Effects of sodium glucose cotransporter-2 inhibitors on serum uric acid in type 2 diabetes mellitus: A systematic review with an indirect comparison meta-analysis

To describe the effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM). PubMed, EMBASE, and CENTRAL were searched for randomized controlled trials of SGLT2 inhibitors in patients with T2DM up to Aug 10, 2017, without language or date restrictions. Thirty-one studies totaling 13,650 patients were included. SGLT2 inhibitors significantly decreased SUA levels compared with placebo, canagliflozin WMD –37.02?μmol/L, 95% CI [–38.41, –35.63], dapagliflozin WMD –38.05?μmol/L, 95% CI [–44.47, –31.62], empagliflozin WMD –42.07?μmol/L, 95% CI [–46.27, –37.86]. The drug class effect of SUA reduction suggesting SGLT2 inhibitors might be beneficial for diabetic patients with hyperuricemia.     

Structural hybridization of pyrrolidine-based T-type calcium channel inhibitors and exploration of their analgesic effects in a neuropathic pain model

Highly effective and safe drugs for the treatment of neuropathic pain are urgently required and it was shown that blocking T-type calcium channels can be a promising strategy for drug development for neuropathic pain. We have developed pyrrolidine-based T-type calcium channel inhibitors by structural hybridization and subsequent assessment of in vitro activities against Ca_v3.1 and Ca_v3.2 channels. Profiling of in vitro ADME properties of compounds was also carried out. The representative compound 17h showed comparable in vivo efficacy to gabapentin in the SNL model, which indicates T-type calcium channel inhibitors can be developed as effective therapeutics for neuropathic pain.     

Emerging roles of long non‐coding RNAs in neuropathic pain

Neuropathic pain, a type of chronic and potentially disabling pain resulting from primary injury/dysfunction of the somatosensory nervous system and spinal cord injury, is one of the most intense types of chronic pain, which incurs a significant economic and public health burden. However, our understanding of its cellular and molecular pathogenesis is still far from complete. Long non‐coding RNAs (lncRNAs) are important regulators of gene expression and have recently been characterized as key modulators of neuronal functions. Emerging evidence suggested that lncRNAs are deregulated and play pivotal roles in the development of neuropathic pain. This review summarizes the current knowledge about the roles of deregulated lncRNAs (eg, KCNA2‐AS, uc.48+, NONRATT021972, MRAK009713, XIST, CCAT1) in the development of neuropathic pain. These studies suggested that specific regulation of lncRNAs or their downstream targets might provide novel therapeutic avenues for this refractory disease.     

Heat shock proteins: A dual carrier-adjuvant for an anti-drug vaccine against heroin

Heroin is a highly abused opioid that has reached epidemic status within the United States. Yet, existing therapies to treat addiction are inadequate and frequently result into rates of high recidivism. Vaccination against heroin offers a promising alternative therapeutic option but requires further development to enhance the vaccine’s performance. Hsp70 is a conserved protein with known immunomodulatory properties and is considered an excellent immunodominant antigen. Within an antidrug vaccine context, we envisioned Hsp70 as a potential dual carrier-adjuvant, wherein immunogenicity would be increased by co-localization of adjuvant and antigenic drug hapten. Recombinant Mycobacterium tuberculosis Hsp70 was appended with heroin haptens and the resulting immunoconjugate granted anti-heroin antibody production and blunted heroin-induced antinociception. Moreover, Hsp70 as a carrier protein surpassed our benchmark Her-KLH cocktail through antibody-mediated blockade of 6-acetylmorphine, the main mediator of heroin’s psychoactivity. The work presents a new avenue for exploration in the use of hapten-Hsp70 conjugates to elicit anti-drug immune responses.     

Stress and disturbance determine the demographic dynamics of two grass species along a grazing gradient in Southern Mexico

Chronic anthropogenic disturbance (CAD), characterized by low-intensity but high frequency, is a major driver of environmental degradation in developing countries. CAD is a mixture of disturbance sensu stricto (DSS), that is, plant biomass removal and stress that reduces biomass production due to changes in environmental conditions. However, we still lack data on the separate effects of both components and their interaction in nature. We analyze the demographic effects of DSS and stress on two grass species in an area heavily affected by livestock raising (a widespread cause of CAD) during the last 500 year. We compared areas exposed to DSS and stress with areas without grazing but that continue experiencing a gradient of stress. Using matrix and integral projection models, we analyzed DSS and stress effects on population growth rates (λ) of two grass species and determined the relative importance of different vital rates and states for the change on λ. Disturbance and stress affected different individuals and processes. For example, changed conditions due to stress increased seedling mortality, but DSS reduced size (growth) of large plants through grazing. CAD had highly nonlinear and species-specific effects on population size structures, λ and elasticities. Such complex behavior is seemingly due to changes in the components of CAD as it intensified and synergic interactions between disturbance and stress. Given CAD's multivariate nature, these results are not surprising. Nevertheless, grouping this multitude of factors into two broad categories, namely DSS and stress, may prove a useful conceptual tool for analysis.     

Patellofemoral cartilage stresses are most sensitive to variations in vastus medialis muscle forces

The purpose of this study was to evaluate the effects of variations in quadriceps muscle forces on patellofemoral stress. We created subject-specific finite element models for 21 individuals with chronic patellofemoral pain and 16 pain-free control subjects. We extracted three-dimensional geometries from high resolution magnetic resonance images and registered the geometries to magnetic resonance images from an upright weight bearing squat with the knees flexed at 60°. We estimated quadriceps muscle forces corresponding to 60° knee flexion during a stair climb task from motion analysis and electromyography-driven musculoskeletal modelling. We applied the quadriceps muscle forces to our finite element models and evaluated patellofemoral cartilage stress. We quantified cartilage stress using an energy-based effective stress, a scalar quantity representing the local stress intensity in the tissue. We used probabilistic methods to evaluate the effects of variations in quadriceps muscle forces from five trials of the stair climb task for each subject. Patellofemoral effective stress was most sensitive to variations in forces in the two branches of the vastus medialis muscle. Femur cartilage effective stress was most sensitive to variations in vastus medialis forces in 29/37 (78%) subjects, and patella cartilage effective stress was most sensitive to variations in vastus medialis forces in 21/37 (57%) subjects. Femur cartilage effective stress was more sensitive to variations in vastus medialis longus forces in subjects classified as maltrackers compared to normal tracking subjects (p?=?0.006). This study provides new evidence of the importance of the vastus medialis muscle in the treatment of patellofemoral pain.     

人参皂苷Rg2对慢性坐骨神经损伤大鼠痛觉敏化和抑郁状态的影响*

目的:观察人参皂苷Rg₂对慢性坐骨神经损伤大鼠痛觉敏化、抑郁状态的影响。方法: 将50只 SD 大鼠随机分为 5组(n=10): 空白对照组(Normal+生理盐水腹腔注射)、假手术组(手术但不结扎+生理盐水腹腔注射) 、坐骨神经慢性压迫损伤(CCI)组(CCI +生理盐水腹腔注射) 、人参皂苷Rg₂低剂量组(CCI+ Rg₂ 5 mg/kg腹腔注射)、人参皂苷Rg₂高剂量组(CCI+ Rg₂ 10 mg/kg 腹腔注射)。CCI模型建立后,药物通过注射器进行腹腔内注射 5 ml/kg,每天1次,连续14 d。分别在术前1 d和术后 1、3、5、7、10、14 d测定大鼠的机械性缩足反射阈值(MWT)和热缩足潜伏期(TWL);术前1 d和术后第14日时检测明暗箱实验和强迫游泳试验。 结果:与假手术组比较,CCI组术后14 d机械痛阈值和热痛潜伏期明显缩短(P＜0.01),明箱内停留时间明显缩短(P＜0.01),穿梭次数明显减少(P＜0.01),游泳潜伏期明显延长(P＜0.01)。与CCI组比较,人参皂苷Rg₂组术后14 d机械痛阈和热痛潜伏期明显增加(P＜0.01),大鼠在明箱内时间明显延长(P＜0.01),穿梭次数明显增多(P＜0.01),且游泳潜伏期明显缩短(P＜0.01)。结论:人参皂苷Rg₂能抑制 CCI 大鼠的机械痛敏和热痛敏,同时改善其抑郁状态。     

Oxygen‐dependent delayed fluorescence of protoporphyrin IX measured in the stomach and duodenum during upper gastrointestinal endoscopy

Protoporphyrin IX‐triplet state lifetime technique (PpIX‐TSLT) is a method used to measure oxygen (PO₂) in human cells. The aim of this study was to assess the technical feasibility and safety of measuring oxygen‐dependent delayed fluorescence of 5‐aminolevulinic acid (ALA)‐induced PpIX during upper gastrointestinal (GI) endoscopy. Endoscopic delayed fluorescence measurements were performed 4 hours after oral administration of ALA in healthy volunteers. The ALA dose administered was 0, 1, 5 or 20 mg/kg. Measurements were performed at three mucosal spots in the gastric antrum, duodenal bulb and descending duodenum with the catheter above the mucosa and while applying pressure to induce local ischemia and monitor mitochondrial respiration. During two endoscopies, measurements were performed both before and after intravenous administration of butylscopolamine. Delayed fluorescence measurements were successfully performed during all 10 upper GI endoscopies. ALA dose of 5 mg/kg showed adequate signal‐to‐noise ratio (SNR) values >20 without side effects. All pressure measurements showed significant prolongation of delayed fluorescence lifetime compared to measurements performed without pressure (P < .001). Measurements before and after administration of butylscopolamine did not differ significantly in the duodenal bulb and descending duodenum. Measurements of oxygen‐dependent delayed fluorescence of ALA‐induced PpIX in the GI tract during upper GI endoscopy are technically feasible and safe.     

Mechanically Activated Piezo Channels Mediate Touch and Suppress Acute Mechanical Pain Response in Mice

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