection of substances was developed and implemented in experimental practice in Cardiovascular Agents Laboratory of the Volgograd State Medical University Research Institute of Pharmacology. Various ED models were tested and most valid ones were selected. Endothelial protection of new compounds such as Salifen and Flavicin are considered and compared with cardiovascular drugs, antioxidants with metabolic effects, GABA derivatives. These drugs are assumed to belong to a new class of drugs--endothelial protection drugs.

[Effect of phenibut and its composition with nicotinic acid on hemostasis in rats with brain ischemia].

It is shown that, in rats with global cerebral ischemia modeled by a complete irreversible occlusion of the common carotid artery and forced hypotension, the hemostasis is characterized by a shift toward hypercoagulation. A single preventive introduction of phenibut and, to a greater degree, a composition of phenibut with nicotinic acid, in rats with acute cerebral ischemia reduced the extent of disturbances in the hemostasis system of experimental animals.

Effect of citrocard on functional reserves of the heart under conditions of chronic stress.

Chronic stress exposure produces a damaging effect on the myocardium and reduces its functional (inotropic) reserves. Citrocard (50 mg/kg) and fenibut (50 mg/kg) prevent stress effects: animals receiving these preparations demonstrate higher contraction and relaxation rates and higher left-ventricular pressure during functional tests (volume load and maximum isometric load).