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Yamadera S, Nakamura Y, Inagaki M, Kenmotsu S, Nohara T, Sato N, Oguchi T, Tsuji M, Ohsawa I, Gotoh H, Goto Y, Yura A, Kiuchi Y, Iwai S. Linagliptin inhibits lipopolysaccharide-induced inflammation in human U937 monocytes. Inflamm Regen 2018; 38:13. [PMID: 30151063 PMCID: PMC6100723 DOI: 10.1186/s41232-018-0071-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/08/2018] [Indexed: 12/23/2022] Open
Abstract
Background Atherosclerosis and inflammation are more common in patients with diabetes than in patients without diabetes, and atherosclerosis progression contributes to inflammation. Therefore, anti-inflammatory therapy is important for the prognosis of patients with diabetes. Linagliptin is the only bile-excreted, anti-diabetic oral dipeptidyl peptidase-4 (DPP-4) inhibitor. Although the anti-inflammatory effects of DPP-4 inhibitors in vivo and in vitro have been reported, few in vitro studies have examined the effects of linagliptin using monocytes, which play a central role in arteriosclerosis-related inflammation. Herein, we assessed the anti-inflammatory effects of linagliptin in human U937 monocytes. Methods U937 cells at densities of 1 × 106 cells/mL were cultured in Roswell Park Memorial Institute medium supplied with 10% fetal bovine serum and treated with 100 nM phorbol myristate acetate for 48 h for differentiation into macrophages. The media were replaced, and the cells were pretreated with 1, 5, 10, 50, and 100 nM linagliptin for 1 h or were left untreated. The media were then replaced again, and the cells were treated with 1 μg/mL lipopolysaccharide (LPS) or 10 nM interleukin (IL)-1β only, in combination with 1, 5, 10, 50, and 100 nM linagliptin or were left untreated. The extracted media were used to measure IL-6 and tumor necrosis factor (TNF)-α levels using enzyme-linked immunosorbent assay kits. Results LPS alone significantly increased IL-6 and TNF-α production compared with the control treatment. The treatment of cells with linagliptin at all concentrations significantly inhibited the LPS-stimulated IL-6 and TNF-α production. Meanwhile, IL-1β alone significantly increased IL-6 production compared with the control treatment. No significant difference in IL-6 production was noted between the cells treated with IL-1β and simultaneous treatment with IL-1β and linagliptin. Conclusions Linagliptin inhibited LPS-induced inflammation in human monocytic U937 cells.
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Affiliation(s)
- Shiho Yamadera
- 1Department of Healthcare and Regulatory Sciences, Showa University School of Pharmacy, Shinagawa-ku, Tokyo Japan
| | - Yuya Nakamura
- 2Department of Pharmacology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo Japan.,Saiyu Soka Hospital, Soka City, Saitama-ken Japan
| | - Masahiro Inagaki
- 4Department of Chemistry, College of Arts and Sciences, Showa University, Fujiyoshida City, Yamanashi-ken Japan
| | - Sachiyo Kenmotsu
- 4Department of Chemistry, College of Arts and Sciences, Showa University, Fujiyoshida City, Yamanashi-ken Japan
| | - Tetsuhito Nohara
- 2Department of Pharmacology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo Japan
| | - Naoki Sato
- 2Department of Pharmacology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo Japan
| | - Tatsunori Oguchi
- 2Department of Pharmacology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo Japan
| | - Mayumi Tsuji
- 2Department of Pharmacology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo Japan
| | - Isao Ohsawa
- Saiyu Soka Hospital, Soka City, Saitama-ken Japan
| | | | | | - Akihiko Yura
- 5School of Medicine, Showa University Preventive Medicine center, Koto-ku, Tokyo Japan
| | - Yuji Kiuchi
- 2Department of Pharmacology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo Japan
| | - Shinichi Iwai
- 1Department of Healthcare and Regulatory Sciences, Showa University School of Pharmacy, Shinagawa-ku, Tokyo Japan
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Nakamura Y, Inagaki M, Tsuji M, Gocho T, Handa K, Hasegawa H, Yura A, Kawakami T, Ohsawa I, Goto Y, Gotoh H, Kiuchi Y. Linagliptin Has Wide-Ranging Anti-Inflammatory Points of Action in Human Umbilical Vein Endothelial Cells. JAPANESE CLINICAL MEDICINE 2016; 7:27-32. [PMID: 27980448 PMCID: PMC5140011 DOI: 10.4137/jcm.s39317] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/31/2016] [Accepted: 11/04/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Because of the potential anti-inflammatory effects, linagliptin, a therapeutic dipeptidyl peptidase-4 inhibitor, is used as an effective drug for diabetic patients for whom inflammation is a prognosis-related factor. We investigated the anti-inflammatory mechanism of linagliptin using seven markers. METHODS We pretreated human umbilical vein endothelial cells (HUVECs), with linagliptin and lipopolysaccharide (LPS). The cytosolic fractions were evaluated for protein kinase A (PKA), protein kinase B (PKB), protein kinase C (PKC), ratio of reactive oxygen species (ROS) and Cu/Zn superoxide dismutase (SOD), activator protein 1 (AP-1), and adenosine 3′,5′-cyclic monophosphate (cAMP). RESULTS Linagliptin increased the PKA and PKC activities and the cAMP levels in LPS-treated cells. However, it inhibited LPS-induced PKB phosphorylation, ratio of ROS and Cu/Zn SOD, and LPS-stimulated AP-1 nuclear translocation. CONCLUSION We reaffirmed the anti-inflammatory and antioxidant effects of linagliptin. These effects might be related to the three protein kinases. Our findings suggest that linagliptin has a wide range of anti-inflammatory effects.
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Affiliation(s)
- Yuya Nakamura
- Department of Internal Medicine, Saiyu Soka Hospital, Soka City, Saitama-ken, Japan.; Department of Pharmacology, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Masahiro Inagaki
- Department of Chemistry, College of Arts and Sciences, Showa University, Fujiyoshida City, Yamanashi-ken, Japan
| | - Mayumi Tsuji
- Department of Pharmacology, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Toshihiko Gocho
- Department of Pharmacology, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Kazuaki Handa
- Department of Pharmacology, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Hitomi Hasegawa
- Department of Pharmacology, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Akihiko Yura
- Department of Toyosu Clinic Preventive Medicine Center, School of Medicine, Showa University, Koto-ku, Tokyo, Japan
| | - Tomoko Kawakami
- Department of Toyosu Clinic Preventive Medicine Center, School of Medicine, Showa University, Koto-ku, Tokyo, Japan
| | - Isao Ohsawa
- Department of Internal Medicine, Saiyu Soka Hospital, Soka City, Saitama-ken, Japan
| | - Yoshikazu Goto
- Department of Internal Medicine, Saiyu Soka Hospital, Soka City, Saitama-ken, Japan
| | - Hiromichi Gotoh
- Department of Internal Medicine, Saiyu Soka Hospital, Soka City, Saitama-ken, Japan
| | - Yuji Kiuchi
- Department of Pharmacology, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
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Nakamura Y, Hasegawa H, Tsuji M, Oguchi T, Mihara M, Suzuki H, Nishida K, Inoue M, Shimizu T, Ohsawa I, Gotoh H, Goto Y, Inagaki M, Oguchi K. Linagliptin inhibits lipopolysaccharide-stimulated interleukin-6 production, intranuclear p65 expression, and p38 mitogen-activated protein kinase phosphorylation in human umbilical vein endothelial cells. RENAL REPLACEMENT THERAPY 2016. [DOI: 10.1186/s41100-016-0030-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cruz ML, Gleason N, Wang M, Wrenn K, Gonzales R. Transforming the endocrine consult: asynchronous provider consultations. Endocr Pract 2015; 21:514-21. [PMID: 25667365 DOI: 10.4158/ep14297.or] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze the impact of virtual consultations on the spectrum and volume of endocrine consults, access to endocrine care, and downstream healthcare utilization. METHODS A program (eConsults) designed to enable and reimburse asynchronous consultations between primary care physicians (PCPs) and specialists at the University of California, San Francisco, was launched in 2012. All eConsults (n = 158) submitted to endocrinology over the first year were analyzed for clinical focus and use of structured referral templates. PCP compliance with specialist recommendations was measured and stratified by provider type. Impact on endocrine referral volume was calculated using simple linear regression. Changes in wait times to endocrine care were analyzed comparing administrative data from the year of and the year prior to the introduction of eConsults. Downstream endocrine office visits, emergency department visits, and hospitalizations were captured by chart abstraction for all standard endocrine eConsults (n = 113). RESULTS The proportion of endocrine referrals sent as eConsults (15 to 22%) was significantly higher than the combined average for all other participating specialties (7.4%) (P<.001). Overall, 76.0% of endocrinologist recommendations were fully implemented. There was no induced demand in total volume of referrals to endocrinology, and introduction of eConsults significantly improved access to endocrine care (odds ratio, 3.6; 95% confidence interval, 2.7 to 4.9). Rates of downstream healthcare utilization within 6 months of a completed eConsult were low. CONCLUSION Use of virtual consultations in a fee-for-service, academic medical center setting significantly improved access to endocrine care and the quality of referrals. Increasing recognition and reimbursement of nontraditional consultation models will be essential to scaling and disseminating these programs.
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Du Q, Wang YJ, Yang S, Han P. Clinical utility and patient considerations in the use of the sitagliptin-metformin combination in Chinese patients. Patient Prefer Adherence 2015; 9:281-7. [PMID: 25709414 PMCID: PMC4332288 DOI: 10.2147/ppa.s64691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The prevalence of diabetes mellitus (DM) continues to increase each year. However, the efficacy of glucose-lowering therapies remains unsatisfactory. Moreover, the clinical characteristics and manifestations of DM in Chinese patients are different from those in Western patients. Thus, it is imperative to develop an optimal treatment protocol for lowering blood glucose levels in Chinese patients with DM. Sitagliptin has been used in People's Republic of China, and sitagliptin and metformin combination therapy may not alter their individual pharmacokinetics. To date, several clinical trials undertaken to investigate the efficacy of sitagliptin and metformin combination therapy have revealed that it effectively controlled glycated hemoglobin, fasting plasma glucose, and postprandial plasma glucose levels to a greater extent than sitagliptin or metformin alone. In addition, the combined therapy was well tolerated and induced few side effects, which were largely mild. Furthermore, the combined therapy was easy to administer, and the patients receiving this therapy showed good compliance. Therefore, for Chinese patients with type 2 DM, sitagliptin and metformin combination therapy is preferred.
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Affiliation(s)
- Qiang Du
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China
- Correspondence: Qiang Du, Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, People’s Republic of China, Tel +86 138 4206 0676, Email
| | - Yan-Jun Wang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Sheng Yang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Ping Han
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China
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Iabichella ML, Caruso C, Lugli M. The use of an extract of Hypericum perforatum and Azadirachta indica in a neuropathic patient with advanced diabetic foot. BMJ Case Rep 2014; 2014:bcr-2014-205706. [PMID: 25378221 DOI: 10.1136/bcr-2014-205706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The successful use of an extract of Hypericum flowers (Hypericum perforatum) and nimh oil (Azadirachta indica; Hyperoil) in foot wounds with exposed bone in a patient with bilateral advanced diabetic ulcers, has been reported previously. It was hypothesised that this amelioration was linked with the improved glycaemic control and peripheral microvascular circulation. In this case report, the surprisingly successful outcome of another patient using Hyperoil for infection damaged diabetic foot, without prior use of surgical procedure, is described. The patient had no macrovascular pattern impairment. Diabetic foot healing paralleled with controlled local infection and enhanced glycaemic control. The outcome of this patient suggests that the effectiveness of this inexpensive therapy using Hyperoil for diabetic foot is not only linked with the presence of severe microvascular disorder, but also with the appropriate local treatment for ulcer being a must for its recovery.
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Affiliation(s)
- Maria Letizia Iabichella
- Helios Med Onlus, International Health Cooperation, Pozzallo (RG), Italy Cardiovascular Surgery Department, Deep Venous Surgery and Tissue Repair International Centre, Hesperia Hospital, Modena (MO), Italy
| | | | - Marzia Lugli
- Helios Med Onlus, International Health Cooperation, Pozzallo (RG), Italy Cardiovascular Surgery Department, Deep Venous Surgery and Tissue Repair International Centre, Hesperia Hospital, Modena (MO), Italy
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Du Q, Wang YJ, Yang S, Zhao YY, Han P. Liraglutide for the treatment of type 2 diabetes mellitus: a meta-analysis of randomized placebo-controlled trials. Adv Ther 2014; 31:1182-95. [PMID: 25388240 DOI: 10.1007/s12325-014-0164-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Liraglutide has been widely used in the treatment of type 2 diabetes mellitus (T2DM), however, the results of a number of randomized placebo-controlled trials on the effects of liraglutide for the treatment of T2DM have varied. The purpose of this study was to assess the effects of liraglutide versus placebo for the treatment of T2DM. METHODS We searched randomized controlled trials comparing liraglutide and placebo for the treatment of T2DM in the following databases: MEDLINE; EMBASE; Cochrane Library Central Register of Controlled Trials; and Clinical Trials Gov (through August 2014). The standard mean difference (SMD) was calculated for the continuous data and a χ (2) test was used to evaluate heterogeneity. RESULTS Initially, 103 articles were retrieved through the literature search and 11 studies met the requirements for the meta-analysis. The effects of liraglutide on lowering glycosylated hemoglobin, fasting plasma glucose, reducing weight, lowering blood pressure, and the prevalence of adverse events were significantly different from placebo (P < 0.0001, SMD = -0.96, 95% CI = [-1.20, -0.73]; P < 0.0001, SMD = -0.72, 95% CI = [-0.99, -0.45]; P = 0.004, SMD = -0.24, 95% CI = [-0.40, -0.07]; P = 0.021, SMD = -0.15, 95% CI = [-0.27, -0.02], and P = 0.007, respectively). CONCLUSION Liraglutide had greater hypoglycemic, weight-reducing and systolic blood pressure-lowering effects than placebo. However, there were more adverse events in the treatment with liraglutide. It is suggested that additional well-designed, large, studies be conducted to further support the use of liraglutide and provide objective guidance for clinical application of liraglutide.
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Affiliation(s)
- Qiang Du
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, China,
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Du Q, Wu B, Wang YJ, Yang S, Zhao YY, Liang YY. Comparative effects of sitagliptin and metformin in patients with type 2 diabetes mellitus: a meta-analysis. Curr Med Res Opin 2013; 29:1487-94. [PMID: 23927568 DOI: 10.1185/03007995.2013.833090] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sitagliptin has been widely used in the treatment of type 2 diabetes mellitus (T2DM); however, the therapeutic efficacy of sitagliptin remains inconclusive in randomized controlled studies on T2DM in which metformin has served as a control. OBJECTIVES The present meta-analysis aimed to compare the therapeutic efficacy of sitagliptin and metformin in the treatment of T2DM. METHODS We searched the following databases (Medline, Embase, Cochrane databases, Chinese Medical Journal Database, and the Chinese National Knowledge Infrastructure from inception until April 2013), and identified randomized controlled trials (RCTs) involving sitagliptin and metformin for T2DM. Two independent authors determined whether or not these trials met the inclusion criteria. Then, the variance of results from each study was calculated, and I(2) was employed for evaluation of heterogeneity. RESULTS One hundred and twenty-one studies were identified, of which seven were included for further analysis. For T2DM, the therapeutic efficacy of sitagliptin and metformin was comparable in reducing HbA1c (P = 0.148, standard mean difference [SMD] = 0.13, 95% confidence interval [CI] = -0.05, 0.30), decreasing BMI (P = 0.063, SMD = 0.26, 95% CI = -0.01, 0.54), and improving the homeostasis model assessment (HOMA)-β (P = 0.285, SMD = -0.05, 95% CI = -0.15, 0.04), but sitagliptin was inferior to metformin in improving HOMA-IR (P = 0.003, SMD = 0.16, 95% CI = 0.06, 0.27). CONCLUSIONS Sitagliptin is similar to metformin in reducing HbA1c, decreasing body weight, and improving the function of beta cells, but is inferior to metformin in improving insulin sensitivity. More RCTs with large sample sizes are required to provide evidence for the rational application of sitagliptin.
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Affiliation(s)
- Qiang Du
- Department of Endocrinology, Shengjing Hospital of China Medical University , Shenyang , China
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The generation of pancreatic β-cell spheroids in a simulated microgravity culture system. Biomaterials 2013; 34:5785-91. [DOI: 10.1016/j.biomaterials.2013.04.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/03/2013] [Indexed: 01/27/2023]
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Iabichella ML. The use of an extract of Hypericum perforatum and Azadirachta indica in advanced diabetic foot: an unexpected outcome. BMJ Case Rep 2013; 2013:bcr-2012-007299. [PMID: 23413284 DOI: 10.1136/bcr-2012-007299] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This is the first case reporting the results of using an extract of Hypericum flowers (Hypericum perforatum) and neem oil (Azadirachta indica) in foot wounds with exposed bone in a patient with bilateral advanced diabetic ulcers. The effective use of this cheap treatment in patients with diabetic lesions on the feet, if confirmed in a wide controlled study, might allow the caregivers to take care of patients at home.
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