Adenosine mediates transforming growth factor-beta 1 release in kidney glomeruli of diabetic rats

Up regulation of the transforming growth factor-beta 1 (TGF-β1) axis has been recognized as a pathogenic event for progression of glomerulosclerosis in diabetic nephropathy. We demonstrate that glomeruli isolated from diabetic rats accumulate up to sixfold more extracellular adenosine than normal rats. Both decreased nucleoside uptake activity by the equilibrative nucleoside transporter 1 and increased AMP hydrolysis contribute to raise extracellular adenosine. Ex vivo assays indicate that activation of the low affinity adenosine A_2B receptor subtype (A_2BAR) mediates TGF-β1 release from glomeruli of diabetic rats, a pathogenic event that could support progression of glomerulopathy when the bioavailability of adenosine is increased.     

CXCR4基因转染人脐带间充质干细胞移植治疗糖尿病肾病的实验研究

摘要 目的：探讨过表达CXCR4的人脐带间充质干细胞（human umbilical cord mesenchymal stem cell, hUC-MSCs）移植后对糖尿病肾病的治疗作用。方法：构建CXCR4的慢病毒表达载体，并建立过表达 CXCR4 的人脐带间充质干细胞（CXCR4-MSCs）。采用8周龄健康雌性SD大鼠75只，其中15只为正常对照组，60只为实验组。实验组糖尿病成模后一个月，将糖尿病实验大鼠60只随机分为4组：①移植CXCR4-MSCs组(CXCR4基因转染MSCs组)，即CXCR4组；②移植null-MSCs组(空质粒未转染CXCR4基因的MSCs组)，即null-MSCs；③移植MSCs组( MSCs组)；④PBS组(未移植任何的MSCs，单纯PBS注射，PBS组)。将CXCR4-MSCs、null-MSCs及MSCs消化离心，取含1×106个细胞悬液经尾静脉分别注入CXCR4-MSCs组、null-MSCs组及MSCs组大鼠体内，PBS组注射l mL PBS。干细胞治疗8周后，处死五组大鼠。各组大鼠处死前放代谢笼留取24 h尿，计算尿量，保存送检。处死前尾静脉采血检测血糖、称体重并记录。观察血糖、肾脏肥大指数、肾重、体重、24小时尿蛋白排泄量，并观察肾脏组织病理学改变。结果：60只SD雌性大鼠糖尿病模型成功率达100％，至实验8周糖尿病大鼠总共死亡14只，存活率达76.67％。实验开始后的8周，所有CXCR4组、Null-MSCs组、MSCs组、PBS组大鼠与正常组比较，体重均明显减轻(P<0.01)，血糖明显升高(P<0.01)。MSCs治疗后8周，除正常组外，其余各组大鼠血糖、肾重、肾重/体重比、24小时尿蛋白均显著增高，体重显著降低(P<0.05)；与PBS组相比，CXCR4组、null-MSCs组，MSCs组大鼠的肾重、肾重/体重比、24小时尿蛋白均明显降低(P<0.05)，体重无明显增加，血糖无明显降低(P>0.05)。CXCR4组大鼠的肾重、肾重/体重比、24小时尿蛋白较除正常组外的各组均明显降低(P<0.05)。糖尿病成模后，给予大鼠尾静脉注射干细胞悬液或等量培养液，注射后8周，除正常组外，其余各组PAS染色可见大鼠肾小球肥大，肾小球基底膜增厚、系膜增生、系膜基质增多，部分肾小球出现明显硬化，符合糖尿病肾病中期病理表现。CXCR4组大鼠肾小球系膜基质增生较其余各组大鼠减少(P<0.05)。结论：转染CXCR4的MSCs可改善糖尿病肾病。     

Monoamine oxidase-A is an important source of oxidative stress and promotes cardiac dysfunction,apoptosis, and fibrosis in diabetic cardiomyopathy

Oxidative stress is closely associated with the pathophysiology of diabetic cardiomyopathy (DCM). The mitochondrial flavoenzyme monoamine oxidase A (MAO-A) is an important source of oxidative stress in the myocardium. We sought to determine whether MAO-A plays a major role in modulating DCM. Diabetes was induced in Wistar rats by single intraperitoneal injection of streptozotocin (STZ). To investigate the role of MAO-A in the development of pathophysiological features of DCM, hyperglycemic and age-matched control rats were treated with or without the MAO-A-specific inhibitor clorgyline (CLG) at 1 mg/kg/day for 8 weeks. Diabetes upregulated MAO-A activity; elevated markers of oxidative stress such as cardiac lipid peroxidation, superoxide dismutase activity, and UCP3 protein expression; enhanced apoptotic cell death; and increased fibrosis. All these parameters were significantly attenuated by CLG treatment. In addition, treatment with CLG substantially prevented diabetes-induced cardiac contractile dysfunction as evidenced by decreased QRS, QT, and corrected QT intervals, measured by ECG, and LV systolic and LV end-diastolic pressure measured by microtip pressure transducer. These beneficial effects of CLG were seen despite the persistent hyperglycemic and hyperlipidemic environments in STZ-induced experimental diabetes. In summary, this study provides strong evidence that MAO-A is an important source of oxidative stress in the heart and that MAO-A-derived reactive oxygen species contribute to DCM.     

Novel triazine-based pyrimidines suppress glomerular mesangial cells proliferation and matrix protein accumulation through a ROS-dependent mechanism in the diabetic milieu

Diabetic nephropathy (DN) is one of the most serious complications of diabetes worldwide. It is depicted as the leading cause of end-stage renal disease. Oxidative stress plays a key role in hyperglycemia-induced DN. The preparation and characterization of novel mono-, di-, and trisubstituted-s-triazines endowed with uracil and/or thymine are described in this paper. The synthesis of the title compounds was realized through selective nucleophilic substitution reactions of cyanuric chloride with the corresponding hydrazide nucleobases. In this study, we assessed the effects of these derivatives on the progression of diabetic nephropathy. Our results show that trisubstituted-s-triazines endowed with acylhydrazides attenuate high-glucose induced glomerular mesangial cells proliferation and matrix protein accumulation in vitro. Notably, these derivatives also display anti-oxidative properties. This suggests that the novel trisubstituted-s-triazine derivatives provide renal protection through a reactive oxygen species (ROS)-dependent mechanism. Our data provide evidence that these derivatives may serve as potential therapeutic candidates in the treatment of DN.     

口服降糖药和胰岛素对不同临床分期糖尿病视网膜病变病情进程的影响

目的:探讨降糖药物和胰岛素控制血糖对不同临床分期糖尿病视网膜病变进程的影响。方法:收集糖尿病伴有视网膜病变的患者78例。采用随机表法,将糖尿病视网膜病变患者分为药物控制血糖组和胰岛素控制组,药物治疗组38例,胰岛素治疗组40例,使血糖达到控制标准。评价干预前后患者血清C肽、糖化血红蛋白、胰岛素抵抗指数,以及糖尿病视网膜病变分级。结果:药物控制组治疗前后2 h CP、以及糖化血红蛋白测定差异无统计学意义(p0.05)。胰岛素组治疗前后,血清空腹C肽、2 h CP差异有统计学意义(p0.05);而糖化血红蛋白、胰岛素抵抗指数差异无统计学意义(p0.05)。药物组治疗前Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期、Ⅵ期病例数和治疗后相比,差异有统计学意义(p0.05),视网膜病变分级程度明显增高。胰岛素组治疗前Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期、Ⅵ期病例数和治疗后相比,差异有统计学意义(p0.05)。药物组和胰岛素组间视网膜病变分级差异无统计学意义(p0.05);治疗后差异有统计学意义(p0.05)。结论:胰岛素能够提高糖尿病患者血清C肽,降低胰岛素抵抗,和药物控制血糖相比,能够延缓糖尿病视网膜病变的进展。     

Animal models of diabetic retinopathy: doors to investigate pathogenesis and potential therapeutics

Effective and validated animal models are valuable to investigate the pathogenesis and potential therapeutics for human diseases. There is much concern for diabetic retinopathy (DR) in that it affects substantial number of working population all around the world, resulting in visual deterioration and social deprivation. In this review, we discuss animal models of DR based on different species of animals from zebrafish to monkeys and prerequisites for animal models. Despite criticisms on imprudent use of laboratory animals, we hope that animal models of DR will be appropriately utilized to deepen our understanding on the pathogenesis of DR and to support our struggle to find novel therapeutics against catastrophic visual loss from DR.     

前列地尔联合益肾化湿颗粒对糖尿病肾病患者血糖、血脂、肾功能以及尿足细胞相关蛋白的影响

目的:分析前列地尔联合益肾化湿颗粒对糖尿病肾病患者血糖、血脂、肾功能以及尿足细胞相关蛋白的影响。方法:98例糖尿病肾病患者按抽签法分为对照组与实验组,各49例,对照组予以前列地尔治疗,实验组基于对照组加用益肾化湿颗粒治疗,比较两组疗效,糖化血红蛋白(Hb A1c)、血糖(FPG)、餐后2 h血糖低(2h PG),甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C),血尿素氮(BUN)、肌酐(Cr)、β2微球蛋白(β2-MG)、胱抑素(Cys-C),尿足细胞标志蛋白(PCX)nephrin,安全性。结果:实验组总有效率高于对照组(P0.05)。治疗后,两组Hb Alc、FPG、2h PG比较无差异(P0.05)。实验组TG、TC、LDL-C、BUN、Cr、β2-MG、Cys-c、PCX、尿nephrin/尿Cr低于对照组(P0.05)。实验组HDL-C高于对照组(P0.05)。结论:前列地尔联合益肾化湿颗粒治疗对糖尿病肾病的疗效确切,可利于血糖、血脂、肾功能的改善,降低尿足细胞相关蛋白的浓度。     

Synthesis,anti-diabetic evaluation and molecular docking studies of 4-(1-aryl-1H-1, 2, 3-triazol-4-yl)-1,4-dihydropyridine derivatives as novel 11-β hydroxysteroid dehydrogenase-1 (11β-HSD1) inhibitors

11-Beta-Hydroxysteroid dehydrogenase-1(11β-HSD1) inhibitors are one of the emerging classes of molecules to fight against diabetic complications. A novel series of 4-(1-substituted-1H-1,2,3-triazol-4-yl)-1,4-dihydropyridine derivatives were synthesized and evaluated for their anti-diabetic activity. Two compounds showed anti-diabetic activity very effectively. To clarify the mechanism of action of these compounds, the most potent compounds (5g and 5h) of the synthesized analogs were further studied by testing its 11-Beta Hydroxysteroid dehydrogenase-1 inhibitory activity through in vitro enzymatic experiments. The results showed that the 11β-HSD1 inhibitory activity of compounds 5g and 5h was stable and efficient. Molecular docking studies revealed compounds 5g (−9.758) and 5h (−8.495) to have a stable binding patterns to the human 11-Beta-Hydroxysteroid dehydrogenase-1.     

普罗布考联合胰激肽原酶对老年糖尿病周围神经病变患者氧化应激反应及血清NSE水平的影响

目的:探讨普罗布考联合胰激肽原酶对老年糖尿病周围神经病变患者氧化应激反应及血清神经元特异性烯醇化酶(NSE)水平的影响。方法:选择2015年8月至2017年8月我院接诊的94例老年糖尿病周围神经病变患者作为本研究对象,通过随机数表法将其分为观察组(n=47)和对照组(n=47)。对照组在常规治疗基础上给予胰激肽原酶治疗,观察组在对照组基础上联合普罗布考治疗,两组均连续治疗12周。比较两组治疗后的临床疗效、治疗前后运动传导速度(MNCV)、感觉传导速度(SNCV)、多伦多临床评分系统(TCSS)评分、血清丙二醛(MDA)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)及NSE水平的变化和不良反应的发生情况。结果:治疗后,观察组临床疗效总有效率为93.62%(44/47),明显高于对照组[70.21%(33/47)](P0.05);两组正中神经、腓总神经MNCV、SNCV较治疗前均显著延长(P0.05),且观察组正中神经、腓总神经MNCV、SNCV均明显高于对照组(P0.05);两组TCSS评分各内容和总分、血清MDA、NSE水平较治疗前均显著降低(P0.05),且观察组TCSS评分中症状评分、反射评分、感觉评分和总分及、血清MDA、NSE水平均明显低于对照组(P0.05);两组血清超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)水平较治疗前均显著升高(P0.05),且观察组血清SOD、CAT、GSH-Px水平均明显比对照组高(P0.05)。两组治疗期间不良反应总发生率分别为10.64%(5/47)、4.26%(2/47),组间比较差异无统计学意义(P0.05)。结论:普罗布考联合胰激肽原酶治疗老年糖尿病周围神经病变患者的效果显著优于单用胰激肽原酶治疗,可更有效改善神经病变程度,其机制可能和缓解氧化应激反应、降低血清NSE水平有关。     

超声对早期糖尿病肾病的诊断价值及肾动脉血流阻力指数与血清hs-CRP、VEGF的关系分析

目的:研究彩色多普勒超声对早期糖尿病肾病的诊断价值及肾动脉血流阻力指数与血清超敏C反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)的关系。方法:选取从2017年2月～2018年2月兰州大学第二医院收治的早期糖尿病肾病患者50例记为病变组,另取同期于该院进行体检的健康人员50例记为对照组。分别对两组人员进行彩色多普勒超声检查,比较肾血流参数。采用酶联免疫吸附法检测两组人员血清hs-CRP、VEGF水平,并作指标间的相关性分析。结果:病变组肾主动脉、肾锥体两侧叶间动脉、肾段动脉的收缩期峰值速度、舒张期最低速度较对照组降低,病变组肾主动脉、肾锥体两侧叶间动脉、肾段动脉的阻力指数较对照组升高(均P0.05)。病变组血清hs-CRP、VEGF水平较对照组升高(均P0.05)。经Pearson相关性分析显示:早期糖尿病肾病患者肾主动脉、肾锥体两侧叶间动脉、肾段动脉的血流阻力指数与血清hs-CRP、VEGF均呈正相关关系(均P0.05)。结论:彩色多普勒超声应用于早期糖尿病肾病的诊断价值较高,且肾动脉血流阻力指数与血清hs-CRP、VEGF密切相关,临床工作中通过联合检测血清hs-CRP、VEGF,从而有助于早期糖尿病肾病的诊断。