氧化应激与糖尿病

高血糖引起的自由基产生过多或消除障碍导致氧化应激的出现,氧化应激与糖尿病及其并发症的发生发展密切相关。抗氧化治疗为糖尿病及并发症的防治提供了新的思路。     

氧化应激与糖尿病

高血糖引起的自由基产生过多或消除障碍导致氧化应激的出现,氧化应激与糖尿病及其并发症的发生发展密切相关。抗氧化治疗为糖尿病及并发症的防治提供了新的思路。     

抗氧化剂在糖尿病中的应用研究进展

氧化应激是自由基的促氧化与机体的抗氧化失衡造成的.自由基的高反应活性可以使细胞组分发生化学变化,并导致脂质过氧化.越来越多的证据表明:糖尿病患者体内活性氧物质明显增多,并且抗氧化防御系统功能紊乱.抗氧化剂可以降低糖尿病患者体内的氧化应激水平,清除自由基并改善抗氧化防御体系,所以将抗氧化剂应用于糖尿病是可行的.许多抗氧化剂已经用于糖尿病的研究与治疗,本文主要将作用于糖尿病的各种抗氧化剂做一综述.     

臭氧大自血疗法治疗急性缺血性脑梗死患者的临床疗效评估

目的:研究臭氧大自血疗法治疗急性缺血性脑梗死患者的临床疗效,为临床治疗提供依据。方法:选取2014年10月到2015年8月我院收治的急性缺血性脑梗死患者210例,按照随机数字表法将患者分为研究组和对照组,每组105例,两组均给予常规治疗,研究组在常规治疗的基础上给予臭氧大自血疗法,应用barthel指数评定日常生活活动能力,应用美国国立卫生研究院卒中量表(NIHSS)评价神经功能缺损,比较两组临床疗效,治疗前后甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HLD-C)和低密度脂蛋白(LDL-C),并比较两组不良反应。结果:研究组总有效率为87.6%(92/105)显著高于对照组的73.3%(77/105),比较差异具有统计学意义(P0.05);治疗后两组NIHSS评分显著降低,barthel评分显著升高,且研究组NIHSS评分显著低于对照组,barthel评分显著高于对照组,比较差异具有统计学意义(P0.05);治疗后两组TG、TC和LDL-C均显著降低,HDL-C显著升高,且研究组TG、TC和LDL-C低于对照组,HDL-C高于对照组,比较差异具有统计学意义(P0.05);两组不良反应比较无统计学意义(P0.05)。结论:臭氧大自血疗法治疗急性缺血性脑梗死疗效较好,能明显改善患者的神经功能和日常生活。     

硫辛酸在糖尿病微血管病变治疗中的作用

糖尿病是危害人群健康的一种慢性疾病。糖尿病微血管病变是糖尿病的特异性病变,其并发症主要包括肾脏病变,视网膜病变及神经病变。而其发生受多种因素影响,其发生机制研究已形成多种学说,主要有非酶糖基化、多元醇通路、氧化应激及己糖胺通路学说等。近年来硫辛酸对糖尿病微血管并发症的治疗作用是国内外研究的热点,硫辛酸是高效抗氧化剂,清除自由基和活性氧,再生体内谷胱甘肽等其他抗氧化剂,减弱氧化应激,从而硫辛酸可减弱多种糖尿病微血管并发症的诱发因素,并干预多元醇通路与己糖胺通路,对糖尿病微血管并发症中的相应靶器官有保护作用,本文就硫辛酸在糖尿病微血管病变中的应用做一简要综述。     

mTOR信号通路在糖尿病肾病发病机制中的研究进展

糖尿病肾病（diabetic nephropathy,DN）是糖尿病最常见的并发症之一,因其具有高发病率且与晚期肾病、心血管疾病和过早死亡等风险相关,糖尿病肾病已成为全球性的公共健康问题,但目前其发病机制尚不清楚。雷帕霉素靶蛋白（mammalian target of rapamycin,mTOR）是一种丝氨酸/苏氨酸的蛋白酶,在延迟细胞凋亡以及促进细胞分裂、细胞存活、血管生成中发挥着重要作用。近年来有研究表明,mTOR存在于DN进展的关键步骤中,包括自噬、炎症及氧化应激等。因此,就mTOR介导的自噬、炎症及氧化应激信号通路在DN发病机制中的相关研究进展做一综述,以期为DN治疗及预防提供理论参考。     

氧化应激与糖尿病性心肌病的发生发展

糖尿病患者经常表现出一种独特的心脏表型,即糖尿病性心肌病（Diabetic cardiomyopathy,DCM）。由于在糖尿病患者中慢性炎症和氧化应激的发生,改变了机体代谢稳态,引发氧化还原失衡,从而诱发心肌代谢紊乱和心脏微血管病变,使心脏出现危险的氧化应激,致使了糖尿病性心肌病的发生。心肌细胞中脂肪的氧化与毒性增加以及微脉管系统中高水平的细胞血糖,让糖尿病患者体内的线粒体产生过量的活性氧（reactive oxygen species, ROS）。超氧阴离子自由基可增强己糖胺生物合成途径和多元醇通路,诱导活化蛋白激酶C(protein kinase C, PKC),增加晚期糖基化终产物（advanced glycation end products, AGEs）的形成并激活其受体（receptor for advanced glycation end products, RAGE）。这些生化级联反应同时也是ROS的其他额外来源。本文主要概述氧化应激在DCM中的作用及其涉及信号通路。同时,也简要提到了目前用于DCM的治疗方法。基于氧化应激在糖尿病性心肌病中的关键作用,新的抗氧化疗法的...     

紫外线照射和充氧自血回输加白眉蝮蛇抗栓酶治疗脑梗塞的临床实验研究

我们应用紫外线照射和充氧自血回输(简称自血回输)加白眉蝮蛇抗栓酶治疗急性脑梗塞,与单纯用自血回输及单纯用白眉蝮蛇抗栓酶治疗急性脑梗塞进行了临床实验研究.其结果自血回输加白眉蝮蛇抗栓酶疗法优于单纯自血回输疗法,更优于单纯白眉蝮蛇抗栓酶疗法.临床证明两者合用有协同作用,而且方法安全、简单、方便.     

α-硫辛酸的生物医学功能

α-硫辛酸及其还原态二氢硫辛酸是高效抗氧剂,可以清除自由基和活性氧,螯合金属离子,再生谷胱甘肽、维生素C、维生素E、硫氧还蛋白等抗氧剂,可改善葡萄糖代谢,减弱氧化应激,对糖尿病性白内障、糖尿病多发性神经病及心血管损伤等糖尿病并发症具有较好的预防和治疗作用。     

硫氧还蛋白相互作用蛋白在糖尿病及其并发症中的作用

硫氧还蛋白相互作用蛋白(thioredoxin-interacting protein,TXNIP)又称维生素D₃上调蛋白1,因其能够与硫氧还蛋白(thioredoxin,Trx)结合并抑制其活性和表达而得名。本文概述了TXNIP的发现与结构,及其自身通过发挥调节糖脂代谢的作用进而影响糖尿病前期的发生发展。并在此基础上总结了TXNIP参与糖尿病发生发展的2条主要途径:TXNIP通过拮抗Trx的抗凋亡作用来激发细胞凋亡信号导致胰岛细胞凋亡;TXNIP过表达促使胰岛细胞磷酸化,进而使抑癌相关蛋白质表达增加,最终引起胰岛细胞衰老。进一步重点阐述了TXNIP在糖尿病心肌病、糖尿病肾病、糖尿病性视网膜病等糖尿病并发症中的作用:TXNIP能通过各种间接途径干预信号通路,进一步参与氧化应激、细胞凋亡、激活炎症、细胞自噬及糖脂代谢等生理生化过程。TXNIP具有极其重要的生物学功能,深入了解TXNIP在糖尿病及其并发症中的影响机制,对糖尿病及其并发症的治疗具有重要意义。最后对TXNIP的研究进行了展望,未来可进一步着手研究TXNIP基因是如何与其他基因或危险因素协同作用,进而共同参与糖尿病及其并发症的发生发展,且TXNIP单个基因甲基化尚不能全面揭示糖尿病及其并发症发生的分子机制,这些后续的深入研究,将为在糖尿病及其并发症的诊断与治疗中作为靶标分子的应用奠定基础。     

Extracorporeal blood oxygenation and ozonation: clinical and biological implications of ozone therapy

Some lines of evidence have suggested that the challenge to antioxidants and biomolecules provoked by pro-oxidants such as ozone may be used to generate a controlled stress response of possible therapeutic relevance in some immune dysfunctions and chronic, degenerative conditions. Immune and endothelial cells have been proposed to be elective targets of the positive molecular effects of ozone and its derived species formed during blood ozonation. On the bases of these underlying principles and against often prejudicial scepticism and concerns about its toxicity, ozone has been used in autohemotherapy (AHT) for four decades with encouraging results. However, clinical application and validation of AHT have been so far largely insufficient. Latterly, a new and more effective therapeutic approach to ozone therapy has been established, namely extracorporeal blood oxygenation and ozonation (EBOO). This technique, first tested in vitro and then in vivo in sheep and humans (more than 1200 treatments performed in 82 patients), is performed with a high-efficiency apparatus that makes it possible to treat with a mixture of oxygen-ozone (0.5-1 microg/ml oxygen) in 1 h of extracorporeal circulation up to 4800 ml of heparinized blood without technical or clinical problems, whereas only 250 ml of blood can be treated with ozone by AHT. The EBOO technique can be easily adapted for use in hemodialysis also. The standard therapeutic cycle lasts for 7 weeks in which 14 treatment sessions of 1 h are performed. After a session of EBOO, the interaction of ozone with blood components results in 4-5-fold increased levels of thiobarbituric acid reactants and a proportional decrease in plasma protein thiols without any appreciable erythrocyte haemolysis. On the basis of preliminary in vitro evidence, these simple laboratory parameters may represent a useful complement in the routine monitoring of biological compliance to the treatment. The clinical experience gained so far confirms the great therapeutic potential of EBOO in patients with severe peripheral arterial disease, coronary disease, cholesterol embolism, severe dyslipidemia, Madelung disease, and sudden deafness of vascular origin. Extensive investigation on oxidative stress biomarkers and clinical trials are under way to validate this new technique further.     

Extracorporeal blood oxygenation and ozonation: clinical and biological implications of ozone therapy

Abstract

Some lines of evidence have suggested that the challenge to antioxidants and biomolecules provoked by pro-oxidants such as ozone may be used to generate a controlled stress response of possible therapeutic relevance in some immune dysfunctions and chronic, degenerative conditions. Immune and endothelial cells have been proposed to be elective targets of the positive molecular effects of ozone and its derived species formed during blood ozonation. On the bases of these underlying principles and against often prejudicial scepticism and concerns about its toxicity, ozone has been used in autohemotherapy (AHT) for four decades with encouraging results. However, clinical application and validation of AHT have been so far largely insufficient. Latterly, a new and more effective therapeutic approach to ozone therapy has been established, namely extracorporeal blood oxygenation and ozonation (EBOO). This technique, first tested in vitro and then in vivo in sheep and humans (more than 1200 treatments performed in 82 patients), is performed with a high-efficiency apparatus that makes it possible to treat with a mixture of oxygen–ozone (0.5–1 μg/ml oxygen) in 1 h of extracorporeal circulation up to 4800 ml of heparinized blood without technical or clinical problems, whereas only 250 ml of blood can be treated with ozone by AHT. The EBOO technique can be easily adapted for use in hemodialysis also. The standard therapeutic cycle lasts for 7 weeks in which 14 treatment sessions of 1 h are performed. After a session of EBOO, the interaction of ozone with blood components results in 4–5-fold increased levels of thiobarbituric acid reactants and a proportional decrease in plasma protein thiols without any appreciable erythrocyte haemolysis. On the basis of preliminary in vitro evidence, these simple laboratory parameters may represent a useful complement in the routine monitoring of biological compliance to the treatment. The clinical experience gained so far confirms the great therapeutic potential of EBOO in patients with severe peripheral arterial disease, coronary disease, cholesterol embolism, severe dyslipidemia, Madelung disease, and sudden deafness of vascular origin. Extensive investigation on oxidative stress biomarkers and clinical trials are under way to validate this new technique further.     

Glucose-induced endoplasmic reticulum stress is independent of oxidative stress: A mechanistic explanation for the failure of antioxidant therapy in diabetes

Oxidative stress contributes to the pathogenesis of diabetes and its complications. However, a large number of interventional studies have failed to show any health benefits of antioxidants. The overwhelming failure of antioxidant therapy to prevent disease can be explained by inadequacy of the doses of antioxidants used, short duration of therapy, or poor timing of initiation of the supplementation. A more likely reason for failure of antioxidants to reduce diabetes-related complications is the multiplicity of mechanisms of glucotoxicity that are independent of oxidative stress. Recently, endoplasmic reticulum (ER) stress has emerged as an important contributor to diabetes-related complications. Multiple lines of experimental evidence indicate that ER stress in endothelial cells can be uncoupled from oxidative stress induced by hyperglycemia, and antioxidants can ameliorate the latter without altering the ER stress. These observations provide a novel mechanistic explanation for the failure of antioxidant therapy in interventional clinical trials.     

Rational bases for using oxygen-ozonetherapy as a biological response modifier in sickle cell anemia and beta-thalassemia: a therapeutic perspective

We are proposing to evaluate whether a complementary approach based on cycles of oxygen-ozone autohemotherapy (O3-AHT) already performed in millions of patients, can abate the chronic oxidative stress and improve the quality of life of serious hemoglobinopathic patients. Although a preliminary study has yielded encouraging results, it appears appropriate to perform a controlled, randomized and possibly multicentre clinical trial. The long use of this approach in other pathologies has proved to be very useful and it is hoped that scepticism will not prevail over scientific rationale. Ozone, as any other drug, has an intrinsic toxicity that, in the proposed application, is fully tamed by the blood antioxidant system.     

Model-based analysis of avoidance of ozone stress by stomatal closure in Siebold's beech (Fagus crenata)

Background and Aims

Resistance of plants to ozone stress can be classified as either avoidance or tolerance. Avoidance of ozone stress may be explained by decreased stomatal conductance during ozone exposure because stomata are the principal interface for entry of ozone into plants. In this study, a coupled photosynthesis–stomatal model was modified to test whether the presence of ozone can induce avoidance of ozone stress by stomatal closure.

Methods

The response of Siebold''s beech (Fagus crenata), a representative deciduous tree species, to ozone was studied in a free-air ozone exposure experiment in Japan. Photosynthesis and stomatal conductance were measured under ambient and elevated ozone. An optimization model of stomata involving water, CO₂ and ozone flux was tested using the leaf gas exchange data.

Key Results

The data suggest that there are two phases in the avoidance of ozone stress via stomatal closure for Siebold''s beech: (1) in early summer ozone influx is efficiently limited by a reduction in stomatal conductance, without any clear effect on photosynthetic capacity; and (2) in late summer and autumn the efficiency of ozone stress avoidance was decreased because the decrease in stomatal conductance was small and accompanied by an ozone-induced decline of photosynthetic capacity.

Conclusions

Ozone-induced stomatal closure in Siebold''s beech during early summer reduces ozone influx and allows the maximum photosynthetic capacity to be reached, but is not sufficient in older leaves to protect the photosynthetic system.     

Diabetes, metallothionein, and zinc interactions: a review

Epidemiological evidence, associating diabetes with zinc (Zn) deficiencies, has resulted in numerous research studies describing the effects of Zn and associated metallothionein (MT), on reducing diabetic complications associated with oxidative stress. MT has been found to have a profound effect on the reduction of oxidative stress induced by the diabetic condition. Over expression of MT in various metabolic organs has also been shown to reduce hyperglycaemia-induced oxidative stress, organ specific diabetic complications, and DNA damage in diabetic experimental animals, which have been further substantiated by the results from MT-knockout mice. Additionally, supplementation with Zn has been shown to induce in vivo MT synthesis in experimental animals and to reduce diabetes related complications in both humans and animal models. Although the results are promising, some caution regarding this topic is however necessary, due to the fact that the majority of the studies done have been animal based. Hence more human intervention trials are needed regarding the positive effects of MT and Zn before firm conclusions can be made regarding their use in the treatment of diabetes.     

Sodium–glucose cotransporter inhibitors and oxidative stress: An update

Sodium–glucose cotransporter 2 (SGLT2) inhibitors are therapeutic agents that have been used recently to reduce tubular absorption of glucose, leading to enhanced glycosuria, resulting in the reduction of blood glucose and improved diabetes control. Recent data suggest that SGLT2 inhibitors have antioxidant properties that may be key to the reduction in cardiovascular death found in clinical trials. Oxidative stress is involved in the development and progression of atherosclerosis, as well as underlying diabetes complications, and may result from either increased free-radical production, a reduction in antioxidative capacity, or a combination of both. In this report, we have reviewed the recent evidence of the impact that SGLT2 inhibition may have on improved oxidative stress by either amelioration of free-radical generation or potentiation of cellular antioxidative capacity, and its importance in the prevention of cardiovascular and diabetes complications.     

Oxidative stress and the use of antioxidants in diabetes: Linking basic science to clinical practice

Cardiovascular complications, characterized by endothelial dysfunction and accelerated atherosclerosis, are the leading cause of morbidity and mortality associated with diabetes. There is growing evidence that excess generation of highly reactive free radicals, largely due to hyperglycemia, causes oxidative stress, which further exacerbates the development and progression of diabetes and its complications. Overproduction and/or insufficient removal of these free radicals result in vascular dysfunction, damage to cellular proteins, membrane lipids and nucleic acids. Despite overwhelming evidence on the damaging consequences of oxidative stress and its role in experimental diabetes, large scale clinical trials with classic antioxidants failed to demonstrate any benefit for diabetic patients. As our understanding of the mechanisms of free radical generation evolves, it is becoming clear that rather than merely scavenging reactive radicals, a more comprehensive approach aimed at preventing the generation of these reactive species as well as scavenging may prove more beneficial. Therefore, new strategies with classic as well as new antioxidants should be implemented in the treatment of diabetes.     

Immune Activation Reduces Sperm Quality in the Great Tit

Mounting an immune response against pathogens incurs costs to organisms by its effects on important life-history traits, such as reproductive investment and survival. As shown recently, immune activation produces large amounts of reactive species and is suggested to induce oxidative stress. Sperm are highly susceptible to oxidative stress, which can negatively impact sperm function and ultimately male fertilizing efficiency. Here we address the question as to whether mounting an immune response affects sperm quality through the damaging effects of oxidative stress. It has been demonstrated recently in birds that carotenoid-based ornaments can be reliable signals of a male''s ability to protect sperm from oxidative damage. In a full-factorial design, we immune-challenged great tit males while simultaneously increasing their vitamin E availability, and assessed the effect on sperm quality and oxidative damage. We conducted this experiment in a natural population and tested the males'' response to the experimental treatment in relation to their carotenoid-based breast coloration, a condition-dependent trait. Immune activation induced a steeper decline in sperm swimming velocity, thus highlighting the potential costs of an induced immune response on sperm competitive ability and fertilizing efficiency. We found sperm oxidative damage to be negatively correlated with sperm swimming velocity. However, blood resistance to a free-radical attack (a measure of somatic antioxidant capacity) as well as plasma and sperm levels of oxidative damage (lipid peroxidation) remained unaffected, thus suggesting that the observed effect did not arise through oxidative stress. Towards the end of their breeding cycle, swimming velocity of sperm of more intensely colored males was higher, which has important implications for the evolution of mate choice and multiple mating in females because females may accrue both direct and indirect benefits by mating with males having better quality sperm.