Recently, the relationship between gut microbiota and obesity has been highlighted. The
present randomized, double-blind, placebo-controlled study aimed to evaluate the efficacy of
transglucosidase (TGD) in modulating blood glucose levels and body weight gain in patients
with type 2 diabetes mellitus (T2DM) and to clarify the underlying mechanism by analyzing
the gut microbiota of T2DM patients.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
The role of curcumin in streptozotocin induced hepatic damage and the trans-d...Prof. Hesham N. Mustafa
Diabetic patients frequently suffer from non-alcoholic steatohepatitis. The current study aimed to investigate the role of curcumin and the response of hepatic stellate cells in streptozotocin (STZ)-induced hepatic damage. Sixty male rats were divided into three groups. The normal control injected with a citrate buffer vehicle and the diabetic control group which was injected intraperitoneally (IP) with a single-dose of streptozotocin (50mg/kg body weight) and a diabetic group was treated with an oral dose of curcumin at 80 mg/kg body weight daily for 60 days. Curcumin effectively counteracts oxidative stress-mediated hepatic damage and improves biochemical parameters. Alpha-smooth muscle actin (α-SMA) was significantly reduced, and insulin antibodies showed strong positive immunoreactivity with curcumin administration. These results optimistically demonstrate the potential use of curcumin, which is attributed to its antiradical/antioxidant activities and its potential β-cell regenerative properties. Also, it has the capability to encourage the trans-differentiation of hepatic stellate cells into insulin-producing cells for a period of time. In addition, as it is an anti-fibrotic mediator that inhibits hepatic stellate cell activation and the transition to myofibroblast-like cells, this suggests the possibility of considering curcumin's novel therapeutic effects in reducing hepatic dysfunction in diabetic patients.
Effect of emulin on blood glucose in type 2 diabetics - https://emulincanada.comAj Martirano
Effect of Emulin on Blood Glucose in Type 2 Diabetics https://emulincanada.com
,effect of emulin on blood glucose in type 2 diabet ,emulin diabetes ,igalen emulin diabetes ,emulin type 2 diabetes
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
The role of curcumin in streptozotocin induced hepatic damage and the trans-d...Prof. Hesham N. Mustafa
Diabetic patients frequently suffer from non-alcoholic steatohepatitis. The current study aimed to investigate the role of curcumin and the response of hepatic stellate cells in streptozotocin (STZ)-induced hepatic damage. Sixty male rats were divided into three groups. The normal control injected with a citrate buffer vehicle and the diabetic control group which was injected intraperitoneally (IP) with a single-dose of streptozotocin (50mg/kg body weight) and a diabetic group was treated with an oral dose of curcumin at 80 mg/kg body weight daily for 60 days. Curcumin effectively counteracts oxidative stress-mediated hepatic damage and improves biochemical parameters. Alpha-smooth muscle actin (α-SMA) was significantly reduced, and insulin antibodies showed strong positive immunoreactivity with curcumin administration. These results optimistically demonstrate the potential use of curcumin, which is attributed to its antiradical/antioxidant activities and its potential β-cell regenerative properties. Also, it has the capability to encourage the trans-differentiation of hepatic stellate cells into insulin-producing cells for a period of time. In addition, as it is an anti-fibrotic mediator that inhibits hepatic stellate cell activation and the transition to myofibroblast-like cells, this suggests the possibility of considering curcumin's novel therapeutic effects in reducing hepatic dysfunction in diabetic patients.
Effect of emulin on blood glucose in type 2 diabetics - https://emulincanada.comAj Martirano
Effect of Emulin on Blood Glucose in Type 2 Diabetics https://emulincanada.com
,effect of emulin on blood glucose in type 2 diabet ,emulin diabetes ,igalen emulin diabetes ,emulin type 2 diabetes
Diabetes mellitus: The Pandemic of 21st Century!RahulGupta2015
Diabetes mellitus is a major global metabolic disorder of 21 st century. This is due to its broad spectrum of associated complications with risks, like cardiac and renal disorders. The rapid growth of diabetes is becoming a major burden upon healthcare facilities in all affected countries. Due to lack of definitive preventative measures of diabetes, we must be aware of this pandemic and follow a disciplined lifestyle to limit it. In this communication, recent advances in diabetes management and current preventative measures have been concluded.
Gut Microbiota: The Missing Link in Obesity Induced Nonalcoholic Liver DiseaseIOSRJPBS
Background and objective: Recent research has elucidated a close association between intestinal microbiota, obesity, insulin resistance and nonalcoholic hepatic injury. Various studies have also indicated an increase in hepatic marker enzymes in obesity. Hence, this study aims to evaluate the association of gut microbiota with obesity, insulin resistance and hepatic marker enzymes. Material and Method: This case-control study was conducted during March 2015 to October 2016 At S.C.B Medical College, Cuttack, Odisha. The study included 186 subjects (86 irritable bowel syndrome patients as per the Rome III criteria and hundred matched controls). Plasma fasting glucose, serum lipid profile, hepatic marker enzymes were analysed by commercial kits adapted to automated clinical chemistry analyser and serum fasting insulin was estimated by kits adapted to Lisa Scan. Observation: Compared to controls the Irritable bowel syndrome patients had significantly higher Body mass index (20.9± 5.6 vs 30.1±0.22), Waist-hip ratio (0.9 ± 0.11 vs 1.02 ± 0.06), lipid profile, hepatic marker enzymes and insulin resistance. Conclusion: IBS patients were obese, and exhibited dyslipidemia, insulin resistance, elevated hepatic enzymes suggesting development of NAFLD.
Grape Seed Extract : A potential Cancer suppressing agent sudharani028
Natural Polyphenol "Resveratrol" present predominantly in the grape seed plays an very important role in the treatment of devastating disorder Cancer (diseases involving abnormal and uncontrolled growth of cell with the potential to spread to other parts of the body)
Semaglutide brings breakthroughs in weight management for type 2 diabetes bio...DoriaFang
On March 2, "The Lancet" published an important study of semaglutide in patients with type 2 diabetes. In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients. At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
Pharmacodynamic study of Jerusalem artichoke particles in type I and II diabe...Premier Publishers
To study the therapeutic effect of Jerusalem artichoke particles in type I and type II diabetic rats. Male Sprague–Dawley (SD) rats were intraperitoneally injected with 30 mg/kg streptozotocin (STZ) for 3 consecutive days to generate a type I diabetic rat model. The rats were orally administered Jerusalem artichoke particles (50, 100, or 150 mg/kg) once a day for 3 consecutive weeks. Fasting blood glucose levels were determined by ELISA. Male SD rats were fed a high-fat and high-sugar diet then received an intraperitoneal injection of 35 mg/kg STZ to generate a type II diabetic rat model. The rats were treated as mentioned above for 4 consecutive weeks. Fasting blood glucose levels were determined using the glucose oxidase method. Jerusalem artichoke particles significantly reduced blood glucose concentrations in type I and type II diabetic rats. Following 50, 100 and 150 mg/kg Jerusalem artichoke particles treatment for specified weeks, blood glucose concentrations were decreased by 9.7%, 21.69% and 15.48% in type I diabetic rats, respectively; and type II diabetic rats were decreased by 12.07%, 28.57% and 21.80%, respectively. Jerusalem artichoke particles have a hypoglycemic effect in type I and type II diabetic rats.
Transplantation of Autologous Bone Marrow- Derived Stromal Cells in Type 2 Di...CrimsonpublishersITERM
Type 2 Diabetes is a debilitating metabolic disorder which is also the seventh leading cause of death worldwide. Current therapeutic regimes to date have failed to achieve significant long-term glycemic control even with intensive insulin therapy as revealed by deregulated Hb1Ac and C-peptides levels. In the current study, we have evaluated the effect of regenerative cellular therapy for functional recovery from Diabetic pathophysiology. 10 patients with a median age of 51 years were selected for the study and subjected to bone marrow isolation. These samples were processed under sterile conditions for the enrichment of mononuclear cells (BM MNCs) from bone marrow. After strict quality control and characterization of cells, 2 x 106 cells/kg of BM MNCs were infused back into the patient through the anterior pancreaticoduodenal artery. We performed an evaluation of clinical parameters like Body Mass Index, Fasting Plasma Glucose, Fasting Plasma Insulin, HbA1c and C-peptide levels, and followed up the patients for 12 months. Our study showed a reduction in insulin dependency by ≥ 50%.
Alicia Wong1
, Wan Chien Han1
, Elsie Low1
,
Chai Xiang Goh1
,
Siew Li Ng1
,
Lee Kuan Kwan1
Abstract: Diabetes-specific formulas have shown to be effective at improving glucose control with additional
nutritional benefits. Furthermore, diabetes-specific formulas are commonly used for diabetic patients with
insufficient oral intake. However, not much diabetes-specific formulas in the market shows the GI of these
formulas, which is clinically useful on glycemic control in patients with diabetes. The aim of this study was to
assess the GI of a newly developed diabetes-specific formula, Contro eazy NOW. The open labelled, single center
study involved 11 individuals from a pool of 18 healthy subjects. After an overnight fast, volunteers were given
Contro eazy NOW containing 50g of carbohydrate or the reference drink (glucolin) on different occasions in
random order. Postprandial blood glucose levels were measured in finger pricked capillary blood for two hours
after intake of the beverages and positive incremental area under the curve (AUC) was calculated for both Contro
eazy NOW and reference drink. The GI of Contro eazy NOW was determined by dividing AUC (Contro eazy
NOW) by the AUC (reference drink). The results show that the diabetes-specific formula has the GI of 38.4, which
is categorized as low GI. Therefore, Contro eazy NOW with low GI can be the preferred option for nutritional
management of diabetic patients in need of nutritional support.
Keywords: diabetes-specific formula, diabetes, low glycemic index, medical nutrition therapy.
Diabetes mellitus: The Pandemic of 21st Century!RahulGupta2015
Diabetes mellitus is a major global metabolic disorder of 21 st century. This is due to its broad spectrum of associated complications with risks, like cardiac and renal disorders. The rapid growth of diabetes is becoming a major burden upon healthcare facilities in all affected countries. Due to lack of definitive preventative measures of diabetes, we must be aware of this pandemic and follow a disciplined lifestyle to limit it. In this communication, recent advances in diabetes management and current preventative measures have been concluded.
Gut Microbiota: The Missing Link in Obesity Induced Nonalcoholic Liver DiseaseIOSRJPBS
Background and objective: Recent research has elucidated a close association between intestinal microbiota, obesity, insulin resistance and nonalcoholic hepatic injury. Various studies have also indicated an increase in hepatic marker enzymes in obesity. Hence, this study aims to evaluate the association of gut microbiota with obesity, insulin resistance and hepatic marker enzymes. Material and Method: This case-control study was conducted during March 2015 to October 2016 At S.C.B Medical College, Cuttack, Odisha. The study included 186 subjects (86 irritable bowel syndrome patients as per the Rome III criteria and hundred matched controls). Plasma fasting glucose, serum lipid profile, hepatic marker enzymes were analysed by commercial kits adapted to automated clinical chemistry analyser and serum fasting insulin was estimated by kits adapted to Lisa Scan. Observation: Compared to controls the Irritable bowel syndrome patients had significantly higher Body mass index (20.9± 5.6 vs 30.1±0.22), Waist-hip ratio (0.9 ± 0.11 vs 1.02 ± 0.06), lipid profile, hepatic marker enzymes and insulin resistance. Conclusion: IBS patients were obese, and exhibited dyslipidemia, insulin resistance, elevated hepatic enzymes suggesting development of NAFLD.
Grape Seed Extract : A potential Cancer suppressing agent sudharani028
Natural Polyphenol "Resveratrol" present predominantly in the grape seed plays an very important role in the treatment of devastating disorder Cancer (diseases involving abnormal and uncontrolled growth of cell with the potential to spread to other parts of the body)
Semaglutide brings breakthroughs in weight management for type 2 diabetes bio...DoriaFang
On March 2, "The Lancet" published an important study of semaglutide in patients with type 2 diabetes. In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients. At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
Pharmacodynamic study of Jerusalem artichoke particles in type I and II diabe...Premier Publishers
To study the therapeutic effect of Jerusalem artichoke particles in type I and type II diabetic rats. Male Sprague–Dawley (SD) rats were intraperitoneally injected with 30 mg/kg streptozotocin (STZ) for 3 consecutive days to generate a type I diabetic rat model. The rats were orally administered Jerusalem artichoke particles (50, 100, or 150 mg/kg) once a day for 3 consecutive weeks. Fasting blood glucose levels were determined by ELISA. Male SD rats were fed a high-fat and high-sugar diet then received an intraperitoneal injection of 35 mg/kg STZ to generate a type II diabetic rat model. The rats were treated as mentioned above for 4 consecutive weeks. Fasting blood glucose levels were determined using the glucose oxidase method. Jerusalem artichoke particles significantly reduced blood glucose concentrations in type I and type II diabetic rats. Following 50, 100 and 150 mg/kg Jerusalem artichoke particles treatment for specified weeks, blood glucose concentrations were decreased by 9.7%, 21.69% and 15.48% in type I diabetic rats, respectively; and type II diabetic rats were decreased by 12.07%, 28.57% and 21.80%, respectively. Jerusalem artichoke particles have a hypoglycemic effect in type I and type II diabetic rats.
Supervised exercise and diabetes and oxidative stress
Similar to Transglucosidase improves the gut microbiota profile of type 2 diabetes mellitus patients: a randomized double-blind, placebo-controlled study
Transplantation of Autologous Bone Marrow- Derived Stromal Cells in Type 2 Di...CrimsonpublishersITERM
Type 2 Diabetes is a debilitating metabolic disorder which is also the seventh leading cause of death worldwide. Current therapeutic regimes to date have failed to achieve significant long-term glycemic control even with intensive insulin therapy as revealed by deregulated Hb1Ac and C-peptides levels. In the current study, we have evaluated the effect of regenerative cellular therapy for functional recovery from Diabetic pathophysiology. 10 patients with a median age of 51 years were selected for the study and subjected to bone marrow isolation. These samples were processed under sterile conditions for the enrichment of mononuclear cells (BM MNCs) from bone marrow. After strict quality control and characterization of cells, 2 x 106 cells/kg of BM MNCs were infused back into the patient through the anterior pancreaticoduodenal artery. We performed an evaluation of clinical parameters like Body Mass Index, Fasting Plasma Glucose, Fasting Plasma Insulin, HbA1c and C-peptide levels, and followed up the patients for 12 months. Our study showed a reduction in insulin dependency by ≥ 50%.
Alicia Wong1
, Wan Chien Han1
, Elsie Low1
,
Chai Xiang Goh1
,
Siew Li Ng1
,
Lee Kuan Kwan1
Abstract: Diabetes-specific formulas have shown to be effective at improving glucose control with additional
nutritional benefits. Furthermore, diabetes-specific formulas are commonly used for diabetic patients with
insufficient oral intake. However, not much diabetes-specific formulas in the market shows the GI of these
formulas, which is clinically useful on glycemic control in patients with diabetes. The aim of this study was to
assess the GI of a newly developed diabetes-specific formula, Contro eazy NOW. The open labelled, single center
study involved 11 individuals from a pool of 18 healthy subjects. After an overnight fast, volunteers were given
Contro eazy NOW containing 50g of carbohydrate or the reference drink (glucolin) on different occasions in
random order. Postprandial blood glucose levels were measured in finger pricked capillary blood for two hours
after intake of the beverages and positive incremental area under the curve (AUC) was calculated for both Contro
eazy NOW and reference drink. The GI of Contro eazy NOW was determined by dividing AUC (Contro eazy
NOW) by the AUC (reference drink). The results show that the diabetes-specific formula has the GI of 38.4, which
is categorized as low GI. Therefore, Contro eazy NOW with low GI can be the preferred option for nutritional
management of diabetic patients in need of nutritional support.
Keywords: diabetes-specific formula, diabetes, low glycemic index, medical nutrition therapy.
Alicia Wong1
, Wan Chien Han1
, Elsie Low1
,Chai Xiang Goh1
, Siew Li Ng1
,
Lee Kuan Kwan1
1Alpro Academy, Lot 45880, Jalan Techvalley 3/2, Sendayan Techvally, 71950 Bandar Sri Sendayan, Negeri Sembilan,
Malaysia.
Abstract: Glycemic index (GI) describes the blood glucose response after consumption of a carbohydrate
containing test food relative to a carbohydrate containing reference food, typically glucose or white bread. GI was
originally designed for people with diabetes as a guide to food selection, and advice being given to select foods with
a low GI. Nonetheless low GI food should not be limited to diabetes patients but healthy individuals too as more
recent recommendations on the potential of low GI diets to reduce the risk of chronic diseases and to treat other
metabolic syndromes. This study aims to evaluate the GI of 2 oral nutritional supplements, Metabolic Recovery
and Metabolic Relievve in healthy adults. Fasted subjects consumed one of the 2 oral nutritional supplements at
each visit, with a two day wash out period between visits. Every subject received both oral nutritional supplements
and blood glucose at 0, 15, 30, 45, 60, 90 and 120 mins were measured after the consumption of oral nutritional
supplements which all containing 50g carbohydrates per serving. The trapezium method was used to compute the
area under the curve for blood glucose and GI of both oral nutritional supplements were determined with
reference to glucolin. The results show that both oral nutritional supplements has low GI, with Metabolic Recovery
having the GI of 46.7 ± 16.4 and Metabolic Relievve with GI of 45.2 ± 16.4. Therefore, both Metabolic Recovery
and Metabolic Relievve can be the preferred option for nutritional management of diabetic patients and healthy
individuals in need of nutritional support.
Keywords: Oral nutritional supplements, glycemic index, blood sugar level, diabetes, meal replacement.
Estudio científico de la UV demuestra los beneficios de consumir arándanos an...Emisor Digital
La investigación, realizada por las académicas de la Escuela de Nutrición y Dietética de la Universidad de Valparaíso Ximena Palma y Samanta Thomas, junto al doctor Gonzalo Cruz, del Centro de Neurobiología y Fisiopatología Integrativa (CENFI) y académico del Instituto de Fisiología de la UV, apuntó a evaluar el manejo de la glucosa posprandial (después de las comidas) y la capacidad antioxidante de los arándanos frescos.
Search for atoxic cereals: a single blind, cross-over study on the safety of...Enrique Moreno Gonzalez
Cereals of baking quality with absent or reduced toxicity are actively sought as alternative therapy to a gluten-free diet (GFD) for patients with coeliac disease (CD). Triticum monococcum, an ancient wheat, is a potential candidate having no toxicity in in-vitro and exvivo studies. The aim of our study was to investigate on the safety of administration of a single dose of gluten of Tm in patients with CD on GFD.
Rodent Models of Pharmacotherapy and Chronotherapy for Obesity and Cardiometa...InsideScientific
Join Christopher Axelrod and Sander Kooijman, PhD for a discussion on their research into combatting obesity using various new therapies.
Key Topics Include:
Obesity is a chronic disease with limited treatment options that achieve long term weight control
Systemic mitochondrial uncoupling prevents weight gain without altering food intake and improves glucose metabolism independent of body weight
Mitochondrial-targeted drugs such as BAM15 may have clinical utility in the treatment of obesity and related diseases
Mimicked shift work resulted in obesity in male mice and poor blood glucose clearance in female mice
Understanding the circadian regulation of energy metabolism provides an opportunity to maximize the effectiveness of chronotherapy
Rice bran is fabricated from the rice milling enterprise and contains about 10% of the entire weight of rough rice. It is especially composed of aleurone, pericarp, subaleurone layer, and germ. Rice bran is a fertile supply of nutrients, minerals, vital fatty acids, dietary fiber, and different sterols. The quantification of γ-oryzanol in rice bran can be conducted by many methods that require drawing out of rice bran oil (RBO) from the bran, accompanied by way of evaluation of the quantity of γ-oryzanol in the RBO with the aid of high-performance liquid chromatography. RBO is the oil drain out of the outer rigid surface of rice called chaff (rice husk). It is identified for its excessive smoke factor of 232°C (450°F) and soft taste, making it pleasant for excessive-temperature cooking strategies such as blend and deep frying. It is healthy for human expenditure, which is employed in the system of vegetable ghee. Wax was drawn out of RBO and palpanese extract, which is employed for carnauba wax in makeup, confectionery, shoe lotions, and sharpening compounds. It is accepted as a food preparation oil in numerous Asian countries, along with Bangladesh, Japan, India, and China. Regarding the importance of RBO, this overview intends to pay attention at the phytochemistry and therapeutic functions of RBO.
Comparative Evaluation of the Effect of Doxycycline As An Adjunct to Non-Surg...QUESTJOURNAL
Background: The association between diabetes and periodontal disease has long been discussed with conflicting conclusions. Earlier studies demonstrating the relationship between diabetes and severity of periodontal disease has been equivocal. However, recent studies have clearly proven that diabetes increases the risk of periodontal disease progression. Less clear is the impact of periodontal disease on diabetes. It has been hypothesised that periodontal therapy may improve the metabolic control of diabetes. Aim: To determine the effect of doxycycline as an adjunct to non-surgical periodontal therapy in improving the metabolic control of poorly controlled type 2 diabetic subjects with chronic generalized periodontitis. Method: 30 poorly controlled type 2 diabetic subjects with chronic generalized periodontitis and receiving antidiabetic therapy were selected for the study. The subjects were randomly allotted to either of two treatment groups containing 15 subjects each: Group 1 (scaling and root planing(SRP)+ 15 days Doxycycline) or Group 2 (scaling and root planing(SRP). The Glycated haemoglobin (HbA1c) values, Gingival Index(GI), and Probing pocket depth of both the groups were assessed at baseline and after 3 months. Results: Both the treatment groups exhibited reductions in HbA1c, G I and Probing pocket depth compared to baseline over time. The amount of reduction in the glycated haemoglobin and gingival parameters was higher in Group I compared to group 2 after 3 months. Conclusion: Both treatments improved glycemic control in patients with type 2 diabetes; however, the reduction in HbA1c values reached statistical significance only in the group receiving doxycycline as an adjunct to scaling and root planing.
Effect of Piper crocatum Extract Against Weight Loss and Liver Enzyme Levels ...iosrphr_editor
Piper crocatum is one of Indonesian medicinal plant that contain flavonoids, tannins, alkaloids, and saponins. Aims of this study were to evaluate the effect of Piper crocatum aqueous extract against a decrease in body weight (BW) and the activity of enzymes involved in lipid metabolism (AMPK, ACC, FAS) in liver obese rats. This study used four groups of Sprague dawley rat (n = 6), including normal group (N), obese controls (OC), Piper crocatum extract dose 1260 mg/kgBW (PcA), and Piper crocatum extract dose of 1890 mg/kgBW (PcB). Measurement of metabolic liver enzyme levels (AMPK, ACC, FAS) are using ELISA kit (CusabioTM). Results of this study showed that the PcA group produce the highest reduction in body weight (4.52%), and the lowest levels of ACC (9.13 ng/g) and FAS (360.68 ng/g) which was significantly different from obese control group (95% CI). Piper crocatum extract can't activate AMPK. The highest levels in rat liver AMPK is in N group with 8.42 ng/g, but this value is not significantly different from other groups.
Similar to Transglucosidase improves the gut microbiota profile of type 2 diabetes mellitus patients: a randomized double-blind, placebo-controlled study (20)
Incidence of pneumonia and risk factors among patients with head and neck can...Enrique Moreno Gonzalez
This study investigated the incidence and patient- and treatment-related risk factors related to pneumonia acquired during radiotherapy (PNRT) in head and neck cancer (HNC) patients.
Gene expression analysis of a Helicobacter pyloriinfected and high-salt diet-...Enrique Moreno Gonzalez
Helicobacter pylori (H. pylori) infection and excessive salt intake are known as important risk factors for stomach cancer in humans. However, interactions of these two factors with gene expression profiles during gastric carcinogenesis remain unclear. In the present study, we investigated the global gene expression associated with stomach carcinogenesis and prognosis of human gastric cancer using a mouse model.
Acute myeloid leukemia (AML) is a hematopoietic malignancy with a dismal outcome in the majority of cases. A detailed understanding of the genetic alterations and gene expression changes that contribute to its pathogenesis is important to improve prognostication, disease monitoring, and therapy. In this context, leukemia-associated misexpression of microRNAs (miRNAs) has been studied, but no coherent picture has emerged yet, thus warranting further investigations.
Recently, a phase II clinical trial in hepatocellular carcinoma (HCC) has suggested that the combination of sorafenib and 5-fluorouracil (5-FU) is feasible and side effects are manageable. However, preclinical experimental data explaining the interaction mechanism(s) are lacking. Our objective is to investigate the anticancer efficacy and mechanism of combined sorafenib and 5-FU therapy in vitro in HCC cell lines MHCC97H and SMMC-7721.
Differences in microRNA expression during tumor development in the transition...Enrique Moreno Gonzalez
The prostate is divided into three glandular zones, the peripheral zone (PZ), the transition zone (TZ), and the central zone. Most prostate tumors arise in the peripheral zone (70-75%) and in the transition zone (20-25%) while only 10% arise in the central zone. The aim of this study was to investigate if differences in miRNA expression could be a possible explanation for the difference in propensity of tumors in the zones of the prostate.
Multicentric and multifocal versus unifocal breast cancer: differences in the...Enrique Moreno Gonzalez
The aim of this study was to evaluate the expression of the cell adhesion-related glycoproteins MUC-1, β-catenin and E-cadherin in multicentric/multifocal breast cancer in comparison to unifocal disease in order to identify potential differences in the biology of these tumor types.
The life in sight application study (LISA): design of a randomized controlled...Enrique Moreno Gonzalez
It is widely recognized that spiritual care plays an important role in physical and psychosocial well-being of cancer patients, but there is little evidence based research on the effects of spiritual care. We will conduct a randomized controlled trial on spiritual care using a brief structured interview scheme supported by an e-application. The aim is to examine whether an assisted reflection on life events and ultimate life goals can improve quality of life of cancer patients.
Clinical and experimental studies regarding the expression and diagnostic val...Enrique Moreno Gonzalez
Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is a multifunctional Ig-like cell adhesion molecule that has a wide range of biological functions. According to previous reports, serum CEACAM1 is dysregulated in different malignant tumours and associated with tumour progression. However, the serum CEACAM1 expression in nonsmall-cell lung carcinomas (NSCLC) is unclear. The different expression ratio of CEACAM1-S and CEACAM1-L isoform has seldom been investigated in NSCLC. This research is intended to study the serum CEACAM1 and the ratio of CEACAM1-S/L isoforms in NSCLC.
Assessment of preoperative exercise capacity in hepatocellular carcinoma pati...Enrique Moreno Gonzalez
Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma (HCC) patients with chronic liver injury who underwent hepatectomy.
Overexpression of YAP 1 contributes to progressive features and poor prognosi...Enrique Moreno Gonzalez
Yes-associated protein 1 (YAP 1), the nuclear effector of the Hippo pathway, is a key regulator of organ size and a candidate human oncogene in multiple tumors. However, the expression dynamics of YAP 1 in urothelial carcinoma of the bladder (UCB) and its clinical/prognostic significance are unclear.
CXCR7 is induced by hypoxia and mediates glioma cell migration towards SDF-1a...Enrique Moreno Gonzalez
Glioblastomas, the most common and malignant brain tumors of the central nervous system, exhibit high invasive capacity, which hinders effective therapy. Therefore, intense efforts aimed at improved therapeutics are ongoing to delineate the molecular mechanisms governing glioma cell migration and invasion.
Abnormal expression of Pygopus 2 correlates with a malignant phenotype in hum...Enrique Moreno Gonzalez
Pygopus 2 (Pygo2) is a Pygo family member and an important component of the Wnt signaling transcriptional complex. Despite this data, no clinical studies investigating Pygo2 expression in lung cancer have yet been reported.
Differentiation of irradiation and cetuximab induced skin reactions in patien...Enrique Moreno Gonzalez
In order to improve the clinical outcome of patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN) not being capable to receive platinum-based chemoradiation, radiotherapy can be intensified by addition of cetuximab, a monoclonal antibody that blocks the epidermal growth factor receptor (EGFR). The radioimmunotherapy with cetuximab is a feasible treatment option showing a favourable toxicity profile. The most frequent side effect of radiotherapy is radiation dermatitis, the most common side effect of treatment with cetuximab is acneiform rash. Incidence and severity of these frequent, often overlapping and sometimes limiting skin reactions, however, are not well explored. A clinical and molecular differentiation between radiogenic skin reactions and skin reactions caused by cetuximab which may correlate with outcome, have never been described before.
Cholestasis induces reversible accumulation of periplakin in mouse liverEnrique Moreno Gonzalez
Periplakin (PPL) is a rod-shaped cytolinker protein thought to connect cellular adhesion junctional complexes to cytoskeletal filaments. PPL serves as a structural component of the cornified envelope in the skin and interacts with various types of proteins in cultured cells; its level decreases dramatically during tumorigenic progression in human epithelial tissues. Despite these intriguing observations, the physiological roles of PPL, especially in noncutaneous tissues, are still largely unknown. Because we observed a marked fluctuation of PPL expression in mouse liver in association with the bile acid receptor farnesoid X receptor (FXR) and cholestasis, we sought to characterize the role of PPL in the liver and determine its contributions to the etiology and pathogenesis of cholestasis.
Functional p53 is required for rapid restoration of daunorubicin-induced lesi...Enrique Moreno Gonzalez
The tumour suppressor and transcription factor p53 is a major determinant of the therapeutic response to anthracyclines. In healthy tissue, p53 is also considered pivotal for side effects of anthracycline treatment such as lesions in haematopoietic tissues like the spleen. We used a Trp53null mouse to explore the significance of p53 in anthracycline (daunorubicin) induced lesions in the spleen.
Post-diagnosis hemoglobin change associates with overall survival of multiple...Enrique Moreno Gonzalez
Anemia refers to low hemoglobin (Hb) level and is a risk factor of cancer patient survival. The National Comprehensive Cancer Network recently suggested that post-diagnosis Hb change, regardless of baseline Hb level, indicates the potential presence of anemia. However, there is no epidemiological study evaluating whether Hb change has direct prognostic values for cancer patients at the population level.
Cost-effectiveness of MRI for breast cancer screening in BRCA1/2 mutation car...Enrique Moreno Gonzalez
Women with mutations in BRCA1 or BRCA2 are at high risk of developing breast cancer and, in British Columbia, Canada, are offered screening with both magnetic resonance imaging (MRI) and mammography to facilitate early detection. MRI is more sensitive than mammography but is more costly and produces more false positive results. The purpose of this study was to calculate the cost-effectiveness of MRI screening for breast cancer in BRCA1/2 mutation carriers in a Canadian setting.
Impaired mitochondrial beta-oxidation in patients with chronic hepatitis C: r...Enrique Moreno Gonzalez
Hepatic steatosis is often seen in patients with chronic hepatitis C (CH-C). It is still unclear whether these patients have an impaired mitochondrial β-oxidation. In this study we assessed mitochondrial β-oxidation in CH-C patients by investigating ketogenesis during fasting.
Intraepithelial lymphocyte distribution differs between the bulb and the seco...Enrique Moreno Gonzalez
Evaluation of intraepithelial duodenal lymphocytosis (IDL) is important in celiac disease (CD). There is no established cut-off value for increased number of IELs in the bulb. We therefore investigated the relation between IEL counts in the bulb and duodenal specimens in non-celiac subjects.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. Transglucosidase improves the gut microbiota
profile of type 2 diabetes mellitus patients: a
randomized double-blind, placebo-controlled study
Makoto Sasaki1*
*
Corresponding author
Email: msasaki@aichi-med-u.ac.jp
Naotaka Ogasawara1
Email: nogasa@aichi-med-u.ac.jp
Yasushi Funaki1
Email: momomaru@aichi-med-u.ac.jp
Mari Mizuno1
Email: mari@aichi-med-u.ac.jp
Akihito Iida1
Email: iida@aichi-med-u.ac.jp
Chiho Goto2
Email: chiho@nagoya-bunri.ac.jp
Satoshi Koikeda3
Email: skoikeda@amano-enzyme.ne.jp
Kunio Kasugai1
Email: kuku3487@aichi-med-u.ac.jp
Takashi Joh4
Email: tjoh@med.nagoya-cu.ac.jp
1
Department of Gastroenterology, Aichi Medical University School of Medicine,
1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
2
Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya
Bunri University, Nagoya, Japan
3
Department of Frontier Research, Amano Enzyme Inc, Kakamigahara, Japan
4
Department of Gastroenterology and Metabolism, Nagoya City University
Graduate School of Medical Sciences, Nagoya, Japan
3. Abstract
Background
Recently, the relationship between gut microbiota and obesity has been highlighted. The
present randomized, double-blind, placebo-controlled study aimed to evaluate the efficacy of
transglucosidase (TGD) in modulating blood glucose levels and body weight gain in patients
with type 2 diabetes mellitus (T2DM) and to clarify the underlying mechanism by analyzing
the gut microbiota of T2DM patients.
Methods
This study included 60 patients who received placebo or TGD orally (300 or 900 mg/day) for
12 weeks, and blood and fecal samples were collected before and after 12 weeks.
Comparisons of fecal bacterial communities were performed before and after the TGD
treatment and were performed between T2DM patients and 10 healthy individuals, using the
terminal-restriction fragment length polymorphism analysis.
Results
The Clostridium cluster IV and subcluster XIVa components were significantly decreased,
whereas the Lactobacillales and Bifidobacterium populations significantly increased in the
T2DM patients compared with the healthy individuals. By dendrogram analysis, most of the
healthy individuals (6/10) and T2DM patients (45/60) were classified into cluster I, indicating
no significant difference in fecal bacterial communities between the healthy individuals and
the T2DM patients. In the placebo and TGD groups, the bacterial communities were
generally similar before and after the treatment. However, after 12 weeks of TGD therapy,
the Bacteroidetes-to-Firmicutes ratio in the TGD groups significantly increased and was
significantly higher compared with that in the placebo group, indicating that TGD improved
the growth of the fecal bacterial communities in the T2DM patients.
Conclusions
Therefore, TGD treatment decreased blood glucose levels and prevented body weight gain in
the T2DM patients by inducing the production of oligosaccharides in the alimentary tract and
modulating gut microbiota composition.
Trial registration
UMIN-CTR UMIN000010318: https://upload.umin.ac.jp/cgi-open-
bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000012067&lang
uage=E
Keywords
Hemoglobin A1c, Transglucosidase, Type 2 diabetes mellitus, Intestinal microbiota
4. Background
Previously, we introduced a novel strategy using Aspergillus niger transglucosidase (TGD) to
produce oligosaccharides from starch in the digestive tract of humans to decrease
postprandial blood glucose levels in individuals with impaired glucose tolerance and at high
risk of developing type 2 diabetes mellitus (T2DM) [1]. Furthermore, we demonstrated that
TGD administration decreases glycosylated hemoglobin (HbA1c) and insulin levels in T2DM
patients [2]. We suggested that the mechanism underlying the reduction in the total amount of
orally ingested calories is the consequent transformation of digestible substrate to indigestible
fiber in the alimentary tract. Our human microbial genomes encode many metabolic
capacities that we have not fully evolved. There may be evidence to clarify why unabsorbable
carbohydrates improve postprandial hyperglycemia in diabetes patients [3], which is also the
mechanism that explains the effects of TGD. Recently, there is increasing evidence that is
indicative of the relationship between obesity and gut microbiota [4-7]. Comparisons of the
gut microbiota between genetically obese mice and their lean littermates, and between obese
and lean human volunteers revealed that obesity is associated with changes in the relative
abundance of the 2 dominant bacterial divisions, Bacteroidetes and Firmicutes. Colonization
of adult germ-free mice with a distal gut microbial community harvested from conventionally
raised mice produced a dramatic increase in body fat within 10–14 days, despite an
associated decrease in food consumption [4]. These findings have led us to propose that the
gut microbiota of obese individuals may be more efficient at extracting energy from a given
diet than those of lean individuals.
This study aimed to assess the gut microbiota of T2DM patients and healthy individuals by
terminal-restriction fragment length polymorphism (T-RFLP) analysis of fecal samples.
Furthermore, we aimed to clarify the mechanism of the effect of TGD treatment by analyzing
fecal microbiota and comparing fecal microbiota composition before and after TGD
treatment.
Methods
The present study was designed as a randomized, double-blind, placebo-controlled trial and
was conducted in Japan. The ethics review committee of the Nagoya City Graduate
University School of Medical Sciences granted approval of this study, and informed consent
was obtained from all the subjects. TGD (3,000,000 U/g) was purchased from Amano
Enzyme Inc. (Nagoya, Japan). Two types of capsules containing TGD (50 and 150 mg) and a
placebo capsule were prepared. Patients took 2 capsules after every meal for 12 weeks, and
fecal and blood sampling was performed before and at the end of the study. The patient
enrollment criteria and study design used were described previously [1]. Briefly, all the
eligible patients had an established diagnosis of T2DM according to the Japanese Diabetes
Society’s criteria for diabetes mellitus; HbA1c levels of 5.8–7.5% at screening; stable
dosages of medication for at least 1 month; and stable diabetes condition for at least 3 months
(change in HbA1c level by <1.0%). We excluded patients who had a history of gut resection.
Based on our previous in vitro and in vivo experiments [2,8], we used TGD dosages of 300
and 900 mg/day. Using simple randomization technique, the patients were randomized into 3
groups (1:1:1 proportion) according to the treatment received as follows: 100 mg of TGD,
300 mg of TGD, and placebo 3 times a day after the main meal for 12 weeks. The capsules
containing transglucosidase and placebo were prepared by Adaptogen pharmaceutical Co.,
LTD (Tajimi, Japan), and allocation was blinded until the end of study. The statistician
5. generated the randomization list managed by clinical research coordinator. Blood and feces
samplings were performed before and at the end of the study. The primary outcome was the
change in HbA1c level (previously reported ). Patients whose fecal samples were collected
before the treatment in our previous study were included in the evaluation. Important
secondary outcomes included the change in various other metabolic parameters and fecal
microbiota. For comparison, fecal samples were collected from healthy volunteers, who had
no abnormality as determined by medical examination. Fecal microbiota were analyzed using
T-RFLP. To evaluate nutrient intake, a data-based short food frequency questionnaire [9] was
used. The patients received stable dosages of diabetes medication throughout the study. The
sample size calculation was based on a previous study [2,6], and based on alpha of 0.05 with
a power of 80%. Taking into account a drop-out of 10%, a total sample size of 66 patients
will be randomized.
Fecal DNA extraction
The fecal samples were suspended in 4 M guanidinium thiocyanate, 100 mM Tris–HCl (pH
9.0), and 40 mM EDTA after washing 3 times with sterile distilled water and then beaten
with glass beads, using a mini bead beater (BioSpec Products). Thereafter, DNA was
extracted from the bead-treated suspension using benzyl chloride, as described by Zhu et al.
[10]. The DNA extract was then purified using a GFX polymerase chain reaction (PCR)
DNA and Gel Band Purification Kit (Amersham Biosciences). The final concentration of
each DNA sample was adjusted to 10 ng/µL.
T-RFLP analysis
The amplification of the 16SrDNA, digestion of restriction enzymes, size fractionation of T-
RFs, and analysis of T-RFLP data were performed according to the protocol described by
Nagashima et al. [11]. Briefly, polymerase chain reaction (PCR) was performed using the
total fecal DNA (10 ng/µL) and primers of 516f (5′-TGC CAGCAGCCGCGGTA-3′;
Escherichia Coli positions, 516–532) and 1510r (5′-GGTTACCTTGTTACGACTT-3′; E.
coli positions, 1510–1492). The 5′-ends of the forward primers were labeled with 6′-
carboxyfluorescein, which was synthesized by Applied Biosystems (Tokyo, Japan). The
amplified 16S rDNA genes were purified using the GFX PCR DNA and Gel Band
Purification Kit (GE Healthcare Bio-Sciences, Tokyo, Japan) and redissolved in 30 µL of
distilled water. The purified PCR products (2 µL) were digested with 10 U of BslI at 55°C for
3 h. The length of the T-RF was determined using an ABI PRISM 3130 × 1 genetic analyzer
(Applied Biosystems, CA, USA) in GeneScan mode. Standard size markers were used
(MapMarker X-Rhodamine Labeled 50–1000 bp, BioVentures, TN, USA). The fragment
sizes were estimated using the local southern method of the GeneMapper software (Applied
Biosystems, CA, USA). The T-RFs were divided into 30 operational taxonomic units
(OTUs), according to the methods described by Nagashima et al. [11]. The OTUs were
quantified as the percentage values of an individual OTU per total OTU area, expressed as
peak percent area under the curve (%AUC). Cluster analyses were performed using the
software GeneMaths (Applied Maths, Belgium), based on the BslI T-RFLP patterns. The
Pearson similarity coefficient analysis and unweighted pair-group method with arithmetic
means were used to establish the type of dendrogram.
6. Statistical analysis
The patients’ characteristics and nutrient intake profiles were compared between the placebo
and 2 TGD groups, using the chi-square test or 2-way ANOVA and Bonferroni post hoc test.
The relative abundances of specific bacterial groups were reflected through their T-RF peak
areas, and the percentage values were compared between the placebo and 2 TGD groups
using the 2-way ANOVA and Bonferroni post hoc test. A p < 0.05 was considered
statistically significant.
Results
In the previous study, between December 2007 and Marchi 2009, a total of 74 T2DM patients
from our outpatient clinic were recruited and 66 (38 men, 28 women) were randomized into
the following groups: 21, placebo group; 23, TGD300 group to receive 300 mg of TGD a
day; and 22, TGD900 group to receive 900 mg of TGD a day. Six patients did not complete
the study, with 5 discontinuing the treatment and 1 was hospitalized due to another disease
and left the study. In randomized 66 patients, 60 patients (35 men and 25 women, 20; placebo
groups 20; TGD300 group, 20; TGD900 group) whose fecal samples were collected before
the treatment were included in the evaluation before treatment. As 11 patients were lost the
fecal sampling after treatment, 49 patients (16; placebo group, 16; TGD300 group, 17;
TGD900 group) were included in the evaluation after treatment (Figure 1).
Figure 1 Flow diagram of patients included.
The baseline clinical characteristics and biochemical values of the 3 groups had a similar
distribution with regard to age, sex, body mass index (BMI), medical history, and
biochemical data, including HbA1c, fasting blood glucose, and insulin levels. No significant
differences were found between the 3 groups for any of these variables and the nutrient intake
profile (Table 1).
7. Table 1 Patients’ characteristics and nutrient intake profiles
Placebo
(n = 20)
TGD 300 mg/day
(n = 20)
TGD 900 mg/day
(n = 20)
p value
Characteristic
Sex (male/female) 9/11 14/6 12/8 0.272
Age (year) 61.8 ± 8.1 62.4 ± 10.3 62.7 ± 8.3 0.928
Body mass index (kg/m2) 22.8 ± 4.2 25.1 ± 4.8 23.2 ± 3.1 0.187
HbA1c (%) 6.9 ± 0.7 6.7 ± 0.5 6.7 ± 0.4 0.319
Fasting blood glucose
(mg/dL)
141.4 ±
35.3
143.8 ± 20.1 148.8 ± 23.7 0.677
Insulin (mU/mL) 9.2 ± 8.1 13.7 ± 17.5 13.2 ± 21.9 0.651
Nutrients
Energy (Kcal) 1565 ± 320 1768 ± 417 1671 ± 321 0.203
Protein (g) 51.3 ± 11.1 56.9 ± 11.7 52.7 ± 8.4 0.203
Fat (g) 39.8 ± 7.3 45.0 ± 10.3 39.3 ± 8.2 0.069
Cholesterol (mg) 254 ± 80 234 ± 53 235 ± 64 0.548
Ongoing diabetes therapies, n (%)
Insulin injection 3 (15) 2 (10) 6 (30) 0.235
Metoformin 5 (25) 7 (35) 5 (25) 0.720
Insulin secretagogue 13 (65) 12 (60) 9 (45) 0.414
α-Glicosidase inhibitor 8 (40) 10 (50) 10 (50) 0.765
PPAR-γ antagonist 5 (25) 5 (25) 5 (25) 1.000
≥2 diabetes drugs 11 (55) 11 (55) 9 (45) 0.766
Lifestyle modification only 2 (4) 1 (5) 2 (4) 0.804
TGD, transglucosidase; HbA1c, glycolated hemoglobin.
The HbA1c level and BMI before and after the treatment are shown in Figure 2. In the
placebo group, HbA1c levels were increased in 11 patients (69%) after the treatment; levels
were higher but not significant than those in the TGD-treated group (14 [39%]; p = 0.07). In
the placebo group, the BMI had increased in 9 patients (56%) after the treatment; the BMIs
were higher than that in the TGD-treated group (14 [39%]).
Figure 2 The HbA1c levels and BMIs before and after the treatment. Open circle,
placebo; open square, TGD300; open triangle, TGD900.
A total of 10 healthy individuals (7 men and 3 women) were recruited for comparison of their
fecal microbiota with those of the T2DM patients by dendrogram. The %AUC was associated
with the predominance of bacterial species that compose each peak. Significant decreases in
Clostridium cluster IV (OTUs of 168, 369, and 749 bp) and Clostridium subcluster XIVa
components (OTUs of 106, 494, 505, 517, 754, 955, and 990 bp) were observed in the T2DM
patients compared with the healthy individuals. In contrast, the Lactobacillales (OTUs of
332, 520, and 657 bp) and Bifidobacterium populations (OTUs of 124 bp) significantly
increased in the T2DM patients (Figure 3).
8. Figure 3 Gut microbes in the healthy individuals and T2DM patients. Significant
decreases in Clostridium cluster IV and Clostridium subcluster XIVa components were
observed in the T2DM patients compared with the healthy individuals. In contrast, the
Lactobacillales and Bifidobacterium populations significantly increased in the T2DM
patients.
The fecal bacterial communities were analyzed using a dendrogram. Setting the similarity
cutoff at 40% generated 4 major clusters. Most of the healthy individuals (6/10) and T2DM
patients (45/60) were classified into cluster I, indicating no significant difference in fecal
bacterial communities between the healthy individuals and T2DM patients. In the placebo
and TGD groups, the bacterial communities were generally similar before and after the
treatment. These results suggest that bacterial lineages were constant within each individual
(Figure 4).
Figure 4 Dendrogram of the fecal bacteria structure in the T2DM patients and healthy
individuals. T-RFLP patterns by BslI digestions were analyzed using the software
GeneMaths (Applied Maths, Belgium), and the Pearson similarity coefficient analysis and
unweighted pair-group method with arithmetic means were used to establish the type of
dendrogram. Open triangle, healthy volunteers; open square, T2DM patients before the
placebo treatment; closed square, T2DM patients after the placebo treatment; open circle,
T2DM patients before the treatment; closed circle, T2DM patients after the treatment.
To investigate the effects of TGD on fecal bacterial communities, the Bacteroidetes-to-
Firmicutes ratios in the placebo, TGD300, and TGD900 groups were analyzed (Figure 5).
Before the TGD therapy, no significant difference was observed in the Bacteroidetes -to-
Firmicutes ratios between the 3 groups. However, the mean size of the Firmicutes
populations (49.0%) in the T2DM patients was significantly smaller than that in the healthy
patients (58.6%; p < 0.05). After 12 months of TGD therapy, the Bacteroidetes-to-Firmicutes
ratios in both TGD groups significantly increased compared with that before the TGD
treatment and were also significantly higher than that in the placebo group, indicating
improvement of gut microbiota. No significant change in Bacteroidetes-to-Firmicutes ratio
was observed in the placebo group before and after the treatment. In the group with an
increase in Bacteroidetes-to-Firmicutes ratio, 50% (12/24) and 48% (11/23) of the patients
had decreased HbA1c levels and BMIs, respectively, after the TGD treatment; however, in
the group without an increased Bacteroidetes-to-Firmicutes ratio, only 22% (2/9) and 33%
(3/9) of the patients had decreased HbA1c levels and BMIs, respectively, after the TGD
treatment.
Figure 5 Bacteroidetes-to-Firmicutes ratio before and after the TGD treatment in the
T2DM patients. After the TGD therapy, the Bacteroidetes-to-Firmicutes ratio in both TGD
groups significantly increased compared with that before the TGD treatment and was also
significantly higher than that in the placebo group.
No serious adverse events were attributable to TGD administration.
9. Discussion
T2DM is a metabolic disease primarily caused by obesity-linked insulin resistance. Recent
studies have shown a relationship between intestinal microbiota composition and metabolic
diseases such as obesity and diabetes. Two groups of beneficial bacteria, Bacteroidetes and
Firmicutes, are dominant in the human gut. Ley et al. [6] reported that a relative proportion of
Bacteroidetes was decreased in obese people in comparison with lean people and that this
proportion increased with weight loss on a low-energy diet. They also demonstrated that
obese (ob/ob) mice had 50% fewer Bacteroidetes and correspondingly more Firmicutes than
their lean (+/+) siblings [5]. Backhed et al. [4] transplanted gut microbiota from healthy mice
into germ-free recipients, which demonstrated an increase in body fat without any increase in
food consumption, raising the possibility that the microbial community composition in the
gut affects the amount of energy extract from the diet [4]. These results further indicate that
obesity has a microbial component, which might have potential therapeutic implications.
T2DM is a complex disorder influenced by genetic and environmental components. A
genome-wide association study is useful for parsing the underlying genetic contributors to
T2DM, focusing on identifying genetic components in an organism’s genome. Recently, the
risk factors for T2DM was observed to involve other genomes; hence, a metagenome-wide
association study should also be performed to analyze intestinal microbiota content [12].
Larsen et al. [12] indicated that the proportion of Firmicutes was significantly reduced in
T2DM patients. Schwiertz and colleagues [13] also obtained lower Firmicutes-to-
Bacteroidetes ratios in overweight human adults than in lean controls, consistent with our
results that smaller Firmicutes populations were observed in the T2DM patients than in the
healthy patients. Several studies on mice and human models provided evidence, albeit
controversial, that increase in body weight is associated with a large proportion of Firmicutes
and relatively small proportion of Bacteroidetes [4,5,7]. In relation to T2DM, the present
study demonstrated an increase in Bifidobacterium population in the T2DM patients. On the
contrary, Wu et al. [14] observed a decrease in Bifidobacterium population by PCR-
denaturing gradient gel electrophoresis analysis. This discrepancy in results may be due to the
difference in methodology between our study and that of Wu et al.
The results of the present trial suggest that the TGD administration improved the body
weights and blood glucose levels of the T2DM patients, probably owing to the TGD-induced
production of oligosaccharides in the alimentary tract. Dietary fibers of natural and synthetic
origins have gained increasing attention because of their beneficial effects of lowering blood
glucose and lipid levels and protecting against heart disease [15-17]. However, some reports
indicated that dietary fibers have no effect on blood glucose and lipid concentrations [18].
This discrepancy in findings may be due to the reductive effect of oligosaccharide on
postprandial hyperglycemia, which is dependent on the composition of the diet [16]. In the
present study, because all the diabetic patients received nourishment guidance at the
beginning of the treatment, no significant difference in their eating habits was observed,
which was confirmed by the questionnaire survey. Using rat gastrointestinal and gastric
ligation models, we previously demonstrated that TGD can convert carbohydrates to
oligosaccharides [8]. Products such as panose and isomaltooligosaccharide, which are
predominantly utilized by bifidobacteria [19], are indigestible oligosaccharides that reach the
cecum. We have previously proposed that the consumption of TGD can reduce the total
amount of orally ingested calories via the consequent transformation of digestible substrate to
indigestible fiber in the alimentary tract [2]. The reduction in total calorie intake and the
effect of the oligosaccharides generated by TGD can explain the reduction in blood glucose
10. and lipid concentrations observed in this study. Another mechanism to explain the outcome
of this trial may be the improvement in gut microbiota composition, as evident by the
increase in the Bacteroidetes-to-Firmicutes ratio. Our study supports the finding of Ley et al.
that Bacteroidetes abundance was increased according to the decrease in the body weights of
obese individuals by dietary treatment [6].
In summary, we indicated that T2DM in humans is associated with compositional changes in
intestinal microbiota, and TGD treatment improved metabolic condition of T2DM and fecal
microbiota. These evidence suggests that there is the link between metabolic disease and
bacterial population in the gut.
Conclusions
Therefore, based on the results of the present trial, we suggest that the TGD treatment
decreased the blood glucose levels and prevented body weight gain in the T2DM patients by
inducing the production of oligosaccharides in the alimentary tract and modulating gut
microbiota composition.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
ON, FY, MM, and IA coordinated and performed the collection of all the human materials;
GC analyzed the results of the data-based short food frequency questionnaire survey; KK and
JT edited the manuscript; and SM designed the study and wrote the manuscript. All authors
read and approved the final manuscript.
Acknowledgements
This trial was supported by a Grant-in-Aid for Research from Nagoya City University, a
Grant-in-Aid for Research for Promoting Technology Seeds of Comprehensive Support
Programs for Creation of Regional Innovation from the Japan Science and Technology
Agency, and a Grant-in-Aid for Research from the Japanese Research Foundation for Clinical
Pharmacology.
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13. Figure 1.
Assessed for eligibility (n=74)
Allocated to placebo (n=21)
Received allocated intervention
(n=21)
Enrollment
Randomized (n = 66)
Excluded (n=8)
• Not meeting inclusion criteria (n=0)
• Declined to participate (n=8)
Allocated to TGD 300 mg/d (n=23)
Received allocated intervention
(n=23)
Allocated to TGD 900 mg/d (n=22)
Received allocated intervention
(n=22)
AllocationFollow-UpAnalysis
Lost to follow-up(n=1)
• Stopped medication (n=1)
Analyzed before treatment (n=20)
• Excluded from analysis (n=0)
Analyzed after treatment (n=16)
• Lost the fecal sampling after
treatment (n=4)
Lost to follow-up(n=3)
• Stopped medication (n=2)
• Hospitalization (n=1)
Analyzed before treatment (n=20)
• Excluded from analysis (n=0)
Analyzed after treatment (n=16)
• Lost the fecal sampling after
treatment (n=4)
Analyzed before treatment (n=20)
• Excluded from analysis (n=0)
Analyzed after treatment (n=17)
• Lost the fecal sampling after
treatment (n=3)
Lost to follow-up(n=2)
• Stopped medication(n=2)
Figure 1
14. Figure 2.
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l o s t r i d i u m s u b c l u s t e r X I V a
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Percentage of total sequences (%)
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Clostridium subcluster XIVa
Clostridium cluster XI
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Others
Clostridium cluster IV
Prevotella
Bacteroides
Lactobacillales
Bifidobacterium
Figure 3