1.Effects of combined use of active ingredients in Buyang Huanwu Decoction on oxygen-glucose deprivation/reglucose-reoxygenation-induced inflammation and oxidative stress of BV2 cells.
Tian-Qing XIA ; Ying CHEN ; Jian-Lin HUA ; Qin SU ; Cun-Yan DAN ; Meng-Wei RONG ; Shi-Ning GE ; Hong GUO ; Bao-Guo XIAO ; Jie-Zhong YU ; Cun-Gen MA ; Li-Juan SONG
China Journal of Chinese Materia Medica 2025;50(14):3835-3846
This study aims to explore the effects and action mechanisms of the active ingredients in Buyang Huanwu Decoction(BYHWD), namely tetramethylpyrazine(TMP) and hydroxy-safflor yellow A(HSYA), on oxygen-glucose deprivation/reglucose-reoxygenation(OGD/R)-induced inflammation and oxidative stress of microglia(MG). Network pharmacology was used to screen the effective monomer ingredients of BYHWD and determine the safe concentration range for each component. Inflammation and oxidative stress models were established to further screen the best ingredient combination and optimal concentration ratio with the most effective anti-inflammatory and antioxidant effects. OGD/R BV2 cell models were constructed, and BV2 cells in the logarithmic growth phase were divided into a normal group, a model group, an HSYA group, a TMP group, and an HSYA + TMP group. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of inflammatory cytokines such as interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6). Oxidative stress markers, including superoxide dismutase(SOD), nitric oxide(NO), and malondialdehyde(MDA), were also measured. Western blot was used to analyze the protein expression of both inflammation-related pathway [Toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB)] and oxidative stress-related pathway [nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)]. Immunofluorescence was used to assess the expression of proteins such as inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1). The most effective ingredients for anti-inflammatory and antioxidant effects in BYHWD were TMP and HSYA. Compared to the normal group, the model group showed significantly increased levels of IL-1β, TNF-α, IL-6, NO, and MDA, along with significantly higher protein expression of NF-κB, TLR4, Nrf2, and HO-1 and significantly lower SOD levels. The differences between the two groups were statistically significant. Compared to the model group, both the HSYA group and the TMP group showed significantly reduced levels of IL-1β, TNF-α, IL-6, NO, and MDA, lower expression of NF-κB and TLR4 proteins, higher levels of SOD, and significantly increased protein expression of Nrf2 and HO-1. Additionally, the expression of the M1-type MG marker iNOS was significantly reduced, while the expression of the M2-type MG marker Arg-1 was significantly increased. The results of the HSYA group and the TMP group had statistically significant differences from those of the model group. Compared to the HSYA group and the TMP group, the HSYA + TMP group showed further significant reductions in IL-1β, TNF-α, IL-6, NO, and MDA levels, along with significant reductions in NF-κB and TLR4 protein expression, an increase in SOD levels, and elevated Nrf2 and HO-1 protein expression. Additionally, the expression of the M1-type MG marker iNOS was reduced, while the M2-type MG marker Arg-1 expression increased significantly in the HSYA + TMP group compared to the TMP or HSYA group. The differences in the results were statistically significant between the HSYA + TMP group and the TMP or HSYA group. The findings indicated that the combined use of HSYA and TMP, the active ingredients of BYHWD, can effectively inhibit OGD/R-induced inflammation and oxidative stress of MG, showing superior effects compared to the individual use of either component.
Oxidative Stress/drug effects*
;
Drugs, Chinese Herbal/pharmacology*
;
Animals
;
Mice
;
Glucose/metabolism*
;
Cell Line
;
Inflammation/genetics*
;
Oxygen/metabolism*
;
Pyrazines/pharmacology*
;
Microglia/metabolism*
;
NF-E2-Related Factor 2/immunology*
;
NF-kappa B/immunology*
;
Toll-Like Receptor 4/immunology*
;
Anti-Inflammatory Agents/pharmacology*
;
Humans
2.Research progress on macrophage metabolic reprogramming in ocular diseases.
Yun HE ; Junwen OUYANG ; Qian TAN ; Kai HU
Chinese Journal of Cellular and Molecular Immunology 2025;41(8):744-749
Macrophages are the crucial immune cells integral to host defense and the regulation of homeostasis, exhibiting remarkable plasticity across various tissues. Upon exposure to different stimuli, they can polarize into functional subsets. The reorganization process of cellular metabolism, known as metabolic reprogramming, involves the comprehensive adjustment of intracellular metabolites, enzymes, and metabolic pathways. Recent studies have revealed the critical role of metabolic reprogramming in shaping the phenotypes and functions of macrophages. Metabolism drives and regulates macrophages by generating bioenergy and biosynthetic precursors and by altering metabolites that affect gene expression and signal transduction. This review focuses on the immunomodulatory roles of key enzymes and specific products in major metabolic pathways, such as glucose metabolism, lipid metabolism and amino acid metabolism, in macrophages. Additionally, it will highlight recent advancements in targeting metabolic regulation of macrophages in the context of ocular diseases.
Humans
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Macrophages/immunology*
;
Animals
;
Eye Diseases/immunology*
;
Lipid Metabolism
;
Glucose/metabolism*
;
Metabolic Networks and Pathways
;
Signal Transduction
;
Metabolic Reprogramming
3.Porphyromonas gingivalis-induced glucose intolerance during periapical lesions requires its LPS throught a Th17 immune response.
Sylvie LÊ ; Emma STURARO ; Charlotte THOMAS ; Thibault CANCEILL ; Bertrand EKAMBI ; Nawel FELLOUAH ; Claude KNAUF ; Anne ABOT ; Christophe TENAILLEAU ; Benjamin DUPLOYER ; Pascale LOUBIERES ; Alison PROSPER ; Swann DIEMER ; Rémy BURCELIN ; Franck DIEMER ; Matthieu MINTY ; Vincent BLASCO-BAQUE
International Journal of Oral Science 2025;17(1):69-69
This study investigates the role of Interleukin 17 (IL-17) in exacerbating periapical lesions caused by Porphyromonas gingivalis (Pg) lipopolysaccharides (LPS) in the context of metabolic disease and its potential impact on glucose tolerance. Researchers developed a unique mouse model where mice were monocolonized with Pg to induce periapical lesions. After 1 month, they were fed a high-fat diet (HFD) for 2 months to simulate metabolic disease and oral microbiota dysbiosis. To explore the role of LPS from Pg, wild-type (WT) mice were challenged with purified LPS from Porphyromonas gingivalis, as well as with LPS-depleted and non-depleted Pg bacteria; IL-17 knockout (KO) mice were also included to assess the role of IL-17 signaling. The impact on bone lysis, periapical injury, glucose intolerance, and immune response was assessed. Results showed that in WT mice, the presence of LPS significantly worsened bone lysis, Th17 cell recruitment, and periapical injury. IL-17 KO mice exhibited reduced bone loss, glucose intolerance, and immune cell infiltration. Additionally, inflammatory markers in adipose tissue were lower in IL-17 KO mice, despite increased dysbiosis. The findings suggest that IL-17 plays a critical role in amplifying Pg-induced periapical lesions and systemic metabolic disturbances. Targeting IL-17 recruitment could offer a novel approach to improving glycemic control and reducing type 2 diabetes (T2D) risk in individuals with periapical disease.
Animals
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Porphyromonas gingivalis/immunology*
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Th17 Cells/immunology*
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Lipopolysaccharides/immunology*
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Mice
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Glucose Intolerance/microbiology*
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Interleukin-17/metabolism*
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Mice, Knockout
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Mice, Inbred C57BL
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Disease Models, Animal
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Diet, High-Fat
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Periapical Diseases/microbiology*
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Male
;
Dysbiosis
4.Compatibility of cold herb CP and hot herb AZ in Huanglian Ganjiang decoction alleviates colitis mice through M1/M2 macrophage polarization balance via PDK4-mediated glucose metabolism reprogramming.
Yanyang LI ; Chang LIU ; Yi WANG ; Peiqi CHEN ; Shihua XU ; Yequn WU ; Lingzhi REN ; Yang YU ; Lei YANG
Chinese Journal of Natural Medicines (English Ed.) 2025;23(10):1183-1194
Ulcerative colitis (UC) is a chronic and non-specific inflammatory bowel disease (IBD). Huanglian Ganjiang decoction (HGD), derived from ancient book Beiji Qianjin Yao Fang, has demonstrated efficacy in treating UC patients traditionally. Previous research established that the compatibility of cold herb Coptidis Rhizoma + Phellodendri Chinensis Cortex (CP) and hot herb Angelicae Sinensis Radix + Zingiberis Rhizoma (AZ) in HGD synergistically improved colitis mice. This study investigated the compatibility mechanisms through which CP and AZ regulated inflammatory balance in colitis mice. The experimental colitis model was established by administering 3% dextran sulphate sodium (DSS) to mice for 7 days, followed by CP, AZ and CPAZ treatment for an additional 7 days. M1/M2 macrophage polarization levels, glucose metabolites levels and pyruvate dehydrogenase kinase 4 (PDK4) expression were analyzed using flow cytometry, Western blot, immunofluorescence and targeted glucose metabolomics. The findings indicated that CP inhibited M1 macrophage polarization, decreased inflammatory metabolites associated with tricarboxylic acid (TCA) cycle, and suppressed PDK4 expression and pyruvate dehydrogenase (PDH) (Ser-293) phosphorylation level. AZ enhanced M2 macrophage polarization, increased lactate axis metabolite lactate levels, and upregulated PDK4 expression and PDH (Ser-293) phosphorylation level. TCA cycle blocker AG-221 and adeno-associated virus (AAV)-PDK4 partially negated CP's inhibition of M1 macrophage polarization. Lactate axis antagonist oxamate and PDK4 inhibitor dichloroacetate (DCA) partially reduced AZ's activation of M2 macrophage polarization. In conclusion, the compatibility of CP and AZ synergistically alleviated colitis in mice through M1/M2 macrophage polarization balance via PDK4-mediated glucose metabolism reprogramming. Specifically, CP reduced M1 macrophage polarization by restoration of TCA cycle via PDK4 inhibition, while AZ increased M2 macrophage polarization through activation of PDK4/lactate axis.
Animals
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Drugs, Chinese Herbal/chemistry*
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Mice
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Macrophages/immunology*
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Glucose/metabolism*
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Pyruvate Dehydrogenase Acetyl-Transferring Kinase/genetics*
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Male
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Mice, Inbred C57BL
;
Humans
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Colitis/drug therapy*
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Disease Models, Animal
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Colitis, Ulcerative/drug therapy*
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Metabolic Reprogramming
5.Mangiferin ameliorates insulin resistance by inhibiting inflammation and regulatiing adipokine expression in adipocytes under hypoxic condition.
Chao-Qiang YANG ; Jing-Hua XU ; Dan-Dan YAN ; Bao-Lin LIU ; Kang LIU ; Fang HUANG
Chinese Journal of Natural Medicines (English Ed.) 2017;15(9):664-673
Adipose tissue hypoxia has been recognized as the initiation of insulin resistance syndromes. The aim of the present study was to investigate the effects of mangiferin on the insulin signaling pathway and explore whether mangiferin could ameliorate insulin resistance caused by hypoxia in adipose tissue. Differentiated 3T3-L1 adipocytes were incubated under normal and hypoxic conditions, respectively. Protein expressions were analyzed by Western blotting. Inflammatory cytokines and HIF-1-dependent genes were tested by ELISA and q-PCR, respectively. The glucose uptake was detected by fluorescence microscopy. HIF-1α was abundantly expressed during 8 h of hypoxic incubation. Inflammatory reaction was activated by up-regulated NF-κB phosphorylation and released cytokines like IL-6 and TNF-α. Glucose uptake was inhibited and insulin signaling pathway was damaged as well. Mangiferin substantially inhibited the expression of HIF-1α. Lactate acid and lipolysis, products released by glycometabolism and lipolysis, were also inhibited. The expression of inflammatory cytokines was significantly reduced and the damaged insulin signaling pathway was restored to proper functional level. The glucose uptake of hypoxic adipocytes was promoted and the dysfunction of adipocytes was relieved. These results showed that mangiferin could not only improve the damaged insulin signaling pathway in hypoxic adipocytes, but also ameliorate inflammatory reaction and insulin resistance caused by hypoxia.
3T3-L1 Cells
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Adipocytes
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drug effects
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immunology
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Adipokines
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genetics
;
immunology
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Animals
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Cell Hypoxia
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drug effects
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Glucose
;
metabolism
;
Humans
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Hypoxia-Inducible Factor 1, alpha Subunit
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genetics
;
immunology
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Insulin
;
metabolism
;
Insulin Resistance
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Mice
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NF-kappa B
;
genetics
;
immunology
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Oxygen
;
metabolism
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Tumor Necrosis Factor-alpha
;
genetics
;
immunology
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Xanthones
;
pharmacology
6.Brazilein inhibits neuronal inflammation induced by cerebral ischemia and oxygen-glucose deprivation through targeting NOD2 expression.
Xiao-Jin YAN ; Yu-Shuang CHAI ; Zhi-Yi YUAN ; Xin-Pei WANG ; Jing-Fei JIANG ; Fan LEI ; Dong-Ming XING ; Li-Jun DU
Chinese Journal of Natural Medicines (English Ed.) 2016;14(5):354-362
Brazilein is reported to have immunosuppressive effect on cardiovascular and cerebral-vascular diseases. The essential roles of innate immunity in cerebral ischemia are increasingly identified, but no studies concerning the influence of brazilein on the innate immunity receptors have been reported. The present study was designed to investigate the regulation of NOD2 (Nucleotide-binding oligomerization domain-containing protein 2) by brazilein for its protection of neuron in cerebral ischemia in vivo and oxygen-glucose deprivation in vitro. The results showed that brazilein could reverse the elevated expression of NOD2 and TNFα (tumor necrosis factor alpha) elicited by cerebral ischemia and reperfusion. This reduction could also be detected in normal mice and C17.2 cells, indicating that this suppressive effect of brazilein was correlated with NOD2. The results from GFP reporter plasmid assay suggested brazilein inhibited NOD2 gene transcription. In conclusion, brazilein could attenuate NOD2 and TNFα expression in cerebral ischemia and NOD2 may be one possible target of brazilein for its immune suppressive effect in neuro-inflammation.
Animals
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Benzopyrans
;
administration & dosage
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Brain Ischemia
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drug therapy
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genetics
;
immunology
;
metabolism
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Cells, Cultured
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Drugs, Chinese Herbal
;
administration & dosage
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Glucose
;
metabolism
;
Humans
;
Indenes
;
administration & dosage
;
Male
;
Mice
;
Mice, Inbred ICR
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Neurons
;
drug effects
;
immunology
;
Nod2 Signaling Adaptor Protein
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genetics
;
metabolism
;
Oxygen
;
metabolism
;
Tumor Necrosis Factor-alpha
;
genetics
;
immunology
7.Type B insulin-resistance syndrome presenting as autoimmune hypoglycemia, associated with systemic lupus erythematosus and interstitial lung disease.
Seon Mee KANG ; Heung Yong JIN ; Kyung Ae LEE ; Ji Hyun PARK ; Hong Sun BAEK ; Tae Sun PARK
The Korean Journal of Internal Medicine 2013;28(1):98-102
We describe an unusual case of systemic lupus erythematosus with pulmonary manifestations presenting as hypoglycemia due to anti-insulin receptor antibodies. A 38-year-old female suffered an episode of unconsciousness and was admitted to hospital where her blood glucose was found to be 18 mg/dL. During the hypoglycemic episode, her serum insulin level was inappropriately high (2,207.1 pmol/L; normal range, 18 to 173) and C-peptide level was elevated (1.7 nmol/L; normal range, 0.37 to 1.47). Further blood tests revealed the presence of antinuclear antibodies, anti-double-stranded DNA antibodies, and anti-Ro/SSA, anti-La/SSB, anti-ribonucleoprotein, and anti-insulin receptor antibodies. A computed tomography scan of the abdomen, aimed at tumor localization, such as an insulinoma, instead revealed ground-glass opacities in both lower lungs, and no abnormal finding in the abdomen. For a definitive diagnosis of the lung lesion, video-associated thoracoscopic surgery was performed and histopathological findings showed a pattern of fibrotic non-specific interstitial pneumonia.
Adult
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Autoantibodies/*blood
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*Autoimmunity
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Biological Markers/blood
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Blood Glucose/metabolism
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Female
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Humans
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Hypoglycemia/blood/*complications/immunology
;
Insulin/blood
;
*Insulin Resistance
;
Lung Diseases, Interstitial/diagnosis/*etiology/immunology/surgery
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Lupus Erythematosus, Systemic/*complications/diagnosis/immunology
;
Receptor, Insulin/*immunology
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Thoracic Surgery, Video-Assisted
;
Tomography, X-Ray Computed
;
Treatment Outcome
8.Peroxisome proliferator-activated receptor delta agonist attenuates hepatic steatosis by anti-inflammatory mechanism.
Mi Young LEE ; Ran CHOI ; Hong Min KIM ; Eun Ju CHO ; Bo Hwan KIM ; Yeon Sik CHOI ; Jarinyaporn NAOWABOOT ; Eun Young LEE ; Young Chul YANG ; Jang Yel SHIN ; Young Goo SHIN ; Choon Hee CHUNG
Experimental & Molecular Medicine 2012;44(10):578-585
Although peroxisome proliferator receptor (PPAR)-alpha and PPAR-gamma agonist have been developed as chemical tools to uncover biological roles for the PPARs such as lipid and carbohydrate metabolism, PPAR-delta has not been fully investigated. In this study, we examined the effects of the PPAR-delta agonist GW0742 on fatty liver changes and inflammatory markers. We investigated the effects of PPAR-delta agonist GW0742 on fatty liver changes in OLETF rats. Intrahepatic triglyceride contents and expression of inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and monocyte chemo-attractant protein-1 (MCP-1) and also, PPAR-gamma coactivator (PGC)-1alpha gene were evaluated in liver tissues of OLETF rats and HepG2 cells after GW0742 treatment. The level of TNF-alpha and MCP-1 was also examined in supernatant of Raw264. 7 cell culture. To address the effects of GW0742 on insulin signaling, we performed in vitro study with AML12 mouse hepatocytes. Rats treated with GW0742 (10 mg/kg/day) from 26 to 36 weeks showed improvement in fatty infiltration of the liver. In liver tissues, mRNA expressions of TNF-alpha, MCP-1, and PGC-1alpha were significantly decreased in diabetic rats treated with GW0742 compared to diabetic control rats. We also observed that GW0742 had inhibitory effects on palmitic acid-induced fatty accumulation and inflammatory markers in HepG2 and Raw264.7 cells. The expression level of Akt and IRS-1 was significantly increased by treatment with GW0742. The PPAR-delta agonist may attenuate hepatic fat accumulation through anti-inflammatory mechanism, reducing hepatic PGC-1alpha gene expression, and improvement of insulin signaling.
Animals
;
Anti-Inflammatory Agents/*pharmacology/therapeutic use
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Blood Glucose
;
Cytokines/genetics/metabolism
;
Diabetes Mellitus/blood/immunology/metabolism
;
Fatty Liver/blood/*drug therapy/immunology
;
Glucose Tolerance Test
;
Hep G2 Cells
;
Humans
;
Insulin Resistance
;
Liver/metabolism
;
Male
;
PPAR delta/*agonists/metabolism
;
Rats
;
Rats, Long-Evans
;
Thiazoles/*pharmacology/therapeutic use
;
Triglycerides/metabolism
9.Correlation of T lymphocyte subsets with blood glucose level and the first-phase insulin secretion in patients with type 2 diabetes mellitus.
Acta Academiae Medicinae Sinicae 2012;34(3):254-257
OBJECTIVETo explore the relationship between the T cell subsets and glucose level and first-phase insulin secretion function in patients with type 2 diabetes mellitus (T2DM).
METHODSWe determined the oral glucose tolerance (OGTT), insulin release test(IRT), body mass index(BMI), glycohemoglobin A1c (HbA1c), T lymphocyte subsets (CD4(+),CD8(+)), and activity of natural kill(NK) cell and ⊿I(30)/⊿G(30) in 78 newly diagnosed T2DM patients, 60 impaired glucose tolerance (IGT) patients, and 60 normal controls.
RESULTSDM and IGT patients had significantly lower levels of CD4(+), CD4(+)/CD8(+)ratio, activity of NK cell, and ⊿I(30)/⊿G(30) and significantly higher levels of HbA1c and CD8(+)compared with normal controls(all P<0.05). Patients in DM group had significantly lower level of CD4(+),⊿I(30)/⊿G(30) and significantly higher levels of FBG and HbA1c compared with IGT group. There was no significant difference in terms of CD8(+), CD4(+)/CD8(+)ratio, and activity of NK cell between IGT and DM groups, whereas CD4(+) T cells were negatively correlated with FBG and HbA1c and positively with ⊿I(30)/⊿G(30) . Multiple regression stepwise analysis showed that CD4(+) was independently associated with HbA1c and ⊿I(30)/⊿G(30).
CONCLUSIONT2DM patients tends to have disorders in cellular immunity, which is correlated with blood glucose level and the insulin secretion function.
Adult ; Aged ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; immunology ; Female ; Humans ; Immunity, Cellular ; Insulin ; blood ; Male ; Middle Aged ; T-Lymphocyte Subsets ; immunology
10.Chemerin and apelin are positively correlated with inflammation in obese type 2 diabetic patients.
Shan YU ; Ying ZHANG ; Mei-Zhen LI ; Hua XU ; Qian WANG ; Jun SONG ; Peng LIN ; Li ZHANG ; Qian LIU ; Qing-Xian HUANG ; Kun WANG ; Wei-Kai HOU
Chinese Medical Journal 2012;125(19):3440-3444
BACKGROUNDAs two novel adipocytokines, chemerin and apelin play a key role in the pathological process of insulin resistance (IR), glucose metabolism and obesity, researchers have found that the levels of chemerin and apelin changed significantly in type 2 diabetic patients with obesity, however, the underlying mechanism involved remains unclear. The aim of this study was to investigate whether chemerin and apelin play an important role in the pathophysiologic proceeding of diabetes.
METHODSThis study enrolled 81 newly diagnosed obese type 2 diabetes mellitus (T2DM) patients (T2DM group, n = 81). All the patients were randomly assigned to DM1 group treated with metformin (n = 41) and DM2 group treated with pioglitazone (n = 40). After hypoglycemic agents treatment, patients under better blood glucose control were chosen to be given antioxidant treatment. Another 79 subjects without T2DM were recruited as normal control group (NC group), including 40 subjects (NC1 group) with normal body mass index (BMI) and 39 obese subjects (NC2 group). Levels of chemerin, apelin, BMI, tumor necrosis factor-α (TNF-α), homeostasis model assessment of IR (HOMA-IR) and 8-isoprotaglandim F2α (8-iso-PGF2α) were examined at baseline and post-treatment. The relationship between chemerin, apelin and BMI, TNF-α, HOMA-IR, 8-iso-PGF2α was analyzed.
RESULTSThe baseline levels of chemerin, apelin, TNF-α, HOMA-IR and 8-iso-PGF2α in T2DM group were significantly higher than normal control group (P < 0.001). All indices mentioned above were significantly decreased after treatment (P < 0.05). In T2DM patients treated with pioglitazone, indices mentioned above except for HOMA-IR, were decreased significantly compared with patients treated with metformin (P < 0.05). After antioxidant treatment using lipoic acid, levels of chemerin, apelin, TNF-α and 8-iso-PGF2α were further significantly decreased (P < 0.05). Correlation analysis showed that the levels of chemerin and apelin correlated positively with BMI, TNF-α, HOMA-IR and 8-iso-PGF2α before and after treatment with hypoglycemic agents (P < 0.01). The levels of chemerin and apelin also had positive correlation with TNF-α and 8-iso-PGF2α after antioxidant treatment (P < 0.05).
CONCLUSIONSThe levels of chemerin and apelin in obese T2DM patients are closely related to IR. The increased levels may be a result of compensatory response to IR, and also may be the causative factor of IR. The levels of chemerin and apelin correlate closely with oxidative stress and inflammation. The two adipokines may be inflammatory factors playing important roles in the initiation and development of obese T2DM. Chemerin and apelin are related to the pathophysiology of IR, oxidative stress and inflammation.
Apelin ; Blood Glucose ; metabolism ; Body Mass Index ; Chemokines ; metabolism ; Diabetes Mellitus, Type 2 ; drug therapy ; immunology ; metabolism ; Dinoprost ; analogs & derivatives ; metabolism ; Humans ; Hypoglycemic Agents ; therapeutic use ; Inflammation ; metabolism ; Intercellular Signaling Peptides and Proteins ; metabolism ; Metformin ; therapeutic use ; Thiazolidinediones ; therapeutic use ; Tumor Necrosis Factor-alpha ; metabolism

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