诺和锐优化治疗对初诊2型糖尿病患者第一时相胰岛素分泌的影响

目的探讨诺和锐优化治疗对初诊2型糖尿病（他DM）患者第一时相胰岛素分泌缺陷的作用。方法对50例初诊T2DM患者进行每日3次诺和锐＋1次诺和平优化治疗2周,治疗前后分别行静脉葡萄糖耐量实验,测定0．3、4、5、8、10、120分钟血糖、胰岛素及c肽值,计算胰岛素和c肽曲线下面积（AUG）及稳态模型胰岛素抵抗指数（HOMA—IR）。结果患者治疗后血清胰岛素及c肽第一时相分泌明显增加．AUC0～10min均明显升高（P〈O．01）。HOMA—IR指数明显降低（P〈O．01）。结论优化治疗能明显改善初诊T2DM患者C肽的第一时相分泌及胰岛素敏感性。     

Effects on type 2 diabetes complicated with pulmonary tuberculosis: regiment of insulin,isoniazid, rifampicin,pyrazinamide and ethambutol versus the regiment plus Qi-boosting and Yin-nourishing decoction of Traditional Chinese Medicine

OBjECTIVE:To observe the clinical effect on type 2diabetes mellitus(T2DM) complicated with pulmonary tuberculosis(TB) of insulin,isoniazid,rifampicin,pyrazinamide and ethambutol(conventional medication) administered together with Qi-boosting and Yin-nourishing decoction derived from Traditional Chinese Medicine(TCM).METHODS:A total of 60 patients with T2 DM complicated with pulmonary TB were randomly and equally divided into positive control group and treatment group.The control group was treated with Western conventional regiment(WCR):insulin,isoniazid,rifampicin,pyrazinamide,and ethambutol,whereas the treatment group was given both WCR and Qi-boosting and V/n-nourishing decoction prepared from TCM.RESULTS:After the treatment,20(66.7%) and 11(36.7%) cases showed sputum bacteria negative conversion in the WCR plus TCM group and WCM group respectively(P 0.05).A total of 25(83.3%)and 18(60%) cases showed improvement in lung lesion in the WCR plus TCM group and WCM group respectively(P 0.05).Compared with WCR group,fasting plasma glucose and 2-hour postprandial blood glucose levels in the WCR plus TCM group significantly decreased(P 0.05 and P 0.01,respectively).CONCLUSION:Qi-boosting and Yin-nourishing decoction combined with the Western medication showed better curative effect in treating T2 DM complicated with pulmonary TB compared with the group using the conventional Western Medicine alone.     

Extracts from Leonurus sibiricus L. increase insulin secretion and proliferation of rat INS-1E insulinoma cells

Ethnopharmacological relevance

Traditional Mongolian medicine (TMM) uses preparations from herbs as one form of medication for the treatment of a diversity of diseases including diabetes mellitus (DM). We evaluated the effect of extracts from the plant Leonurus sibiricus L. (LS), used in TMM to treat typical symptoms of type 2 DM, on insulin secretion, electrophysiological properties, intracellular calcium concentration and cell proliferation of INS-1E insulinoma cells under standard cell culture conditions (SCC; 11.1 mM glucose).

Materials and methods

Insulin secretion was measured by ELISA, electrical properties were assessed by whole cell patch clamping, intracellular calcium concentration (Ca_i) by Fluo-4 time lapse imaging, insulin receptor expression was verified by RT-PCR and cell proliferation assessed by CellTiter-Glo® cell viability assay.

Results

Insulin released from INS-1E cells into the culture medium over 24 h was significantly increased in presence of 500 mg/L aqueous LS extract (LS OWE) as well as methanolic LS extract (LS MeOH/H2O) but not in the presence of the butanol-soluble extract (LS MeOH/BuOH). Acute application of LS OWE resulted in a depolarization of the cell membrane potential paralleled by an initial increase and subsequent decline and silencing of action potential frequency, by KATP channel inhibition, persisting depolarization and an increase in Ca_i. The electrophysiological effects were comparable to those of 100 μM tolbutamide, which, however failed to elevate insulin secretion under SCC. Furthermore all LS extracts stimulated INS-1E cell proliferation.

Conclusions

The finding that extracts from Leonurus sibiricus L. enhance insulin secretion and/or foster cell proliferation may provide possible explanations for the underlying therapeutic principles in the empirical use of LS-containing formulations in DM and DM-related disorders as applied in TMM.     

Cordyceps militaris extract stimulates Cl(-) secretion across human bronchial epithelia by both Ca(2+)(-) and cAMP-dependent pathways

Ethnopharmacological relevance

The caterpillar fungus Cordyceps militaris (CM; Clavicipitaceae) is a well-known traditional Chinese medicine that can be artificially cultivated on a large scale. We have previously demonstrated that its stimulatory action on ion transport in human airway epithelia is similar to Cordyceps sinensis (Clavicipitaceae), which has been traditionally used to treat respiratory diseases.

Aim of the study

To investigate the signal transduction mechanism(s) underlying CM-induced ion transport activity in cultured human bronchial epithelia.

Materials and methods

16HBE14o-, a human bronchial epithelial cell line, was used to study the regulation of ion transport by the water extract of CM. CM extract was added to the apical or basolateral aspect of the epithelia. In subsequent experiments, different Cl⁻ channel and K⁺ channel blockers, adenylate cyclase and protein kinase A (PKA) inhibitors, and an intracellular Ca²⁺ chelator were used to examine the involvement of apical Cl⁻ and basolateral K⁺ channels in mediating CM-induced Cl⁻ secretion and the underlying signal transduction mechanism(s). PKA activity was also measured in 16HBE14o- cells.

Results

CM stimulated Cl⁻ secretion across 16HBE14o- monolayers in a dose-dependent manner. Cl⁻ secretion could be inhibited by apical application of the cystic fibrosis transmembrane conductance regulator (CFTR) Cl⁻channel blocker and the calcium-activated Cl⁻ channel (CaCC) blocker. Cl⁻ secretion was sensitive to basolateral application of different K⁺ channel blockers. Similar inhibitory patterns were obtained in nystatin-permeabilized epithelia. The CM-induced Cl⁻ secretion could be inhibited by adenylate cyclase and PKA inhibitors as well as an intracellular Ca²⁺ chelator. Data from the PKA assay suggested that CM extract caused a significant increase in PKA activity compared with untreated control epithelia.

Conclusions

These results suggest that CM extract stimulated Cl⁻ secretion across human bronchial epithelia, possibly via apical CFTR and CaCC, and the basolateral K⁺ channels are involved in driving apical Cl⁻ exit. The underlying signal transduction mechanisms involve both cAMP- and Ca²⁺-dependent pathways.