Review on the role of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway in diabetes: mechanistic insights and therapeutic implications.

This review explores the pivotal role of the nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3) inflammasome in the pathogenesis of diabetes and its complications, highlighting the therapeutic potential of various oral hypoglycemic drugs targeting this pathway. NLRP3 inflammasome activation, triggered by metabolic stressors like hyperglycemia, hyperlipidemia, and free fatty acids (FFAs), leads to the release of pro-inflammatory cytokines interleukin-1ß and interleukin-18, driving insulin resistance, pancreatic ß-cell dysfunction, and systemic inflammation. These processes contribute to diabetic complications such as nephropathy, neuropathy, retinopathy, and cardiovascular diseases (CVD). Here we discuss the various transcriptional, epigenetic, and gut microbiome mediated regulation of NLRP3 activation in diabetes. Different classes of oral hypoglycemic drugs modulate NLRP3 inflammasome activity through various mechanisms: sulfonylureas inhibit NLRP3 activation and reduce inflammatory cytokine levels; sodium-glucose co-transporter 2 inhibitors (SGLT2i) suppress inflammasome activity by reducing oxidative stress and modulating intracellular signaling pathways; dipeptidyl peptidase-4 inhibitors mitigate inflammasome activation, protecting against renal and vascular complications; glucagon-like peptide-1 receptor agonists attenuate NLRP3 activity, reducing inflammation and improving metabolic outcomes; alpha-glucosidase inhibitors and thiazolidinediones exhibit anti-inflammatory properties by directly inhibiting NLRP3 activation. Agents that specifically target NLRP3 and inhibit their activation have been identified recently such as MCC950, Anakinra, CY-09, and many more. Targeting the NLRP3 inflammasome, thus, presents a promising strategy for managing diabetes and its complications, with oral hypoglycemic drugs offering dual benefits of glycemic control and inflammation reduction. Further research into the specific mechanisms and long-term effects of these drugs on NLRP3 inflammasome activity is warranted.

Assessment on infection prevention and control knowledge among medical professionals in south Indian population.

INTRODUCTION: Healthcare workers are always at higher risk of biological exposure as the healthcare setting is hazardous, and it is impracticable to exclude infection. Poor compliance with standard precautions among healthcare workers is one of the leading causes of healthcare-associated infections. This study analyzed the gaps in knowledge, attitude, and practice of infection control among healthcare workers and the influence of the COVID-19 pandemic, internet, and social media usage on infection control. METHODOLOGY: A cross-sectional study was conducted from 1st to 31st March 2022 among various healthcare professionals using a self-administered structured questionnaire to evaluate knowledge, attitude, and practice on infection control. The impact of COVID-19, Internet, and social media usage on infection control practices was also analyzed. RESULTS: Among 382 healthcare workers who participated in the study, 89.4% of the participants had good knowledge, 55.26% had a neutral attitude, and all showed good practice levels on infection control. Similarly, the result showed that internet and social media usage during COVID-19 had significantly enhanced the knowledge, attitude, and practice on infection control. CONCLUSIONS: Healthcare professionals must be frequently updated on infection control guidelines and routine training programs. The hospital's adherence to the Joint Commission International (JCI) guidelines reduces the risk of healthcare-associated infections. As observed in this study, due to the prominent influence of social media and the internet, these platforms can be exploited to provide training and awareness to healthcare professionals and the public.