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Post-transplantation diabetes is better controlled after conversion from prednisone to deflazacort: a prospective trial in renal transplants 总被引:2,自引:0,他引:2
Yu Seun Kim Myoung Soo Kim Soon Il Kim Seung Kil Lim Ho Yung Lee Dae Suk Han Kiil Park 《Transplant international》1997,10(3):197-201
It is well known that long-term use of steroids plays a decisive role in the development of glucose intolerance and diabetes
mellitus (DM). Deflazacort, an oxazoline derivative of prednisolone, has been introduced as a potential substitute for conventional
steroids in order to ameliorate glucose intolerance. We initiated a randomized study of conversion from prednisone to deflazacort
in kidney transplantation (Tx) recipients presenting with pre-Tx or post-Tx DM to ascertain whether or not the switch to deflazacort
would ameliorate the diabetic state. Forty-two recipients in the conversion group were compared with 40 patients on prednisone
(the control group) in a prospective manner. The dose reduction of insulin or oral blood glucose-lowering agents, the adequacy
of glucose control, and the development of side effects were the criteria for evaluating outcome. In the conversion group,
patients were switched to deflazacort at a dose ratio of 6 mg deflazacort to 5 mg prednisone. During the mean follow-up period
of 13.2 months, neither graft dysfunction nor acute rejection developed in the conversion group. Improvement in blood glucose
control in the conversion group was noted. When the conversion group was stratified into pre- or post-Tx DM, promising effects
were clearly evident in the post-Tx DM patients. More than 50 % dose reduction of blood glucose-lowering agents was possible
in 42.3 % of post-Tx DM patients. In conclusion, it was readily possible to control blood glucose better in post-Tx DM recipients
without seriously affecting the immunosuppressive activity after conversion to deflazacort.
Received: 20 August 1996 Received after revision: 25 November 1996 Accepted: 6 December 1996 相似文献
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Susan Yung Heinz Hausser Gareth Thomas Liliana Schaefer Hans Kresse Malcolm Davies 《Peritoneal dialysis international》2004,24(2):147-155
OBJECTIVE: Previous studies have shown that decorin and biglycan account for over 70% of the proteoglycans (PGs) synthesized by human peritoneal mesothelial cells (HPMCs). Since these PGs are involved in the control of cell growth, cell differentiation, and matrix assembly, we investigated their turnover in cultured HPMCs. METHODS: Confluent HPMCs were metabolically labeled with [35S]-sulfate and the labeled products isolated from the cell medium and the cell layer characterized by sensitivity to bacterial eliminases. Experiments were undertaken with exogenous labeled decorin, and its metabolic state was studied. RESULTS: In a 24-hour labeling period, 75% of the newly synthesized chondroitin sulfate/dermatan sulfate (CS/DS) PGs appeared in the culture medium, the majority of which (90%) was decorin. In the cell layer, protein-free glycosaminoglycan (GAG) chains accounted for 21% of the total CS/DS at 24 hours and exhibited constant specific activity at 12-16 hours. The latter material was turned over with a half-life of approximately 2.5 hours. Exogenous decorin underwent receptor-mediated endocytosis and subsequent intracellular degradation. Uptake but not degradation could be inhibited by heparin. CONCLUSIONS: HPMCs are distinguished by a rapid turnover of decorin. A characteristic metabolic feature is the existence of a large intracellular pool of protein-free DS-GAGs. Understanding the control of decorin turnover in HPMCs might lead to delineation of its potential role in both the physiology and pathophysiology of the membrane in PD patients. 相似文献
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Several likely precursors of schizophrenia have been identified. These range from possibly causative features, such as exposure
to perinatal insults, to features that are the effects of an underlying vulnerability, such as abnormal childhood behaviors.
Unfortunately none of these precursors is specific enough to be used in identifying individuals for targeted preventive treatment.
A more useful strategy is to combine risk factors for psychotic disorders in a population seeking help for psychiatric problems.
Thus, individuals who are possibly prodromal are identified. Research into this group has found high rates of onset of psychotic
disorders, particularly schizophrenia, within a short time frame. Preliminary treatment trials suggest that symptoms can be
reduced and psychosis onset possibly delayed or averted. 相似文献
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Membrane attachment activates dnaA protein, the initiation protein of chromosome replication in Escherichia coli. 总被引:15,自引:2,他引:13
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B Y Yung A Kornberg 《Proceedings of the National Academy of Sciences of the United States of America》1988,85(19):7202-7205
ADP and ATP are tightly bound to dnaA protein and are crucial to its function in DNA replication; the exchange of these nucleotides is effected specifically by the acidic phospholipids (cardiolipin and phosphatidylglycerol) present in Escherichia coli membranes [Sekimizu, K. & Kornberg, A. (1988) J. Biol. Chem. 263, 7131-7135]. We now find that phospholipids derived from membranes lacking an unsaturated fatty acid (e.g., oleic acid) are unable to promote the exchange. This observation correlates strikingly with the long-known effect of 3-decynoyl-N-acetylcysteamine, a "suicide analog" that prevents initiation of a cycle of replication in E. coli by inhibiting the synthesis of oleic acid, an inhibition that can be overcome by providing the cells with oleic acid. Profound influences on the specific binding of dnaA protein to phospholipids by temperature, the content of unsaturated fatty acids, and the inclusion of cholesterol can be explained by the need for the phospholipids to be in fluid-phase vesicles. These findings suggest that membrane attachment of dnaA protein is vital for its function in the initiation of chromosome replication in E. coli. 相似文献