高压氧治疗糖尿病足的疗效分析

为观察高压氧(HBO)治疗糖尿病并发糖尿病足的临床疗效,HBO组36例患者在使用抗生素及局部换药等治疗的同时,采用HBO治疗;对照组34例患者仅使用抗生素及局部换药等治疗。结果表明,HBO组患者总的有效率为91.7%,而对照组总有效率为67.5%,两组的疗效有显著性差异(P<0.05)。HBO对糖尿病足有显著的疗效,值得临床进一步研究和应用。     

Potential Roles of Anti-Inflammatory Plant-Derived Bioactive Compounds Targeting Inflammation in Microvascular Complications of Diabetes

Diabetes mellitus (DM) is a group of metabolic disorders, the characteristics of which include chronic hyperglycemia owing to defects in insulin function, insulin secretion, or both. Inflammation plays a crucial role in DM pathogenesis and innate immunity in the development of microvascular complications of diabetes. In addition, hyperglycemia and DM mediate a proinflammatory microenvironment that can result in various microvascular complications, including diabetic nephropathy (DNP), diabetic neuropathy (DN), and diabetic retinopathy (DR). DNP is a major cause of end-stage renal disease. DNP can lead to albuminuria, decreased filtration, mesangium expansion, thickening of the basement membrane, and eventually renal failure. Furthermore, inflammatory cells can accumulate in the interstitium and glomeruli to deteriorate DNP. DN is another most prevalent microvascular complication of DM and the main cause of high mortality, disability, and a poor quality of life. DNs have a wide range of clinical manifestations because of the types of fiber dysfunctions and complex structures of the peripheral nervous system. DR is also a microvascular and multifactorial disease, as well as a major cause of visual impairment globally. Pathogenesis of DR is yet to be fully revealed, however, numerous studies have already confirmed the role of inflammation in the onset and advancement of DR. Despite evidence, and better knowledge regarding the pathogenesis of these microvascular complications of diabetes, there is still a deficiency of effective therapies. Bioactive compounds are mainly derived from plants, and these molecules have promising therapeutic potential. In this review, evidence and molecular mechanisms regarding the role of inflammation in various microvascular complications of diabetes including DNP, DN, and DR, have been summarized. The therapeutic potential of several bioactive compounds derived from plants in the treatment of these microvascular complications of diabetes has also been discussed.     

The Role of Hypoxia-Inducible Factor-1 Alpha in Renal Disease

Partial pressure of oxygen (pO₂) in the kidney is maintained at a relatively stable level by a unique and complex functional interplay between renal blood flow, glomerular filtration rate (GFR), oxygen consumption, and arteriovenous oxygen shunting. The vulnerability of this interaction renders the kidney vulnerable to hypoxic injury, leading to different renal diseases. Hypoxia has long been recognized as an important factor in the pathogenesis of acute kidney injury (AKI), especially renal ischemia/reperfusion injury. Accumulating evidence suggests that hypoxia also plays an important role in the pathogenesis and progression of chronic kidney disease (CKD) and CKD-related complications, such as anemia, cardiovascular events, and sarcopenia. In addition, renal cancer is linked to the deregulation of hypoxia pathways. Renal cancer utilizes various molecular pathways to respond and adapt to changes in renal oxygenation. Particularly, hypoxia-inducible factor (HIF) (including HIF-1, 2, 3) has been shown to be activated in renal disease and plays a major role in the protective response to hypoxia. HIF-1 is a heterodimer that is composed of an oxygen-regulated HIF-1α subunit and a constitutively expressed HIF-1β subunit. In renal diseases, the critical characteristic of HIF-1α is protective, but it also has a negative effect, such as in sarcopenia. This review summarizes the mechanisms of HIF-1α regulation in renal disease.     

Protective Effects of Swertiamarin against Methylglyoxal-Induced Epithelial-Mesenchymal Transition by Improving Oxidative Stress in Rat Kidney Epithelial (NRK-52E) Cells

Increased blood glucose in diabetic individuals results in the formation of advanced glycation end products (AGEs), causing various adverse effects on kidney cells, thereby leading to diabetic nephropathy (DN). In this study, the antiglycative potential of Swertiamarin (SM) isolated from the methanolic extract of E. littorale was explored. The effect of SM on protein glycation was studied by incubating bovine serum albumin with fructose at 60 °C in the presence and absence of different concentrations of swertiamarin for 24 h. For comparative analysis, metformin was also used at similar concentrations as SM. Further, to understand the role of SM in preventing DN, in vitro studies using NRK-52E cells were done by treating cells with methylglyoxal (MG) in the presence and absence of SM. SM showed better antiglycative potential as compared to metformin. In addition, SM could prevent the MG mediated pathogenesis in DN by reducing levels of argpyrimidine, oxidative stress and epithelial mesenchymal transition in kidney cells. SM also downregulated the expression of interleukin-6, tumor necrosis factor-α and interleukin-1β. This study, for the first time, reports the antiglycative potential of SM and also provides novel insights into the molecular mechanisms by which SM prevents toxicity of MG on rat kidney cells.     

Effects of Tang Luo Ning on diabetic peripheral neuropathy in rats revealed by LC–MS metabolomics approach

Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes with limited therapies. Tang Luo Ning (TLN), a traditional Chinese medicine compound, has been proved to be effective in the treatment of DPN in clinical and experimental studies. However, the potential metabolic mechanism of TLN for the treatment of DPN is still unclear. Here the therapeutic effect of TLN on DPN was studied, and HPLC-IT-TOF/MS was used to explore the metabolic changes related to DPN and to explore the mechanism of TLN on DPN induced by high glucose. Furthermore, metabolic pathway analysis was used to explore the metabolic changes induced by DPN and TLN. As a result, TLN could improve the peripheral nerve function of DPN rats, and TLN could reduce the demyelination of the sciatic nerve in DPN rats. Metabolomics analysis showed that 14 potential biomarkers (citrate, creatine, fumarate, glyceric acid, glycine, succinate, etc.) of both DPN and TLN treatment were identified. Pathway analysis showed that the changes in these metabolites were mainly related to the citrate cycle (TCA cycle); glycine, serine, and threonine metabolism; and glyoxylate and dicarboxylate metabolism.     

Comparative pharmacokinetic study of six lignans in normal and diabetic rats after oral administration of Saururus chinensis extract by LC–MS/MS

Saururus chinensis (SC) possesses significant anti-diabetic activity and lignans were its major bioactive compounds. In this study, a rapid and sensitive ultra-high-performance liquid chromatography–tandem mass spectrometry (UHPLC–MS/MS) method was established for simultaneous quantification of six lignans, namely (-)-(7R,8R)-machilin D ( 1 ), verrucesin ( 2 ), rel-(7S,8S,7′R,8′R)-3,3′,4,4′,5,5′-hexamethoxy-7.O.7′,8.8′-lignan ( 3 ), manassantin A ( 4 ), manassantin B ( 5 ), and saucerneol F ( 6 ) in rat’s plasma. It was validated with acceptable linearity (r ≥ 0.9922), accuracy (80.42–95.17%), precision (RSD ≤ 12.08%), and extraction recovery (80.36–93.45%). The method was successfully applied to the comparative pharmacokinetic study of the six lignans in normal and diabetic rats after oral administration of SC extract. Results showed that the areas under the plasma concentration-time curve (AUC_{0 → t} and AUC_{0 → ∞}) of (-)-(7R,8R)-machilin D, rel-(7S,8S,7′R,8′R)-3,3′,4,4′,5,5′-hexamethoxy-7.O.7′,8.8′-lignan, manassantin B, and saucerneol F in diabetic rats were significantly increased, and the plasma clearance (CL) of (-)-(7R,8R)-machilin D in diabetic rats was significantly decreased. However, the AUC_{0 → t} and AUC_{0 → ∞} of verrucesin were significantly decreased, and its CL was significantly increased in diabetic rats compared with those in normal rats. These results indicated that there were remarkable differences in the pharmacokinetic parameters between the normal and diabetic rats. The pharmacokinetic studies might be beneficial for the clinical use of SC as hypoglycemic agent.     

Synthesis,characterization, antioxidant and anti‐diabetic activities of a novel protein–vanadium complex

The protein–vanadium complex was successfully synthesized and systematically characterized using electron paramagnetic resonance, Fourier transform‐infrared spectroscopy and thermogravimetric analysis. The antioxidant activity analysis indicated that it had better radical scavenging activity on 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH), 2,2′‐azinobis (3‐ethylbenzothiazoline)‐6‐sulfonic acid (ABTS) and O₂^? compared with the free protein and vanadate. Additionally, the complex exhibited high anti‐diabetic activity against Saccharomyces cerevisiae α‐glucosidase and rat intestinal maltase with IC₅₀ values of 258.53 and 72.41 μg/ml, respectively. Kinetics study showed that the complex was a mixed inhibition type against S. cerevisiae α‐glucosidase and uncompetitive inhibition type against rat intestinal maltase. These indicated that the complex with antioxidant and anti‐diabetic potential could be used for lowering blood glucose that might be caused by insufficient secretion of insulin in the body or excess fat storage. Our findings provide a new protein–vanadium complex for further use in diabetes mellitus or obesity.     

Delaying of cataract through intervention of Hemidesmus indicus in STZ induced diabetic rats

Hemidesmus indicus (L.) R. Br. was extensively used as hypoglycaemic agent and significance of this plant on secondary complications of diabetes remained unknown. The present study was to investigate the anti-cataractous activity of H. indicus against streptozotocin (STZ)-induced diabetic cataract in rodent model. Root extracts have been prepared and tested for inhibition of rat lens aldose reductase (AR) activity. In addition, its pharmacological potential has been investigated in STZ-induced diabetic cataract. Methanol extract of H. indicus-inhibited AR activity in vitro decreased the blood glucose levels, inhibited the AR activity and delayed the onset and progression of cataract in a dose-dependent manner in in vivo and the antioxidant markers have been normalised. Our results demonstrate that H. indicus has decrease the osmotic stress by inhibiting the AR activity and prevented the loss of antioxidants and delayed the progression of diabetic cataract in STZ-induced diabetic rats.     

Fourier-transform-infrared-spectroscopy based metabolomic spectral biomarker selection towards optimal diagnostic differentiation of diabetes with and without retinopathy

Abstract

The purpose of this study is to identify Fourier transform infrared (FTIR) spectroscopy-based serum metabolomic spectral biomarkers using chemometrics for the diagnosis of Diabetic Retinopathy. FTIR spectroscopy was performed on 85 human serum samples [30 type 2 diabetes patients each without retinopathy and with retinopathy along with 25 normal healthy individuals as control]. Difference between mean spectra (DBMS), forward feature selection (FFS), and Mann–Whitney’s U tests were applied for spectral biomarker selection. Classification of disease conditions was achieved using analysis of different combinations of spectral features with linear, quadratic, and cubic Support Vector Machine at 10-fold cross validation. Twelve spectral signatures extracted by FFS could differentiate diabetes and diabetic retinopathy with 90% sensitivity, 92.7% specificity, and 90.5% overall accuracy. Two peaks (1042, 1114.18?cm^?1) were associated with carbohydrate and polysaccharide content and five peaks (1114.18, 1165, 1211.18, 1402.70, 1451.14, 1657?cm^?1) represented aberrations in total lipid content. Four peaks (1114.18, 1117, 1147, 1165?cm^?1) were associated with protein phosphorylation and three peaks (1527, 1544.71, 1591.10?cm^?1) with Amide II group. Again, lipidic signatures were strongly corroborated with glycosylated hemoglobin levels in diabetic retinopathy and diabetic subjects. Spectral signatures also revealed an elevated level of β-sheet containing proteins in serum in diabetic retinopathy condition. The method was validated through spectral biomarker selection by the DBMS technique. Thus, this method has the capability of diagnostic cost minimization for detection of diabetic retinopathy by label-free spectral biomarker identification.