Insulin is a peptide hormone that regulates blood glucose levels. It was discovered in 1921 and is now produced through recombinant DNA technology. Insulin is composed of two polypeptide chains connected by disulfide bonds. It is derived from proinsulin and cleaved to form the A and B chains. Insulin is secreted in response to increased blood glucose to promote glucose uptake. Lack of insulin production causes diabetes, which is managed through insulin therapy via injections or pumps. Various insulin types exist based on their duration of action. Monoclonal antibodies targeting insulin and related proteins are used to study diabetes and develop new treatments.
It includes information about Hybrid closed loop insulin delivery system-Artificial Pancreas.Its details and how insulin pump develops with the time.It also includes the information about companies which manufacturing pumps.Also includes info about diabetes mellitus.
It includes information about Hybrid closed loop insulin delivery system-Artificial Pancreas.Its details and how insulin pump develops with the time.It also includes the information about companies which manufacturing pumps.Also includes info about diabetes mellitus.
Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications.
Diabetes mellitus (DM):- It is a metabolicdisorder characterized by hyperglycaemia, (fasting plasma glucose ≥ 126 mg/dl and/or ≥ 200 mg/dl 2 hours after 75 g oral glucose),glycosuria, hyperlipidaemia, negative nitrogen balance and sometimes ketonaemia.
Diabetes mellitus, one of the major public health problems worldwide, is a metabolic disorder of multiple etiologies distinguished by a failure of glucose homeostasis with disturbances of carbohydrate, fat and protein metabolism as a result of defects in insulin secretion and/or insulin action.
According to International Diabetes Federation (IDF) report, elevated blood glucose is the third uppermost risk factor for premature mortality, following high blood pressure and tobacco use globally
Cardiovascular diseases, neuropathy, nephropathy, and retinopathy are among the major risks that are associated with diabetes.These chronic complications may lead to hardening and narrowing of arteries (atherosclerosis) that could advance to stroke, coronary heart disease, and other blood vessel diseases, nerve damage, kidney failure, and blindness with time
Two major types of diabetes mellitus are
1. Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
2. Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
There is β cell destruction in pancreatic islets; majority of cases are autoimmune (type 1A) antibodies that destroy β cells are detectable in blood, but some are idiopathic (type 1B)-no βcell antibody is found.
2.Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Type 2 diabetes mellitus (T2DM) is the most prevalent metabolic disease worldwide.
There is no loss or moderate reduction in β cell mass: insulin in circulation is low. normal or even high. no anti-β -cell antibody is demonstrable: has a high degree of genetic predisposition: generally has a late onset (past middle age). Over 90% cases of diabetes are type 2 DM
Abnormality in gluco-receptor of β cells so that they respond at higher glucose concentration or relative β cell deficiency. In either way. insulin secretion is impaired: may progress to β cells failure.
Reduced sensitivity of peripheral tissues to insulin: reduction in number of insulin receptors, “down regulation” of insulin receptors.
Insulin history:
Insulin was discovered in 1921 by Banting and Best who demonstrated the hypoglycaemic action of an extract of pancreas prepared after degeneration of the exocrine part due to ligation of pancreatic duct.
It was first obtained in pure crystalline form in 1926 and the chemical structure was fully worked out in 1956 by Sanger.
Insulin is a two chain polypeptide having 51 amino acids and MW about 6000.
The A-chain has 21 while B-chain has 30 amino acids.
Insulin is synthesized in the β cells of pancreatic islets as a single chain peptide Preproinsulin (110 AA) from which
Diabetes mellitus (DM):- It is a metabolicdisorder characterized by hyperglycaemia, (fasting plasma glucose ≥ 126 mg/dl and/or ≥ 200 mg/dl 2 hours after 75 g oral glucose),glycosuria, hyperlipidaemia, negative nitrogen balance and sometimes ketonaemia.
Diabetes mellitus, one of the major public health problems worldwide, is a metabolic disorder of multiple etiologies distinguished by a failure of glucose homeostasis with disturbances of carbohydrate, fat and protein metabolism as a result of defects in insulin secretion and/or insulin action.
According to International Diabetes Federation (IDF) report, elevated blood glucose is the third uppermost risk factor for premature mortality, following high blood pressure and tobacco use globally
Cardiovascular diseases, neuropathy, nephropathy, and retinopathy are among the major risks that are associated with diabetes.
These chronic complications may lead to hardening and narrowing of arteries (atherosclerosis) that could advance to stroke, coronary heart disease, and other blood vessel diseases, nerve damage, kidney failure, and blindness with time
Two major types of diabetes mellitus are
1. Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
2. Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
There is β cell destruction in pancreatic islets; majority of cases are autoimmune (type 1A) antibodies that destroy β cells are detectable in blood, but some are idiopathic (type 1B)-no βcell antibody is found.
2.Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Type 2 diabetes mellitus (T2DM) is the most prevalent metabolic disease worldwide.
There is no loss or moderate reduction in β cell mass: insulin in circulation is low. normal or even high. no anti-β -cell antibody is demonstrable: has a high degree of genetic predisposition: generally has a late onset (past middle age). Over 90% cases of diabetes are type 2 DM
Abnormality in gluco-receptor of β cells so that they respond at higher glucose concentration or relative β cell deficiency. In either way. insulin secretion is impaired: may progress to β cells failure.
Reduced sensitivity of peripheral tissues to insulin: reduction in number of insulin receptors, “down regulation” of insulin receptors.
Insulin history:
Insulin was discovered in 1921 by Banting and Best who demonstrated the hypoglycaemic action of an extract of pancreas prepared after degeneration of the exocrine part due to ligation of pancreatic duct.
It was first obtained in pure crystalline form in 1926 and the chemical structure was fully worked out in 1956 by Sanger.
Insulin is a two chain polypeptide having 51 amino acids and MW about 6000.
The A-chain has 21 while B-chain has 30 amino acids.
Insulin is synthesized in the β cells of pancreatic islets as a single chain peptide Preproinsulin (110 AA) from whic
Diabetes is a chronic health condition that affects how the body converts food into energy. There are two main types of diabetes: type 1 and type 2. In type 1 diabetes, the body doesn't produce enough insulin, a hormone that regulates blood sugar levels. In type 2 diabetes, the body becomes resistant to insulin or doesn't produce enough insulin.
High blood sugar levels associated with diabetes can cause a range of health problems, including nerve damage, kidney disease, and heart disease. Managing diabetes involves monitoring blood sugar levels, taking medications, and making lifestyle changes such as eating a healthy diet and exercising regularly.
If you have diabetes, it's important to work closely with your healthcare provider to develop a treatment plan that meets your individual needs. This may include regular blood sugar testing, taking medications as prescribed, and making lifestyle changes to help manage your condition.
A detailed study of insulin medication from past to present & future.
Different types of insulin medications their storage & safety condition along with the sites for the administration of insulin dosage forms.
Diabetes mellitus (DM):- It is a metabolicdisorder characterized by hyperglycaemia, (fasting plasma glucose ≥ 126 mg/dl and/or ≥ 200 mg/dl 2 hours after 75 g oral glucose),glycosuria, hyperlipidaemia, negative nitrogen balance and sometimes ketonaemia.
Diabetes mellitus, one of the major public health problems worldwide, is a metabolic disorder of multiple etiologies distinguished by a failure of glucose homeostasis with disturbances of carbohydrate, fat and protein metabolism as a result of defects in insulin secretion and/or insulin action.
According to International Diabetes Federation (IDF) report, elevated blood glucose is the third uppermost risk factor for premature mortality, following high blood pressure and tobacco use globally
Cardiovascular diseases, neuropathy, nephropathy, and retinopathy are among the major risks that are associated with diabetes.
These chronic complications may lead to hardening and narrowing of arteries (atherosclerosis) that could advance to stroke, coronary heart disease, and other blood vessel diseases, nerve damage, kidney failure, and blindness with time
Two major types of diabetes mellitus are
1. Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
2. Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
There is β cell destruction in pancreatic islets; majority of cases are autoimmune (type 1A) antibodies that destroy β cells are detectable in blood, but some are idiopathic (type 1B)-no βcell antibody is found.
2.Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Type 2 diabetes mellitus (T2DM) is the most prevalent metabolic disease worldwide.
There is no loss or moderate reduction in β cell mass: insulin in circulation is low. normal or even high. no anti-β -cell antibody is demonstrable: has a high degree of genetic predisposition: generally has a late onset (past middle age). Over 90% cases of diabetes are type 2 DM
Abnormality in gluco-receptor of β cells so that they respond at higher glucose concentration or relative β cell deficiency. In either way. insulin secretion is impaired: may progress to β cells failure.
Reduced sensitivity of peripheral tissues to insulin: reduction in number of insulin receptors, “down regulation” of insulin receptors.
Excess of hyperglycemic hormones (glucagon, ete. ) obesity: ; cause relative insulin deficiency the β cells Tag behind
Insulin history:
Insulin was discovered in 1921 by Banting and Best who demonstrated the hypoglycaemic action of an extract of pancreas prepared after degeneration of the exocrine part due to ligation of pancreatic duct.
It was first obtained in pure crystalline form in 1926 and the chemical structure was fully worked out in 1956 by Sanger.
Insulin is a two chain polypeptide having 51 amino acids and MW about 6000.
The A-chain has 21 while B-chain has 30 amino acids.
Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications.
Diabetes mellitus (DM):- It is a metabolicdisorder characterized by hyperglycaemia, (fasting plasma glucose ≥ 126 mg/dl and/or ≥ 200 mg/dl 2 hours after 75 g oral glucose),glycosuria, hyperlipidaemia, negative nitrogen balance and sometimes ketonaemia.
Diabetes mellitus, one of the major public health problems worldwide, is a metabolic disorder of multiple etiologies distinguished by a failure of glucose homeostasis with disturbances of carbohydrate, fat and protein metabolism as a result of defects in insulin secretion and/or insulin action.
According to International Diabetes Federation (IDF) report, elevated blood glucose is the third uppermost risk factor for premature mortality, following high blood pressure and tobacco use globally
Cardiovascular diseases, neuropathy, nephropathy, and retinopathy are among the major risks that are associated with diabetes.These chronic complications may lead to hardening and narrowing of arteries (atherosclerosis) that could advance to stroke, coronary heart disease, and other blood vessel diseases, nerve damage, kidney failure, and blindness with time
Two major types of diabetes mellitus are
1. Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
2. Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
There is β cell destruction in pancreatic islets; majority of cases are autoimmune (type 1A) antibodies that destroy β cells are detectable in blood, but some are idiopathic (type 1B)-no βcell antibody is found.
2.Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Type 2 diabetes mellitus (T2DM) is the most prevalent metabolic disease worldwide.
There is no loss or moderate reduction in β cell mass: insulin in circulation is low. normal or even high. no anti-β -cell antibody is demonstrable: has a high degree of genetic predisposition: generally has a late onset (past middle age). Over 90% cases of diabetes are type 2 DM
Abnormality in gluco-receptor of β cells so that they respond at higher glucose concentration or relative β cell deficiency. In either way. insulin secretion is impaired: may progress to β cells failure.
Reduced sensitivity of peripheral tissues to insulin: reduction in number of insulin receptors, “down regulation” of insulin receptors.
Insulin history:
Insulin was discovered in 1921 by Banting and Best who demonstrated the hypoglycaemic action of an extract of pancreas prepared after degeneration of the exocrine part due to ligation of pancreatic duct.
It was first obtained in pure crystalline form in 1926 and the chemical structure was fully worked out in 1956 by Sanger.
Insulin is a two chain polypeptide having 51 amino acids and MW about 6000.
The A-chain has 21 while B-chain has 30 amino acids.
Insulin is synthesized in the β cells of pancreatic islets as a single chain peptide Preproinsulin (110 AA) from which
Diabetes mellitus (DM):- It is a metabolicdisorder characterized by hyperglycaemia, (fasting plasma glucose ≥ 126 mg/dl and/or ≥ 200 mg/dl 2 hours after 75 g oral glucose),glycosuria, hyperlipidaemia, negative nitrogen balance and sometimes ketonaemia.
Diabetes mellitus, one of the major public health problems worldwide, is a metabolic disorder of multiple etiologies distinguished by a failure of glucose homeostasis with disturbances of carbohydrate, fat and protein metabolism as a result of defects in insulin secretion and/or insulin action.
According to International Diabetes Federation (IDF) report, elevated blood glucose is the third uppermost risk factor for premature mortality, following high blood pressure and tobacco use globally
Cardiovascular diseases, neuropathy, nephropathy, and retinopathy are among the major risks that are associated with diabetes.
These chronic complications may lead to hardening and narrowing of arteries (atherosclerosis) that could advance to stroke, coronary heart disease, and other blood vessel diseases, nerve damage, kidney failure, and blindness with time
Two major types of diabetes mellitus are
1. Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
2. Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
There is β cell destruction in pancreatic islets; majority of cases are autoimmune (type 1A) antibodies that destroy β cells are detectable in blood, but some are idiopathic (type 1B)-no βcell antibody is found.
2.Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Type 2 diabetes mellitus (T2DM) is the most prevalent metabolic disease worldwide.
There is no loss or moderate reduction in β cell mass: insulin in circulation is low. normal or even high. no anti-β -cell antibody is demonstrable: has a high degree of genetic predisposition: generally has a late onset (past middle age). Over 90% cases of diabetes are type 2 DM
Abnormality in gluco-receptor of β cells so that they respond at higher glucose concentration or relative β cell deficiency. In either way. insulin secretion is impaired: may progress to β cells failure.
Reduced sensitivity of peripheral tissues to insulin: reduction in number of insulin receptors, “down regulation” of insulin receptors.
Insulin history:
Insulin was discovered in 1921 by Banting and Best who demonstrated the hypoglycaemic action of an extract of pancreas prepared after degeneration of the exocrine part due to ligation of pancreatic duct.
It was first obtained in pure crystalline form in 1926 and the chemical structure was fully worked out in 1956 by Sanger.
Insulin is a two chain polypeptide having 51 amino acids and MW about 6000.
The A-chain has 21 while B-chain has 30 amino acids.
Insulin is synthesized in the β cells of pancreatic islets as a single chain peptide Preproinsulin (110 AA) from whic
Diabetes is a chronic health condition that affects how the body converts food into energy. There are two main types of diabetes: type 1 and type 2. In type 1 diabetes, the body doesn't produce enough insulin, a hormone that regulates blood sugar levels. In type 2 diabetes, the body becomes resistant to insulin or doesn't produce enough insulin.
High blood sugar levels associated with diabetes can cause a range of health problems, including nerve damage, kidney disease, and heart disease. Managing diabetes involves monitoring blood sugar levels, taking medications, and making lifestyle changes such as eating a healthy diet and exercising regularly.
If you have diabetes, it's important to work closely with your healthcare provider to develop a treatment plan that meets your individual needs. This may include regular blood sugar testing, taking medications as prescribed, and making lifestyle changes to help manage your condition.
A detailed study of insulin medication from past to present & future.
Different types of insulin medications their storage & safety condition along with the sites for the administration of insulin dosage forms.
Diabetes mellitus (DM):- It is a metabolicdisorder characterized by hyperglycaemia, (fasting plasma glucose ≥ 126 mg/dl and/or ≥ 200 mg/dl 2 hours after 75 g oral glucose),glycosuria, hyperlipidaemia, negative nitrogen balance and sometimes ketonaemia.
Diabetes mellitus, one of the major public health problems worldwide, is a metabolic disorder of multiple etiologies distinguished by a failure of glucose homeostasis with disturbances of carbohydrate, fat and protein metabolism as a result of defects in insulin secretion and/or insulin action.
According to International Diabetes Federation (IDF) report, elevated blood glucose is the third uppermost risk factor for premature mortality, following high blood pressure and tobacco use globally
Cardiovascular diseases, neuropathy, nephropathy, and retinopathy are among the major risks that are associated with diabetes.
These chronic complications may lead to hardening and narrowing of arteries (atherosclerosis) that could advance to stroke, coronary heart disease, and other blood vessel diseases, nerve damage, kidney failure, and blindness with time
Two major types of diabetes mellitus are
1. Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
2. Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Insulin-dependent diabetes mellitus (IDDM) / juvenile onset diabetes mellitus
There is β cell destruction in pancreatic islets; majority of cases are autoimmune (type 1A) antibodies that destroy β cells are detectable in blood, but some are idiopathic (type 1B)-no βcell antibody is found.
2.Noninsulin-dependent diabetes mellitus (NIDDM) / maturity onset diabetes mellitus
Type 2 diabetes mellitus (T2DM) is the most prevalent metabolic disease worldwide.
There is no loss or moderate reduction in β cell mass: insulin in circulation is low. normal or even high. no anti-β -cell antibody is demonstrable: has a high degree of genetic predisposition: generally has a late onset (past middle age). Over 90% cases of diabetes are type 2 DM
Abnormality in gluco-receptor of β cells so that they respond at higher glucose concentration or relative β cell deficiency. In either way. insulin secretion is impaired: may progress to β cells failure.
Reduced sensitivity of peripheral tissues to insulin: reduction in number of insulin receptors, “down regulation” of insulin receptors.
Excess of hyperglycemic hormones (glucagon, ete. ) obesity: ; cause relative insulin deficiency the β cells Tag behind
Insulin history:
Insulin was discovered in 1921 by Banting and Best who demonstrated the hypoglycaemic action of an extract of pancreas prepared after degeneration of the exocrine part due to ligation of pancreatic duct.
It was first obtained in pure crystalline form in 1926 and the chemical structure was fully worked out in 1956 by Sanger.
Insulin is a two chain polypeptide having 51 amino acids and MW about 6000.
The A-chain has 21 while B-chain has 30 amino acids.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
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Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
2. INTRODUCTION
Insulin is a peptide hormone secreted by the Beta cells of pancreatic islets
of Langerhans and maintains normal blood glucose level by regulating
carbohydrate, lipid and protein metabolism.
Insulin was discovered by Frederick Banting and Charles Best in 1921.
Soon afterward , manufacturing processes were developed to extract the
insulin from porcine and bovine pancreata.
3. From 1921 to 1980, efforts were directed at increasing the purity of
insulin and provide different formulations for providing glucose
control.
Purification was done by implementing chromatographic processes
,while formulations focused on improving chemical stability of insulin
molecule.
Evolution of rDNA technology combined with improved purification
methods led to the availability of purest human insulin ever made.
4. Insulin is composed of two polypeptide chains(Chain A & Chain B)
that are connected by two interchain disulfide bonds.
The interchain disulfide linkages occur between A7-B7 and A20-B19
respectively. A third intrachain disulfide bond is located in the A
chain, between A6 –A11.
6. Insulin is derived from a 74-amino-acid prohormone molecule called
proinsulin. Proinsulin is relatively inactive, and under normal
conditions only a small amount of it is secreted.
In the endoplasmic reticulum of beta cells the proinsulin molecule is
cleaved in two places, yielding the A and B chains of insulin and an
intervening, biologically inactive C peptide.
The A and B chains become linked together by two sulfur-sulfur
(disulfide) bonds.
7. •Factors stimulating insulin release:
the concentration of glucose in the arterial (oxygenated) blood that
perfuses the islets. When blood glucose concentrations increase (i.e.,
following a meal), large amounts of glucose are taken up and
metabolized by the beta cells, and the secretion of insulin increases.
Conversely, as blood glucose concentrations decrease, the secretion of
insulin decreases; however, even during fasting, small amounts of
insulin are secreted.
The secretion of insulin may also be stimulated by certain amino acids,
fatty acids, keto acids (products of fatty acid oxidation), and several
hormones secreted by the gastrointestinal tract.
8. • Diabetes
Inadequate production of insulin is responsible for the
condition called diabetes mellitus. Severe diabetics require
periodic injections of insulin.
Diabetes is a group of conditions where the body cannot
produce enough or any insulin, cannot properly use the
insulin that is produced, or cannot do a combination of
either.
9. • Types of diabetes
The three main types of diabetes are:
type 1 diabetes
type 2 diabetes
gestational Diabetes
10. Type 1 diabetes
Type 1 diabetes is believed to be an autoimmune condition.
This means your immune system mistakenly attacks and destroys
the beta cells in your pancreas that produce insulin.
The damage is permanent.
What prompts the attacks is not clear.
There may be both genetic and environmental reasons. Lifestyle
factors are not believed to play a role.
11. Type 2 diabetes
Type 2 diabetes starts out as insulin resistance.
This means your body cannot use insulin efficiently, which causes your
pancreas to produce more insulin until it cannot keep up with demand.
Insulin production then decreases, which causes high blood sugar.
The exact cause of type 2 diabetes is unknown.
12. Contributing factors of type 2 diabetes may
include:
Genetics
A more sedentary lifestyle
Higher weight or obesity
There may also be other health factors and environmental reasons
13. Gestational diabetes
Gestational diabetes is caused by insulin-blocking hormones that are
produced during pregnancy.
This type of diabetes only happens during pregnancy. It is often seen in
people with pre-existing prediabetes and a family history of diabetes.
About 50 percent of people diagnosed with gestational diabetes go on to
develop type 2 diabetes.
14. General symptoms of unmanaged diabetes
include:
excessive thirst and hunger
frequent urination
drowsiness or fatigue
dry, itchy skin
blurry vision
slow-healing wounds
15. Symptoms of both types of diabetes can appear at any age, but type 1
usually appears in children and young adults.
Type 2 typically appears in people over the age of 45. But younger
people are increasingly being diagnosed with type 2 diabetes due to
sedentary lifestyles and an increase in weight.
There’s no cure for type 1 diabetes. It requires lifelong disease
management. But with consistent monitoring and adherence to
treatment,[must take insulin to live since damage to the pancreas is
permanent.
16. type 2 diabetes can often be successfully managed or even reversed
with diet and exercise. It can also be treated with a variety of
medications to help manage blood sugar.
The first-line medication is usually metformin (Glumetza, Glucophage,
Fortamet, Riomet). This drug works by reducing glucose production in
the liver. If metformin does not work, your doctor can prescribe another
medication.
17. Insulin therapy
The goal of taking insulin is to keep your blood sugar level in a normal
range as much as possible.
Insulin therapy replaces the insulin the body would normally make.
People with type 1 diabetes must take insulin every day.
People with type 2 diabetes need to take insulin when other treatments
and medicines fail to control blood sugar levels.
18. Insulin doses are given in two main ways:
Basal dose - provides a steady amount of insulin delivered all day and night. This
helps maintain blood glucose levels by controlling how much glucose the liver
releases (mainly at night when the time between meals is longer).
Bolus dose - provides a dose of insulin at meals to help move absorbed sugar from
the blood into muscle and fat. Bolus doses can also help correct blood sugar when it
gets too high. Bolus doses are also called nutritional or meal-time doses.
19. Dosing schedule may depend on:
Your weight
Type of insulin you take
How much and what you eat
Level of physical activity
Your blood sugar level
Other health conditions
20. There are several types of insulin available.
Insulin types are based on the following factors:
Onset - how quickly it starts working after injection
Peak - time when the dose is the strongest and most effective
Duration - total time the insulin dose stays in the bloodstream and lowers
blood sugar
21. Types of insulin
Rapid acting
Regular or short acting
Intermediate acting
Long acting
Premixed
22.
23. Commercially available insulin products
Product Type Peculiarity Company
Humulin rh insulin Eli Lilly
Novlin Human regular Intermediate acting Novo Nordisk
Humalog Insulin lispro An insulin analogue Eli Lilly
Liprolog Bio lysprol Short acting insulin Eli Lilly
Novolog mix
70/30
Insulin aspart Short acting rh-insulin Novo Nordisk
Lantus Insulin glargine Long acting rh-insulin Aventis pharmaceuticals
24. Administration methods and routes
Insulin is administered by two methods of delivery:
• Injection
• Infusion
25.
26. Injection
Insulin syringe:
This is the most common insulin delivery method. The classic injection
device is an insulin syringe.
The plastic, disposable syringes currently are available in three sizes,
and hold up to 30, 50 or 100 units of insulin.
The needles are fine (up to 31 gauge) with lengths ranging from 3/16th
of an inch for infants, to ½ inch or more for adults.
The insulin is injected into the layer of fat (subcutaneous tissue) just
under the skin.
27. Insulin Pen:
A popular alternative to the insulin syringe is an insulin pen.
An insulin pen has a replaceable reservoir of insulin called a cartridge,
a replaceable needle to puncture the skin and to deliver insulin to the
subcutaneous tissue, a dial to choose the insulin dose, and a mechanical
pumping or insulin release mechanism.
These may be disposable devices or re-useable devices with disposable
insulin cartridges.
They are very convenient for active individuals taking multiple
injections, as well as those who are visually or dexterity-challenged.
28. Continuous Subcutaneous Insulin Infusion Device:
Continuous subcutaneous insulin infusion (CSII) devices (also
known as insulin pumps) are the most sophisticated form of insulin
delivery.
These are small, computerized devices that are programmed to deliver
insulin under the skin.
The insulin pump is durable and lasts for years, but the insulin supply
and certain pump components (insulin reservoir, tubing and infusion
set) are changed every few days.
29. Infusion
Human regular insulin may be injected directly into the vein in a
hospital setting under close medical supervision only.
Insulin is added to intravenous fluids, and the insulin dose and blood
sugar are strictly monitored .
The intravenous route of delivery is ONLY given under a doctor’s
orders in a hospital to facilitate the management of diabetes during
surgery or an intensive care stay.
33. INTRODUCTION
3 3
1.An antibody or immunoglobulin (Ig) is a glycoprotein that is made by plasma cells in
response to an antigen and can recognize and bind to the antigen that caused its
production. Antibodies bind antigen with a high degree of specificity and affinity.
Antibodies recognize a variety of three-dimensional shapes (amino acids, lipids,
carbohydrates, etc.). Antibodies have more than one antigen combining site Some
bivalent Ab molecules can combine to form multimeric Abs that have upto 10 combining
sites
2. An antibody is a protein used by the immune system to identify and neutralize foreign
objects like bacteria and viruses. Each antibody recognizes a specific antigen unique to
its target. Monoclonal antibodies (mAb) are antibodies that are identical because they
were produced by one type of immune cell, all clones of a single parent cell. Polyclonal
antibodies are antibodies that are derived from different cell lines. They differ in
aminoacidsequence.
35. MONOCLONAL ANTIBODY
• A type of protein that is made in the laboratory and can bind to certain targets in the body, such as antigens on the
surface of cancer cells. There are many kinds of monoclonal antibodies, and each monoclonal antibody is made so that
it binds to only one antigen. Monoclonal antibodies are being used in the diagnosis and treatment of many diseases,
including some types of cancer. They can be used alone or to carry drugs, toxins, or radioactive substances directly to
cancer cells.
• Monoclonal antibodies (mAb) are a single type of antibody that are identical and are directed against a specific
epitope (antigen, antigenic determinant). These are produced by B-cell clones of a single parent or a single hybridoma
cell line. A hybridoma cell line is formed by the fusion of a one B-cell lymphocyte with a myeloma cell. Some
myeloma cells synthesize single mAb antibodies naturally.
3 5
36. • Monoclonal antibodies (mAb) are a single type of antibody that are identical and are directed against a
specific epitope (antigen, antigenic determinant) and are produced by B-cell clones of a single parent or a
single hybridoma cell line.
• A hybridoma cell line is formed by the fusion of a one B- cell lymphocyte with a myeloma cell.
• Some myeloma cells synthesize single mAb antibodies naturally
3 6
38. • Immunize animal
• Isolate spleen cells (containing antibody-producing B cells)
• Fuse spleen cells with myeloma cells (e.g. using PEG - polyethylene glycol)
• Allow unfused B cells to die
• Add aminopterin to culture to kill unfused myeloma cells
• Clone remaining cells (place 1 cell/well and allow each cell to grow into a clone of cells)
• Screen supernatant of each clone for presence of the desired antibody
• Grow the chosen clone of cells in tissue culture indefinitely.
• Harvest antibody from the culture supernatant.
• (If you’re a biotech company) charge about $1,000-$2,000 per mg.
3 8
Practical steps in the production of monoclonal antibodies
39. EXAMPLE FOR MONOCLONAL ANTIBODY
2. Drozitumab
Drozitumab is a human monoclonal antibody in
development for the treatment of cancers. It targets Tumor
Necrosis Factor Related Apoptosis-inducing
Ligand(TRAIL), whose receptors are found on the surface
of many types of malignant cells. Drozitumab was
developed by Genentech
Although drozitumab was studied in phase II trials for
treating chondrosarcoma, colorectal cancer, non-Hodgkin
lymphoma, and non-small cell lung cancer, development
has been halted due to lack of clinical response.
1.Abagovomab
Abagovomab is a mouse anti-idiotype monoclonal
antibody whose variable epitope mirrors a tumor antigen
(CA-125) highly expressed in the epithelial ovarian cancer.
Abagovomab does not bind directly to CA-125, but it works
as a "surrogate" antigen, enabling the immune system to
identify and attack tumor cells displaying the CA-125
protein.
Through this, it is hoped that the body's immune system may
be able to combat any remaining individual tumor cells and
thus prevent recurrence of the disease.
3 9
40. Best Uses of Monoclonal Antibodies:
• To detect a specific antigen
• To detect a single member of a protein family
• To create consistent results between experiments/batches
• To stain cells with less background – excellent for immunohistochemistry,
immunocytochemistry, and immunofluorescence experiments
• To quantify protein expression (ex. Flow cytometry or fluorescence-activated cell sorting)
• To detect changes in molecular conformation
• To detect changes in phosphorylation states
• To detect a target for x-ray crystallography
• To create animal models lacking a specific cell type
• Immunotherapy
4 0
41. MONOCLONAL DIAGNOSTIC USE
• A monoclonal antibody can be used to detect pregnancy only 14 days after conception. Other
monoclonal antibodies allow rapid diagnosis of hepatitis, influenza, herpes, streptococcal, and
Chlamydia infections.
• They can be used to detect for the presence and quantity of this substance, for instance in a
Western blot test (to detect a substance in a solution) or an immunofluorescence test.
• Monoclonal antibodies can also be used to purify a substance with techniques called
immunoprecipitation and affinity chromatography.
4 1
42. MONOCLONAL ANTIBODIES FOR CANCER TREATMENTS
4 2
Possible treatment for cancer involves monoclonal antibodies
that bind only to cancer cells specific antigen and induce
immunological response on the target cancer cell (naked
antibodies). mAb can be modificated for delivery of [toxin],
radioisotope, cytokine.
43. A BREAKTHROUGH IN DIAGNOSTICS
• In Pregnancy by detecting the urinary levels of human chorionic gonadotropin.
• Cancer estimation of plasma carcinoembryonic antigen in colorectal cancer, and prostate specific
antigen for prostate cancer.
• They can be used to detect for the presence and quantity of this substance, for instance in a Western
blot test (to detect a substance in a solution) or an immunofluorescence test.
• The radioisotopes commonly used for labeling MAb are iodine—131 and technetium—99. The MAb
tagged with radioisotope are injected intravenously into the patients.
• Single photon emission computed tomography (SPECT) cameras are used to give a more sensitive 3d
appearance of the spots localized by radiolabeled— MAbs.
4 3
44. DIAGNOSTIC APPLICATIONS
• 1. Detects protein of interest by immune florescence or blotting.
• 2. Cardiovascular diseases.
• 3. Deep vein thrombosis.
• 4. Location of primary and secondary metastatic tumors.
• 5. Immunosuppressive therapy.
• 6. Pregnancy testing kits.
4 4
THERAPEUTIC APPLICATIONS
1. Radioisotope immune conjugates.
2. Toxin and drug immune conjugates.
3. Immunoliposome based kits.
4. In cancer.
5. Inflammatory disease.
45. POLYCLONAL ANTIBODY
• A polyclonal antibody refers to an antibody normally recognizing only a single antigen but within which
a number of different epitopes are recognized.
• Polyclonal antibodies (PAbs) are a mixture of antibodies that are secreted by different B cell lineages.
These antibodies are actually a collection of immunoglobulin molecules that react against a specific
antigen, each identifying a different epitope on an antigen.
• A Polyclonal Antibody represents a collection of antibodies from different B cells that recognize
multiple epitopes on the same antigen. Each of these individual antibodies recognizes a unique epitope
that is located on that antigen.
4 5
46. PRODUCTION OF POLYCLONAL ANTIBODY
4 6
• Antibodies used for research and diagnostic purposes are often obtained by injecting a lab animal such as
a rabbit with a specific antigen.
• Within a few weeks, the animal’s immune system will produce high levels of antibodies specific for the
antigen.
• These antibodies can be harvested in an antiserum, which is whole serum collected from an animal
following exposure to an antigen
• Because most antigens are complex structures with multiple epitopes, they result in the production of
multiple antibodies in the lab animal.
• This so-called polyclonal antibody response is also typical of the response to infection by the human
immune system.
47. • Antiserum drawn from an animal will thus contain antibodies from multiple clones of B cells, with each B
cell responding to a specific epitope on the antigen
• Antiserum obtained from animals will not only contain antibodies against the antigen artificially
introduced in the laboratory, but it will also contain antibodies to any other antigens to which the animal has
been exposed during its lifetime.
• For this reason, antisera must first be “purified” to remove other antibodies before using the antibodies for
research or diagnostic assays.
4 7
50. ADVANTAGES OF POLYCLONAL ANTIBODIES
1. Inexpensive.
2. Easy to store.
3. Quick to produce.
4. Ready to use in under four months.
5. Highly stable and tolerant of pH or buffer changes.
6. High affinity as the antibodies bind to more than one epitope, they can help amplify the signal from target
protein even with low expression level.
5 0
51. • The use of polyclonal antibodies (PAbs) over monoclonal antibodies has its advantages. The technical
skills needed to produce polyclonal antibodies is not as demanding. They're inexpensive to make and
can be generated fairly quickly, taking up to several months to produce. PAbs are heterogeneous, which
allows them to bind to a wide range of antigen epitopes.
• Because PAbs are produced from a large number of B cell clones, they're more likely to successfully
bind to a specific antigen. PAbs remain stable in different environments, such as a change in pH or salt
concentration, which allows them to be more applicable in certain procedures.
• Additionally, depending on the amount needed, PAbs can be made in large quantities in relation to the
size of the animal used.
5 1
52. USES OF PLOYCLONAL ANTIBODIES
1. Sandwich ELISA for tumor markers or other antigens can be designed with polyclonal antibodies.
2. To detect a known or unknown is forms of antigens with high antigen homology
3. To detect low levels of a particular antigen
4. To capture as much antigen as possible
5. To detect denatured proteins
6. To detect a target in solutions with varying pH and salt concentrations
5 2
56. ● Cardiovascular drug, any agent that affects the function of
the heart and blood vessels.
● Drugs that act on the cardiovascular system are among the most widely
used in medicine.
● Examples of disorders in which such drugs may be useful
include hypertension (high blood pressure), angina pectoris (chest pain
resulting from inadequate blood flow through the coronary arteries to the
heart muscle), heart failure (inadequate output of the heart muscle in
relation to the needs of the rest of the body),
and arrhythmias (disturbances of cardiac rhythm).
57. TYPES AND USE OF CARDIO VASCULAR DRUG
● Wide range of medications are used to treat various heart conditions. Some
examples of the drugs used in cardiovascular medicine include:
● Anticoagulants or blood thinners - These agents prevent coagulation or clotting
of the blood. Injectable forms of anticoagulants include dalteparin, enoxaparin,
tinzaparin and heparin.
● Warfarin is a commonly used blood thinner that can be taken in the form of a
tablet.
58. • These drugs do not dissolve existing blood clots but are preventive
agents in patients who have had a heart attack.
• Antiplatelet agents - Platelets play an important role in blood clotting
and the formation of platelet plugs that prevent bleeding.
• Examples of antiplatelet medications include aspirin, ticlopidine,
lopidogrel and dipyridamole.
• They are used as preventive agents in patients who have had a heart
attack.
59. ● Thrombolytic agents - These agents are used to break up blood clots that
have formed and examples include streptokinase, reteplase and altepase.
● Angiotensin-converting enzyme (ACE) inhibitors - These agents
expand blood vessels by lowering levels of angiotensin II, a potent
vasoconstrictor that drives blood pressure up. ACE inhibitors are used to
treat high blood pressure, heart failure and heart attacks. Examples of
agents in this class include captopril, enalapril, fosinopril and lisinopril.
60. Angiotensin II receptor blockers (ARBs) - These agents prevent
angiotensin II from having any effects on the heart and blood vessels by
blocking the receptors it usually binds to. These agents are useful in the
treatment of high blood pressure, heart failure and heart attacks. Examples
of drugs in this class include candesartan, irbesartan, losartan, telmisartan
and valsartan
61. ● Diuretics - Diuretics increase the excretion of water and sodium in the
urine, therefore decreasing the total blood volume. This reduces blood
pressure and the heart's workload. Examples of agents in this class
include chlorothiazide, amiloride, furosemide, bumetanide, indapamide
and spironolactone.
● Vasodilators - These drugs relax the blood vessels and cause blood
pressure to fall. They are useful in the treatment of high blood pressure,
heart failure, angina and heart attacks. Examples include isosorbide,
dinitrate and hydralazine.
● Digoxin - This agent is used to stimulate a heartbeat in some cases of
heart failure.
62. .
● Statins - These agents reduce the synthesis of blood cholesterol in the
liver. High blood cholesterol is one of the major causes of atherosclerosis.
Some of the most well known examples include atorvastatin, lovastatin
and simvastatin.
● Drugs that are used to regulate an abnormal heart rhythm include
quinidine, lidocaine, amiodarone, sotalol, verapamil, diltiazem, dofetilide
and adenosine.
● Beta blockers or beta-adrenergic blocking agents - These agents
decrease the heart rate and the final cardiac output. This lowers blood
pressure and heart rate. Beta blockers are useful therapies in high blood
pressure and some types of arrhythmia. Agents in this class include
atenolol, bisoprolol, metoprolol, propranolol and sotalol.
63. Calcium channel blockers - Calcium channel blockers stop the movement of
calcium into the cells of the heart and blood vessels. This relaxes the vessels and
reduces blood pressure. Calcium channel blockers are useful therapies in high
blood pressure, angina, and some forms of arrhythmia. Examples of drugs in this
class include amlodipine, felodipine, nifedipine and varapamil
65. ● Anticoagulants are commonly known as blood thinners.
● They are chemical substances that prevent or reduce coagulation of blood,
prolonging the clotting time.
● Anticoagulants are used in therapy for thrombotic disorders.
● Oral anticoagulants (OACs) are taken by many people in pill or tablet form,
and various intravenous anticoagulant dosage forms are used in hospitals.
● Common anticoagulants include warfarin and heparin.
66. There are three main types of anticoagulant medications:
● Vitamin K antagonists
● Direct Oral Anticoagulants (DOACs)
● Low molecular weight heparins (LMWH)
Each type works in a different way to prevent unneeded blood clots.
67. VITAMIN K ANTAGONIST ANTICOAGULANTS
● Vitamin K helps in blood clot.
● We get it from green leafy vegetables like broccoli and spinach and from the action of
bacteria in your gut.
● Vitamin K “antagonists” like warfarin stop your liver from processing vitamin K into
“factors” that normally help clot your blood.
● This curbs blood clotting.
● One of the potential advantages of this type of anticoagulant is that it’s easier than others
to reverse in case you have sudden bleeding from trauma or emergency surgery.
68. DIRECT ORAL ANTICOAGULANTS (DOACS)
● DOACs work more quickly than vitamin K antagonists.
DOACs include:
a) Direct thrombin inhibitors:
● These drugs interfere with your body’s use of thrombin, a key enzyme
that helps clot your blood. Though it's typically injected in a vein, you
can take it in pill form as dabigatran (Pradaxa).
69. b) Direct factor Xa inhibitors:
● This type of anticoagulant stops the Xa factor in the clotting process from
working as it should.
● These medications, which come in pill form, include apixaban (Eliquis),
betrixaban (Bevyxxa), edoxaban (Savaysa), and rivaroxaban (Xarelto).
70. LOW MOLECULAR WEIGHT HEPARIN (LMWH)
ANTICOAGULANTS
● Low-molecular weight heparin is gradually replacing heparin for
treatment of most patients with venous thromboembolism and acute
coronary syndromes because it has more convenient and cost-effective
● It has similar results to heparin
● Administered by subcutaneous injection
● LOVENOX® is an example
72. ● Antithrombotic agents are medications that are used to prevent the formation
or development of blood clots within the body.
● These agents work by inhibiting platelet aggregation or by reducing blood
coagulation.
Some common antithrombotic agents include:
1. Aspirin: Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that
works by inhibiting platelet aggregation.
2. Heparin: Heparin is an anticoagulant that prevents blood from clotting by
inhibiting the action of thrombin and factor Xa.
73. 3. Warfarin: Warfarin is an oral anticoagulant that interferes with the synthesis of
vitamin K-dependent clotting factors in the liver.
4. Direct oral anticoagulants (DOACs): DOACs, also known as novel oral
anticoagulants (NOACs), are a newer class of anticoagulants that directly inhibit
factor Xa or thrombin.
5. Clopidogrel: Clopidogrel is an antiplatelet medication that works by inhibiting
the ADP receptor on platelets.
74. MAIN TYPES
1. Antiplatelet agents: These agents work by inhibiting platelet activation and
aggregation. Examples include aspirin, clopidogrel, dipyridamole, and
ticagrelor
2. Anticoagulants: These agents prevent the formation of blood clots by
inhibiting the coagulation cascade. Examples include heparin, warfarin,
direct oral anticoagulants (DOACs) such as dabigatran, rivaroxaban,
apixaban, and edoxaban.
75. 3. Thrombolytic agents: These agents are used to dissolve blood clots that
have already formed. Examples include alteplase, reteplase, and tenecteplase.
4. Anti-fibrinolytic agents: These agents work by preventing the breakdown
of blood clots. Examples include tranexamic acid and aminocaproic acid.
5. Other agents: There are also other types of antithrombotic agents, such as
prostacyclin analogues (epoprostenol, iloprost), glycoprotein IIb/IIIa
inhibitors (abciximab, eptifibatide, tirofiban), and phosphodiesterase
inhibitors (dipyridamole, cilostazol).
76. 1. Prevention of blood clots: Antithrombotic agents are used to prevent the
formation of blood clots in people who are at high risk due to certain medical
conditions, such as atrial fibrillation, deep vein thrombosis, pulmonary
embolism, heart valve disease, or recent surgery.
2. Treatment of blood clots: Antithrombotic agents are used to treat existing
blood clots and prevent them from growing or traveling to other parts of the
body. This is particularly important in the case of deep vein thrombosis,
pulmonary embolism, or stroke.
3. Prevention of cardiovascular events: Some antithrombotic agents, such as
aspirin, are used to prevent heart attack and stroke in people with a high risk
of cardiovascular disease.
USES
78. ● Hemostasis is a process to prevent and stop bleeding, meaning to keep
blood within a damaged blood vessel.
● It is the first stage of wound healing.
● This involves coagulation, which changes blood from a liquid to a gel.
● Hemostasis is maintained in the body via four mechanisms:
79.
80.
81. USES
1. Control of bleeding during surgery: Hemostasis is critical during
surgery to prevent excessive bleeding and ensure good visibility of
the surgical site.
2. Treatment of bleeding disorders: Hemostasis is important in the
management of bleeding disorders, such as hemophilia and von
Willebrand disease. Patients with these conditions may receive
transfusions of clotting factors or medications to promote blood
clotting.
3. Management of trauma: Hemostasis is critical in the immediate
management of trauma, such as in the case of severe injuries or
major surgery.
84. CHEMOTHERAPY
Chemotherapy involves the use of cytotoxic medications to cure cancer or
decrease tumour size or to prevent or treat suspected metabases.
It interfering with the ability of the malignant cell to synthesize vital enzymes
and chemicals.
Chemotherapy disrupts the cell cycle in various phase by interrupting cell
metabolism and replication.
Based on the chemical makeup and biological activity, different drugs used for
cancer treatment act in specific phases and sub phases of the cell cycle.
85. ADJUVANT AND NEO-ADJUVANT CHEMOTHERAPY
Adjuvant chemotherapy:- Chemotherapy given after surgery or irradiation to
destroy micrometastasis and prevent development of secondary neoplasm.
Neo-adjuvant chemotherapy:- Chemotherapy given before surgery or
radiotherapy in order to diminish the volume of large primary neoplasm.
86. CLASSES OF CHEMOTHERAPY DRUGS
Chemotherapeutic agents can be classified either by the effects of the agent on
the cell or by the pharmacological properties of the agent.
Chemotherapeutic agents can be divided into:-
Cell cycled-specific agents
Cell cycle-nonspecific agents
87. CELL CYCLE-SPECIFIC AND CELL CYCLE-NONSPECIFIC
AGENTS
Cell cycle-specific:- These are the agents effective at a specific phase (example,
S and M phases) in the cell replication by damaging cellular DNA and blocking
production of protein necessary for DNA and RNA synthesis.
Cell cycle-nonspecific:- These are the agents effective throughout all the phases
of the cell cycle, including the resting phase.
88. OTHER CLASSIFICATIONS OF CHEMOTHERAPEUTIC
AGENTS
Chemotherapeutic agents are classified based on pharmacological properties of
the agent. The classifications include:
a. Alkylating agents
b. Antimetabolites
c. Antitumour antibiotics
d. Mitotic inhibitors
e. Hormones and hormone antagonists
f. Miscellaneous agents
89. ALKYLATING AGENTS
Alkylating agents are not phase specific and basically act on performed nucleic
acids by creating defects in tumour DNA. They cause crosslinking of DNA
strands and interfere with replication and transcription.
It acts with proliferating and non proliferating cells those in G0 phase.
The several subclasses of alkylating agents include:-
a. Nitrogen mustards:- Mechlorethamine, Melphalan, Chlorambucil,
cyclophosphamide, ifosfamide.
b. Ethyleneimine:- Thiotepa
c. Alkyl Sulfonate:- Busulfan
d. Nitrosureas:- Carmustine, lomustine, streptozocin
e. Triazines:- Dacarbazine, temozolamide
90. ANTIMETABOLITES
Antimetabolites are phase specific, working best in the S phase and having little
effect in G0. It interfere with nucleic acid synthesis by displacing metabolites at
the regulatory site of a key enzyme.
Classifications are:-
a. Folate antagonists:- Methotrexate
b. Purine antagonists:- 6 Mercaptopurine, 6 Thioguanine, Azathioprine
c. Pyrimidine antagonists:- 5 Fluorouracil, cytarabine, gemcitabine
91. ANTITUMOUR ANTIBIOTICS
Antitumour antibiotics derived from natural sources that are generally too toxic
to be used as anti-bacterial agents.
They are not phase specific and act in several ways: they disrupt DNA replication
and RNA transcription; create free radicals, which generate breaks in DNA and
other forms of damage; and interfere with DNA repair.
These antibiotics include:-
a. Actinomycin D
b. Doxorubicin
c. Bleomycin
d. Mitomycin-C
e. Mithramycin
92. MITOTIC INHIBITORS
Mitotic inhibitors are drugs that act to prevent cell division during the M phase.
Mitotic inhibitors include plant alkaloids and taxoids.
Plant alkaloids consists of medications extracted from plant sources (periwinkle
plant): Vinca
Alkaloids (example, vincristine and vinblastine) and etoposide.
The toxoids acts during the G2 phase to inhibit cell divison (example, Paclitaxel
and Docetaxel).
93. HORMONES AND HORMONE ANTAGONISTS
The main hormones used in cancer therapy are the corticosteroids which are
phase specific (G1).
These act by binding to specific intracellular receptors, repressing transcription
of mRNA and therapy altering cellular function and growth.
Hormone antagonists work with hormone binding tumours. They block the
hormones receptor site on the tumour and prevent it from receiving normal
hormonal growth stimulation.
Example of hormone and hormone antagonists are:-
• Corticosteroids:- Prednisolone
• Oestrogens:- Ethinyl Estradiol
• Aromatase inhibitors:- Letrozole, Anastrazole, Exemestane
• Progestins:-Hydroxyprogesterone
95. MISCELLANEOUS AGENTS
Several miscellaneous agents act at different phases in the cell cycle.
The miscellaneous agents are:-
Cisplatin
Carboplatin
Hydroxurea
Procarbazine
Mitotane
Imatinib
97. CHEMOTHERAPY
Chemotherapy involves the use of cytotoxic medications to cure cancer or
decrease tumour size or to prevent or treat suspected metabases.
It interfering with the ability of the malignant cell to synthesize vital enzymes
and chemicals.
Chemotherapy disrupts the cell cycle in various phase by interrupting cell
metabolism and replication.
Based on the chemical makeup and biological activity, different drugs used for
cancer treatment act in specific phases and sub phases of the cell cycle.
98. ADJUVANT AND NEO-ADJUVANT CHEMOTHERAPY
Adjuvant chemotherapy:- Chemotherapy given after surgery or irradiation to
destroy micrometastasis and prevent development of secondary neoplasm.
Neo-adjuvant chemotherapy:- Chemotherapy given before surgery or
radiotherapy in order to diminish the volume of large primary neoplasm.
99. CLASSES OF CHEMOTHERAPY DRUGS
Chemotherapeutic agents can be classified either by the effects of the agent on
the cell or by the pharmacological properties of the agent.
Chemotherapeutic agents can be divided into:-
Cell cycled-specific agents
Cell cycle-nonspecific agents
100. CELL CYCLE-SPECIFIC AND CELL CYCLE-NONSPECIFIC
AGENTS
Cell cycle-specific:- These are the agents effective at a specific phase (example,
S and M phases) in the cell replication by damaging cellular DNA and blocking
production of protein necessary for DNA and RNA synthesis.
Cell cycle-nonspecific:- These are the agents effective throughout all the phases
of the cell cycle, including the resting phase.
101. OTHER CLASSIFICATIONS OF CHEMOTHERAPEUTIC
AGENTS
Chemotherapeutic agents are classified based on pharmacological properties of
the agent. The classifications include:
a. Alkylating agents
b. Antimetabolites
c. Antitumour antibiotics
d. Mitotic inhibitors
e. Hormones and hormone antagonists
f. Miscellaneous agents
102. ALKYLATING AGENTS
Alkylating agents are not phase specific and basically act on performed nucleic
acids by creating defects in tumour DNA. They cause crosslinking of DNA
strands and interfere with replication and transcription.
It acts with proliferating and non proliferating cells those in G0 phase.
The several subclasses of alkylating agents include:-
a. Nitrogen mustards:- Mechlorethamine, Melphalan, Chlorambucil,
cyclophosphamide, ifosfamide.
b. Ethyleneimine:- Thiotepa
c. Alkyl Sulfonate:- Busulfan
d. Nitrosureas:- Carmustine, lomustine, streptozocin
e. Triazines:- Dacarbazine, temozolamide
103. ANTIMETABOLITES
Antimetabolites are phase specific, working best in the S phase and having little
effect in G0. It interfere with nucleic acid synthesis by displacing metabolites at
the regulatory site of a key enzyme.
Classifications are:-
a. Folate antagonists:- Methotrexate
b. Purine antagonists:- 6 Mercaptopurine, 6 Thioguanine, Azathioprine
c. Pyrimidine antagonists:- 5 Fluorouracil, cytarabine, gemcitabine
104. ANTITUMOUR ANTIBIOTICS
Antitumour antibiotics derived from natural sources that are generally too toxic
to be used as anti-bacterial agents.
They are not phase specific and act in several ways: they disrupt DNA replication
and RNA transcription; create free radicals, which generate breaks in DNA and
other forms of damage; and interfere with DNA repair.
These antibiotics include:-
a. Actinomycin D
b. Doxorubicin
c. Bleomycin
d. Mitomycin-C
e. Mithramycin
105. MITOTIC INHIBITORS
Mitotic inhibitors are drugs that act to prevent cell division during the M phase.
Mitotic inhibitors include plant alkaloids and taxoids.
Plant alkaloids consists of medications extracted from plant sources (periwinkle
plant): Vinca
Alkaloids (example, vincristine and vinblastine) and etoposide.
The toxoids acts during the G2 phase to inhibit cell divison (example, Paclitaxel
and Docetaxel).
106. HORMONES AND HORMONE ANTAGONISTS
The main hormones used in cancer therapy are the corticosteroids which are
phase specific (G1).
These act by binding to specific intracellular receptors, repressing transcription
of mRNA and therapy altering cellular function and growth.
Hormone antagonists work with hormone binding tumours. They block the
hormones receptor site on the tumour and prevent it from receiving normal
hormonal growth stimulation.
Example of hormone and hormone antagonists are:-
• Corticosteroids:- Prednisolone
• Oestrogens:- Ethinyl Estradiol
• Aromatase inhibitors:- Letrozole, Anastrazole, Exemestane
• Progestins:-Hydroxyprogesterone
108. MISCELLANEOUS AGENTS
Several miscellaneous agents act at different phases in the cell cycle.
The miscellaneous agents are:-
Cisplatin
Carboplatin
Hydroxurea
Procarbazine
Mitotane
Imatinib
110. What are they?
• An oligonucleotide is a short, single-stranded DNA or RNA molecule
typically composed of 10-50 nucleotides.
• The sequence of nucleotides in an oligonucleotide can be designed to
bind specifically to a complementary sequence of nucleotides in a
target DNA or RNA molecule, allowing for applications such as gene
expression analysis, DNA sequencing, and genetic engineering.
• Oligonucleotides are widely used in research, diagnostics,
and therapeutics.
111. Types of Oligonucleotides
• There are several types of oligonucleotides, each with specific characteristics and
applications.
• The most common types of oligonucleotides are:
1. DNA oligonucleotides: These are short, single-stranded DNA molecules
typically composed of 10-50 nucleotides. They are widely used in molecular
biology research and in diagnostics.
2. RNA oligonucleotides: These are short, single-stranded RNA molecules
typically composed of 10-50 nucleotides. They are used in a variety of
applications, including gene expression analysis, RNA interference, and
therapeutic applications.
3. siRNA (short interfering RNA): These are double-stranded RNA molecules
typically composed of 21-23 nucleotides. They are used to silence the expression
of specific gene by targeting and degrading the mRNA molecules that encode
them.
112. 4. miRNA (microRNA): These are short, single-stranded RNA molecules typically
composed of 20-24 nucleotides. They regulate gene expression by binding to mRNA
molecules and inhibiting their translation into proteins.
5. Antisense oligonucleotides: These are synthetic single-stranded DNA or RNA
molecules designed to hybridize with specific mRNA molecules and inhibit their
translation into proteins. They are used in therapeutic applications to target disease-
causing genes or proteins.
6. Aptamers: These are short, single-stranded DNA or RNA molecules that bind to
specific target molecules with high affinity and specificity. They are used in a
variety of applications, including diagnostics, therapeutics, and research.
113. Biological Importance
• Oligonucleotides are biologically important because they are essential components
of DNA and RNA, the molecules that carry genetic information in all living
organisms. They play a crucial role in many biological processes, including gene
expression, DNA replication, and protein synthesis.
• Some examples of the biological importance of oligonucleotides:
1. DNA replication: Oligonucleotides are the building blocks of DNA, which
replicates itself during cell division. The two complementary strands of DNA are
synthesized by the enzyme DNA polymerase, which uses oligonucleotides as a
template to build new strands of DNA.
2. Gene expression: Oligonucleotides are involved in the process of gene
expression, which is the process by which genetic information is used to
synthesize proteins. During gene expression, RNA molecules are synthesized
from DNA templates, and these RNA molecules contain oligonucleotide
sequences that are important for protein synthesis.
114. 3. Protein synthesis: Oligonucleotides are involved in protein synthesis, which is the
process by which RNA molecules are translated into proteins. During this process,
ribosomes read the sequence of nucleotides in the RNA molecule and use this
information to assemble amino acids into a protein chain.
4. Genetic engineering: Oligonucleotides are essential tools for genetic engineering,
which involves manipulating DNA sequences to add, delete, or modify genes.
Oligonucleotides can be used to introduce specific mutations or to target specific
DNA sequences for editing.
115. Production of Oligonucleotides
• Oligonucleotides can be produced using several methods, including enzymatic
synthesis, solid-phase synthesis, and chemical synthesis.
• The general steps involved in the production of oligonucleotides using solid-phase
synthesis:
Design and selection of the target sequence: The first step is to determine the
sequence of the oligonucleotide required for the desired application. The sequence
is typically chosen based on the function of the oligonucleotide, such as primers
for PCR or probes for hybridization assays.
Synthesis of the oligonucleotide: The oligonucleotide is synthesized on a solid
support, such as polystyrene beads, using an automated oligonucleotide
synthesizer. The nucleotides are added stepwise in a specific order, with each
addition being protected by a temporary chemical group to prevent unwanted
reactions.
116. Deprotection and cleavage: After the synthesis is complete, the oligonucleotide is
deprotected to remove the temporary chemical groups and cleaved from the solid
support. The oligonucleotide is then purified by HPLC or another method to
remove any impurities and ensure a high degree of purity.
Analysis and quality control: The final step is to analyze the oligonucleotide to
ensure that it meets the desired specifications, including length, purity, and yield.
Quality control may involve gel electrophoresis, mass spectrometry, or other
techniques.
117. • The other most common methods for producing and synthesizing oligonucleotides
are :
Enzymatic synthesis: This method involves using enzymes to synthesize
oligonucleotides from nucleotide triphosphates. One of the most commonly used
enzymes for this purpose is polynucleotide phosphorylase (PNPase). This method
is often used to synthesize short RNA oligonucleotides.
Chemical synthesis: This method involves using chemical reactions to synthesize
oligonucleotides from nucleotide building blocks. One of the most commonly
used chemical methods for this purpose is phosphoramidite chemistry, which
involves the sequential addition of nucleotide building blocks to a growing chain.
This method is widely used for the synthesis of DNA oligonucleotides.
• After synthesis, oligonucleotides can be purified using a variety of methods,
including HPLC, PAGE, or ion-exchange chromatography. The purity and quality
of oligonucleotides are critical factors in their performance and applications.
118. Application of Oligonucleotides
• Oligonucleotides have a wide range of applications in various fields, including :
1. Research: Oligonucleotides are widely used in molecular biology research to
probe and manipulate nucleic acid sequences. They are used for gene expression
analysis, DNA sequencing, and genetic engineering.
2. Diagnostics: Oligonucleotides can be designed to specifically bind to and detect
target DNA or RNA sequences, making them useful for diagnostic applications
such as detecting infectious agents or genetic mutations.
3. Therapeutics: Oligonucleotides can be used as therapeutic agents to target
specific disease-causing genes or proteins. They can be designed to inhibit the
expression of disease-causing genes, promote the degradation of disease-
causing RNA molecules, or modulate the activity of disease-causing proteins.
4. Forensics: Oligonucleotides can be used in forensic investigations to analyze
DNA samples for identification purposes.
5. Agriculture: Oligonucleotides can be used in agriculture to genetically engineer
crops with desirable traits, such as increased yield or resistance to pests
119. Examples of Oligonucleotides Drugs
1. Spinraza - This antisense oligonucleotide drug is used to treat spinal muscular atrophy
(SMA), a rare genetic disorder that affects the muscles. Spinraza works by increasing
the production of the SMN protein, which is deficient in SMA patients.
2. Onpattro (patisiran) - This RNA interference (RNAi) therapeutic is used to treat
hereditary transthyretin-mediated amyloidosis (hATTR), a rare disease in which
abnormal proteins build up in the body's tissues and organs. Onpattro works by
reducing the production of the protein responsible for this buildup.
3. Tegsedi (inotersen) - Another antisense oligonucleotide drug, Tegsedi is used to treat
hATTR. It works by blocking the production of the abnormal protein that causes the
disease.
4. Givosiran (Givlaari) - This RNAi therapeutic is used to treat acute hepatic porphyria
(AHP), a rare genetic disorder that affects the liver. Givosiran works by reducing the
production of a specific enzyme that is responsible for the symptoms of the disease.
5. Lumasiran (Oxlumo) - This RNAi therapeutic is used to treat primary hyperoxaluria
type 1 (PH1), a rare genetic disorder that causes the buildup of oxalate crystals in the
kidneys and other organs. Lumasiran works by reducing the production of an enzyme
that is responsible for the overproduction of oxalate in PH1 patients.
120. Other examples are :
• Fomiversin for the treatment of cytomegalovirus retinitis.
• Mipomersen for high cholesterol
• Genasense against cancer
• AP 1-2009 for the treatment of high grade glimoas
122. • Consist of many glands that secrete hormones into the blood.
• When glands malfunction they secrete either by:
• Decreased amount of hormone
• Increased amount of hormone
ENDOCRINE SYSTEMS
123.
124. Insulin drugs used to treat diabetes mellitus
• Insulin
• Secreted by beta cells in islets of Langerhans in the pancreas
• Plays an essential role in glucose metabolism
• Lowers blood glucose levels enabling cells to utilize glucose
• Transports glucose to the cell
• Binds with an insulin receptor on the cell membrane
• Transport glucose inside the cell
• The glucose is metabolized to provide energy
125. Diabetes Mellitus
• Disease of pancreas and body cells
• Type 1
• The pancreas doesn’t produce any insulin
• Type 2
• The pancreas produces too little insulin
• The number of or sensitivity of insulin receptors on body cells in decreased
126. Type 1 Diabetes Mellitus
• Previously known as:
• Insulin-dependent diabetes mellitus
(IDDM)
• Juvenile-onset diabetes mellitus
• Treated with subcutaneously injected insulin
127. Type 2 Diabetes Mellitus
• Previously known as:
• Non-insulin-dependent diabetes mellitus (NIDDM)
• Adult-onset diabetes mellitus
• Treated with antidiabetic drugs
• Insulin maybe needed
• Untreated or uncontrolled diabetes mellitus results in consistently
elevated blood glucose level.
• Eventually leads to diabetic complications of:
• Arteriosclerosis
• Ketoacidosis
• Death
128. • All insulin drugs are grouped according to:
• How quickly they act in the body to lower the blood glucose
• Size of insulin crystalline
• Hours their therapeutic effect continues
• Amount of protamine and zinc added to the insulin
129. Rapid acting insulin drugs
• Taken in the morning or before eating
• Onset of therapeutic effect is almost immediate
• Can begin to lower blood glucose levels in as little as 15 minutes
• Therapeutic effect last 2 to 12 hours .
• Also known as regular insulin
• Sometimes reflected in the drug’s trade name as the abbreviation R.
130. • Three types of rapid acting insulin :
• Derived from pig pancreas
• Regular I Letin II
• Created by recombinant DNA technology
• Humulin R
• Novolin R
• Insulin analog drugs created by recombinant DNA technology
131. Intermediate acting insulin drugs
• Slower onset but a longer effect than rapid acting insulin
• Therapeutic effect
• Onset is between 1 to 2 hours
• Last for 24 hours
• Two types:
• Those with added protamine and zinc (NPH insulin drugs ) to prolong the
therapeutic effect of insulin.
• Those with different size of insulin crystals (lente insulin drugs) to slow down
the onset of action.
132. Long acting insulin drugs
• Have large insulin crystals containing added zinc
• Doesn't begin to lower the blood sugar for an hour
• Therapeutic effect lasts a full 24 hours after just one dose
• Also known as ultralente insulin
133. Combination insulin drugs
• Contain a mixture of:
• An intermediate acting insulin
• NPH insulin
• Insulin analog
• A rapid acting insulin
• Regular insulin
• Insulin analog
134. Drugs used to treat diseases of thyroid gland
• Hypothyroidism
• Too little thyroid hormone secreted
• Hyperthyroidism
• Too much thyroid hormone secreted
135. Drugs for hypothyroidism
• Thyroid gland secretes hormones:
• Triiodothyronine (T3)
• Thyroxine (T4)
• Decreased level causes hypothyroidism
• Drugs for hypothyroidism is obtained naturally from desiccated (dried)
animal thyroid glands or manufactured synthetically.
• Drugs for hypothyroidism
• Containing only T3
• Liothyronine (Cytomel, Triostat)
• Containing only T4
• Levothyroxine (Levothroid , Synthroid)
• Containing both T3 and T4
• Desiccated thyroid (Armour thyroid )
• Liotrix (Thyrolar )
136. Biological functions
• T3 is considered the major regulator of mitochondrial activity
• Induces early stimulation of transcription and increases transcription factor
(TFA) expression
• Stimulate oxygen consumption by mitochondria
• Regulate the rate of overall metabolism
• T3 increases basal metabolic rate
• T3 is an important regulator of skeletal maturation at the growth
plate
• T4 is responsible for metabolism, mood and body temperature.
137. Drugs for hyperthyroidism
• Also known as thyrotoxicosis
• Increased levels of T3 and T4
• Drugs inhibit production of T3 and T4 in the thyroid
• Radioactive sodium iodide 131
• Used to treat hyperthyroidism and thyroid cancer
• Low level radiation emitted destroys both hyperactive benign thyroid and
cancerous thyroid tissues.
• Iodine (ThyroShield)
• Methimazole (Tapazole)
138. Drugs used to treat diseases of pituitary gland
• Growth hormone
• Secreted by anterior pituitary gland
• Stimulate the production of insulin like growth factor 1
• Children with failure to grow can have an abnormality in any of these areas:
• Decreased amount of growth hormone
• Antibodies against growth hormone
• Abnormalities of growth hormone receptors on cells
• Deceased amount of insulin like growth factor 1
139. Drugs for acromegaly
• Acromegaly
• Over production of growth hormone (anterior pituitary)
• Causes widening and enlargement of facial features, hands and feet
• Drugs for acromegaly
• Decrease production of growth hormone
• Block growth hormone by anterior pituitary or block growth hormone from
activating receptors on cell membrane
140. Growth hormone replacement drugs
• Drugs are used as replacement therapy
• Sermorelin (Geref )
• Somatropin ( Humatrope, Nutropin )
• Somatrem (Protropin)
141. Drugs used to treat adrenal gland dysfunction
• Drugs for crushing syndrome
• Too much adrenal gland hormone is secreted
• Tumour on adrenal gland cortex
• Causes increase in amount of cortisol produced
• Removal by surgery preferred option
• Drugs suppresses cortisol secretion in patients who cannot have surgery
142. Drugs for addison disease
• Autoimmune disease in which body’s own antibodies destroys adrenal cortex
• Too little adrenal gland hormone is secreted
• Causes fatigue, weight loss
• Decreased ability to tolerate :
• Stress
• Disease
• Surgery
• Patients have unusual bronzed colour to the skin
143. • Drugs for addison disease
• Cortisone
• Hydrocortisone (Cortef)
Cortisone functions:
• Provide relief for inflamed areas of the body
• They lessen swelling, redness, itching and allergic reactions
• Most commonly injected into joints such as ankle, elbow, hip, knee,
shoulders, spine or wrist
144. Corticosteroid drugs
• Adrenal cortex secrete glucocorticoid hormones
• Cortisol
• Powerful anti-inflammatory effect
• Act as a natural hormone secreted by the adrenal cortex
• Used as a replacement therapy to treat addison disease
• Given by mouth or injection to treat inflammatory reactions in various parts of the
body
• Used to treat systemic inflammation caused by autoimmune diseases (Rheumatoid
arthritis, Multiple sclerosis etc)
145. Cortisol function
• Plays an important role in the stress response
• Regulates a wide range of vital processes throughout the
body , including metabolism and immune response
146. Drugs used to treat diseases of the testes
• Testosterone
• Androgen
• Most abundant and biologically active male sex hormone
• Androgen drugs
• Treat diseases of hypo secretion due to:
• Cryptorchidism
• Orchitis
• Delayed puberty
• Chemotherapy
• Alcoholism
• Surgical removal of testes
149. TNF- 𝞪
Tumour Necrosis Factor alpha (TNF alpha), is an inflammatory
cytokine produced by macrophages/monocytes during acute
inflammation and is responsible for a diverse range of signalling
events within cells, leading to necrosis or apoptosis.
Tumor necrosis factor (TNF) is a multifunctional cytokine that plays
important roles in diverse cellular events such as cell survival,
proliferation, differentiation, and death. As a pro-inflammatory
cytokine, TNF is secreted by inflammatory cells, which may be
involved in inflammation-associated carcinogenesis or in other words
TNF signals cells to die.
150. TNFs are primarily produced by macrophages and are responsible for regulation of inflammatory
and immune responses in cell death.
They occur in 2 distinct forms
1. Membrane integrated
2. Soluble form - exists in form of homotrimers
These TNFs bind to the receptors TNFR1 & TNFR2
TNFR1 is found in most of the tissues and responds to the soluble form of TNF- 𝞪. It
increases inflammation and induces powerful immune responses.
TNFR2 is found in immune cells and responds to membrane bound form of TNF-𝞪. It exhibits
anti inflammatory property and promotes cell proliferation
152. Role of TNFs
● The TNF signaling pathway plays an important role in various
physiological and pathological processes, including cell proliferation,
differentiation, apoptosis, and modulation of immune responses and
induction of inflammation.
● TNF (Tumor Necrosis Factor) is a multifunctional proinflammatory
cytokine, with effects on lipid metabolism, coagulation, insulin
resistance, and endothelial function.
● Ever since its discovery two decades ago, TNF has been considered
as an anti-cancer agent.
● Members of the TNFR (TNF Receptor) super family can send both
survival and death signals to cells.
153. TNF signaling has been implicated in many other
diseases
● Tumor necrosis factor alpha (TNF-α) was initially recognized as a
factor that causes the necrosis of tumors, but it has been recently
identified to have additional important functions as a pathological
component of autoimmune diseases.
● TNF-α binds to two different receptors, which initiate signal
transduction pathways. These pathways lead to various cellular
responses, including cell survival, differentiation, and proliferation.
● However, the inappropriate or excessive activation of TNF-α
signaling is associated with chronic inflammation and can eventually
lead to the development of pathological complications such as
autoimmune diseases.
● Understanding of the TNF-α signaling mechanism has been expanded
and applied for the treatment of immune diseases, which has
resulted in the development of effective therapeutic tools, including
TNF-α inhibitors.
● Currently, clinically approved TNF-α inhibitors have shown noticeable
potency in a variety of autoimmune diseases, and novel TNF-α
signaling inhibitors are being clinically evaluated.
