Brain glycogen and its role in supporting glutamate and GABA homeostasis in a type 2 diabetes rat model

The number of people suffering from diabetes is hastily increasing and the condition is associated with altered brain glucose homeostasis. Brain glycogen is located in astrocytes and being a carbohydrate reservoir it contributes to glucose homeostasis. Furthermore, glycogen has been indicated to be important for proper neurotransmission under normal conditions. Previous findings from our laboratory suggested that glucose metabolism was reduced in type 2 diabetes, and thus we wanted to investigate more specifically how brain glycogen metabolism contributes to maintain energy status in the type 2 diabetic state. Also, our objective was to elucidate the contribution of glycogen to support neurotransmitter glutamate and GABA homeostasis. A glycogen phosphorylase (GP) inhibitor was administered to Sprague-Dawley (SprD) and Zucker Diabetic Fatty (ZDF) rats in vivo and after one day of treatment [1-13C]glucose was used to monitor metabolism. Brain levels of 13C labeling in glucose, lactate, alanine, glutamate, GABA, glutamine and aspartate were determined. Our results show that inhibition of brain glycogen metabolism reduced the amounts of glutamate in both the control and type 2 diabetes models. The reduction in glutamate was associated with a decrease in the pyruvate carboxylase/pyruvate dehydrogenase ratio in the control but not the type 2 diabetes model. In the type 2 diabetes model GABA levels were increased suggesting that brain glycogen serves a role in maintaining a proper ratio between excitatory and inhibitory neurotransmitters in type 2 diabetes. Both the control and the type 2 diabetic states had a compensatory increase in glucose-derived 13C processed through the TCA cycle following inhibition of glycogen degradation. Finally, it was indicated that the type 2 diabetes model might have an augmented necessity for compensatory upregulation at the glycolytic level.     

Role of matrix metalloproteinase-2 and -9 in the development of diabetic retinopathy

Diabetic retinopathy represents the most common causes of vision loss in patients affected by diabetes mellitus. The cause of vision loss in diabetic retinopathy is complex and remains incompletely understood. One of the earliest changes in the development of retinopathy is the accelerated apoptosis of retinal microvascular cells and the formation of acellular capillaries by unknown mechanism. Results of a recent research suggest an important role of matrix metalloproteinases (MMPs) in the development of diabetic retinopathy. MMPs are a large family of proteinases that remodel extracellular matrix components, and under pathological condition, its induction is considered as a negative regulator of cell survival; and in diabetes, latent MMPs are activated in the retina and its capillary cells, and activation of MMP-2 and -9 induces apoptosis of retinal capillary cells. This review will focus on the MMP-2 and MMP-9 in the diabetic retina with special reference to oxidative stress, mitochondria dysfunction, inflammation and angiogenesis, as well as summarizing the current information linking these proteins to pathogenesis of diabetic retinopathy.     

离子导入疗法对防治糖尿病视网膜病变及改善症状的临床研究

目的：探讨离子导入疗法对糖尿病视网膜病变患者进行护理的临床效果。方法：选取88例（122眼）糖尿病视网膜病变患者,随机分为照组和实验组,其中对照组44例（58眼）,给予常规护理治疗;实验组44例（64眼）,在对照组基础上采用离子导入疗法进行护理。观察患者视网膜改变、视力的改善及自觉症状改善情况。结果：实验组实施干预后,视网膜改变、视力的改善、自觉症状的改善显效率明显高于对照组,差异有统计学意义（P〈0．01）。结论：离子导入疗法有助于改善糖尿病视网膜病变患者眼底血液循环。促进出血点吸收、改善临床症状,操作简单易行,患者易于接受。     

血管内皮祖细胞与糖尿病微血管病变研究进展

糖尿病微血管病变严重影响了患者生活质量,是患者致死致残主要原因。微血管病变主要表现在视网膜、肾、神经、心肌组织。微血管病变的机制尚未完全清楚,近年越来越多研究发现血管内皮祖细胞(endothelial progenitor cells,EPCs)是该病发病重要原因。EPCs有分化为成熟的内皮细胞并且参与新血管形成和新生的能力。正常情况下内皮损失和EPCs对内皮的修复作用处于动态平衡状态,一旦EPCs受损,内皮损害和修复之间的平衡被打破,内皮层的完整性遭到破坏,必然参与糖尿病血管病变的发生发展。国内外大量研究证明糖尿病合并大血管病变EPCs数目功能改变,而糖尿病合并微血管病变EPCs的怎样变化?本文就EPCs与糖尿病微血管病变的关系进行系统综述。     

糖尿病急性并发症合并横纹肌溶解患者临床特征及预后

目的:分析糖尿病急性并发症患者合并横纹肌溶解的临床特征及预后,为临床及时诊断和治疗提供依据。方法:对我院2003年1月～2009年5月住院患者查阅病例资料,糖尿病酮症酸中毒及高血糖高渗状态患者根据肌酸激酶升高与否,分为血清肌酸激酶升高组(A组)和血清肌酸激酶正常组(B组),比较两组临床特征及预后。结果:A、B两组比较,A组较B组血清尿素氮、肌酐、肌红蛋白明显升高,住院时间明显延长,但出院时A组较B组每天每公斤胰岛素剂量减少,差异有统计学意义(P<0.05)。A组中3例患者血清肌酸激酶大于1000U/L,符合横纹肌溶解综合征诊断标准。结论:糖尿病酮酸中毒及高血糖高渗状态患者应重视肌酶检查,早期诊断横纹肌溶解综合征,保护肾脏和胰岛β细胞功能,缩短住院时间。     

2 型糖尿病神经病变患者血清IL-6、8-iso-PGF2α 检测及意义

目的:探讨2型糖尿病神经病变(DPN)患者血清IL-6、8-iso-PGF2α水平的变化及意义。方法:选择2型糖尿病患者伴神经病变的患者55例,单纯2型糖尿病不伴有神经病变的患者25例,另选25例体检健康者作为对照组。采用ELISA法分别测定各组血清IL-6、8-iso-PGF2α水平。结果:血清IL-6、8-iso-PGF2α水平在糖尿病组和糖尿病神经病变组均较对照组显著升高,差异具有统计学意义(P<0.01)。DN组8-iso-PGF2α较DM组显著升高,差异具有统计学意义(P<0.05);但IL-6在两组间差异无统计学意义(P>0.05)。结论:IL-6在糖尿病神经病变发病中的作用不能肯定。8-iso-PGF2α可能通过氧化应激作用参与糖尿病神经病变的发生发展。     

苯那普利对糖尿病大鼠肾小球MMP-9影响的实验研究

目的探讨苯那普利对糖尿病大鼠肾小球基质金属蛋白酶-9（MMP-9）表达的影响。方法将雄性SD大鼠30只,随机抽出10只动物作为正常对照组（C组）,其余20只采用腹腔注射STZ制备糖尿病大鼠模型。将这20只造模成功的糖尿病大鼠模型随机分为2组：糖尿病组（DM组）和药物处理组（DB组）。其中药物处理组即DB组大鼠每天应用苯那普利进行治疗性灌胃,C组和DM组用等量自来水灌胃。分别于治疗4、8周后,测定皿糖和内生肌苷清除率,用代谢笼收集24h尿量。利用免疫组织化学染色及图像分析方法,对MMP-9在肾组织不同时间点的含量变化进行定性分析。结果苯那普利治疗组血糖水平和内生肌苷清除率明显降低,与糖尿病模型组相比有显著性差异。免疫组织化学染色显示：MMP-9在正常肾小球有阳性表达;DM组大鼠病程第8周时,MMP-9在肾小球表达明显减弱;DB组大鼠病程第8周时,经苯那普利治疗后,与同期糖尿病组比较表达明显上调。图像分析方法定量分析免疫组织化学染色阳性面积百分比,苯那普利治疗后第4周和第8周糖尿病肾病的大鼠肾小球MMP-9的阳性面积百分比分别为25．55％±3．44％和20．10％±2．11％,与糖尿病组对比有明显的提高（P〈0．01）。结论MMP-9在糖尿病肾小球中的表达随病程进展逐渐减弱,苯那普利可能部分通过上调MMP-9在肾小球中的表达起到保护肾脏的作用。     

Adhesion molecules (ICAM-1 and VCAM-1) and diabetic retinopathy in type 2 diabetes

The expression of intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) were studied in the conjunctiva of diabetic patients with and without retinopathy. All patients underwent a complete ophthalmic examination including ocular fundus and retinal fluorescein angiography. The indirect immunoperoxidase method was performed on 15 normal conjunctivas taken during cataract surgery (group 1), on 40 eyes of 40 patients with type 2 diabetes without diabetic retinopathy (DR) (group 2) and 13 eyes of 13 patients with DR (group 3). ICAM-1 and VCAM-1 are located in epithelial cells, vascular endothelial cells and in stromal cells. Our results show a statistically significant increase in the immunohistochemical expression of these proteins in the conjunctiva of diabetic patients with and without DR in comparison with normal conjunctiva (P = 0.001). Noteworthy, ICAM-1 and VCAM-1 are upregulated in the conjunctiva of diabetic patients with and without retinopathy, reflecting the inflammatory nature of this condition and suggesting a possible role for these mediators in the pathogenesis of diabetic microangiopathy.     

实验恒河猴糖尿病动物模型建立及视网膜并发症的研究

[目的]糖尿病是由于多种因素和遗传因素导致体内胰岛素相对或绝对分泌不足,而引起的代谢性内分泌疾病,它以血糖、尿糖升高为特点,起病隐蔽,通过并发症使人致残致死,是继心血管、癌症之后的第三大致死性疾病,很可能成为21世纪人类的“第一杀手”(1,2)。本文采用人工诱导的方法,建立恒河猴糖尿病动物模型,研究糖尿病疾病的发展和及其并发症的发生、发展规律和防治措施,同时对于治疗糖尿病新药的安全性评价和药物疗效的观察具有广阔的运用前景。[方法]选用成熟的、健康的、雄性恒河猴9只,随机分成三个组,其中高剂量组(60mg/kg)1只,中剂量组(45m…     

STZ诱导糖尿病肾病大鼠模型的建立

目的建立糖尿病大鼠动物模型,探讨其肾脏损害规律。方法用STZ65mg/kg一次性腹腔内注射方式制作糖尿病大鼠模型,设立空白对照组,饲养14周,期间观察大鼠血糖、尿糖及一般情况变化,实验结束时测定血肌酐、尿素氮、尿蛋白、尿白蛋白排泄率,取肾作病理及超微病理检查。结果模型组大鼠出现血肌酐、尿素氮、尿蛋白、尿白蛋白明显升高,出现肾脏肥大,病理显示明显的肾小球、肾小管病变。结论STZ诱导糖尿病大鼠肾脏表现肾小球及小管间质损害,可以用作糖尿病肾病研究的动物模型。