糖尿病的药物治疗

目的近年,随着糖尿病发病率的日益上升,抗糖尿病药物越来越受到重视,本文主要介绍国内外治疗糖尿病的药物以及抗糖尿病药物的研究方向。为临床合理用药提供参考。方法参阅国外大量相关文献,进行归纳和总结。结果按作用机制和化学结构治疗糖尿病的药物主要有胰岛素促泌剂、胰岛素增敏剂、α-葡萄糖苷酶抑制剂、胰岛素及胰岛素类似物、二肽基肽酶-Ⅳ(DPP-Ⅳ)抑制剂、其他口服降糖药。在临床使用中,二甲双胍、格列齐特、阿卡波糖应用广泛,居主导地位。在糖尿病的治疗中,常常联合用药。结论糖尿病的发生、发展与酶功能的紊乱密切相关。与糖尿病关系较为密切的酶,包括α-葡萄糖苷酶、醛糖还原酶、一氧化氮合酶、血管紧张素转换酶、肉碱脂酰转移酶Ⅰ和Ⅱ、蛋白激酶C、二肽基肽酶Ⅳ、蛋白酪氨酸激酶、蛋白酪氨酸磷酸酶,这些酶都可能成为糖尿病治疗的靶点,是研发糖尿病治疗药物的新方向。     

罗格列酮对86例2型糖尿病患者骨密度的临床观察

目的观察罗格列酮对2型糖尿病患者骨密度的影响。方法 86例2型糖尿病患者分为两组,对照组(40例,服用二甲双胍或格列本脲)和实验组(46例,加服罗格列酮)。治疗48周后,比较两组骨密度。结果 48周后,实验组患者骨密度低于对照组,差异有统计学意义(P<0.05)。结论罗格列酮可改善2型糖尿病代谢紊乱,但存在降低患者骨密度的风险。考虑到噻唑烷二酮类药物使患者骨折的风险性增加,对于50岁以上的患者,评估其自身骨折风险是十分重要的。如果其本身骨折风险较高,最好采用其他降糖治疗方法。如果确实需要使用噻唑烷二酮类药物进行治疗,则建议同时进行骨质疏松的治疗。     

Synthesis,in‐vitro Microbial and Cytotoxic Studies of New Benzimidazole Derivatives

Several new classes of benzimidazole derivatives were synthesized and evaluated for in‐vitro antimicrobial and cytotoxic activities. The results showed that all synthesized compounds exhibited moderate antimicrobial activity, and compounds 2 , 4 , and 13 displayed cytotoxic activity (as LD₅₀) at the concentration 1×10^–3 M against Artemia salina.     

吡格列酮抑制实验鼠损伤血管的IL-1β和NF-кB表达及内膜增生研究

摘要：目的：观察吡格列酮对非糖尿病血管损伤模型鼠内膜增生反应、血管组织局部核因子kappa B(NF-кB)和外周血单个核细胞白介素-1β（IL-1β）表达的影响。方法：建立实验鼠颈总动脉通气—干燥法损伤模型，观察吡格列酮干预后实验大鼠颈总动脉血管内膜增生情况，并应用原位杂交技术分析NF-кB的表达和用半定量逆转录多聚酶链反应（RT-PCR）的方法检测外周血单个核细胞IL-1βmRNA的表达。结果：两组损伤血管管腔均较对照侧显著狭窄；实验组和安慰组的对照侧血管均几乎未见NF-Kappa B P65mRNA表达，损伤侧血管在手术后1周见NF-Kappa B P65mRNA表达，且实验组与安慰组表达无显著性差异，第2周时两组均较第1周时表达更为显著（P<0.05），且安慰组相对实验组表达增加；吡格列酮干预后，实验组IL-1βmRNA的相对半定量值较安慰剂组差异具有显著性（P<0.05）。结论：1． 通气-干燥法血管损伤后外周血单个核细胞IL-1βmRNA表达及血管局部NF-кB原位表达增加、血管内膜面积增大。2. 外周血单个核细胞IL-1βmRNA和血管壁局部NF-кB表达水平与血管内膜面积存在正相关关系。3. 吡格列酮抑制损伤血管的内膜增生及NF-кB原位表达和外周血单个核细胞IL-1βmRNA的表达，且不依赖其代谢调节作用。     

Binding of acetaldehyde to a glutathione metabolite: mass spectrometric characterization of an acetaldehyde-cysteinylglycine conjugate

BACKGROUND: Ethanol administration decreases hepatic glutathione levels and increases urinary sulfhydryl excretion. Ethanol-induced liver injury is blunted by the administration of glutathione precursors. Acetaldehyde generated in the metabolism of ethanol binds to a number of amino acid residues in proteins and peptides, but it does not react readily with glutathione. Due to the possible role of acetaldehyde in cysteine and glutathione homeostasis, we investigated the reaction of acetaldehyde to cysteinylglycine, the dipeptide generated in vivo in the hydrolysis of glutathione by gamma-glutamyltransferase. METHODS: A conjugate between acetaldehyde and cysteinylglycine was generated under physiologically relevant conditions, both in vitro and in vivo. It was separated by a new reverse-phase high-performance liquid chromatography method and identified by electrospray ionization/ion trap tandem mass spectrometric analysis. RESULTS: The conjugate with a stoichiometry of 1:1 between cysteinylglycine and acetaldehyde is most rapidly generated in vitro and was identified by mass spectroscopy as 2-methyl-thiazolidine-4-carbonyl-glycine. This thiazolidine derivative is stable in vitro and in biological fluids of rats. The conjugate was present in high concentrations in the bile of rats pretreated with ethanol and an inhibitor of aldehyde dehydrogenase. CONCLUSIONS: The sequestering of cysteinylglycine by acetaldehyde occurs rapidly under physiologic conditions. Long-lived sulfur-containing biomolecules that incorporate acetaldehyde might affect cysteine and glutathione homeostasis and may also play a protective role by reducing circulating acetaldehyde levels. The acetaldehyde conjugate or its metabolic products could potentially serve as markers of ethanol consumption.     

The antihepatotoxic activity of dithiocarb as compared with six other thio compounds in mice

In mice, diethyldithiocarbamate (dithiocarb, 100 mg/kg i.p.) completely prevented the increments of serum enzyme activities (GOT, GPT, SDH) induced by oral administration of carbon tetrachloride (0.1 ml/kg), allyl alcohol (0.05 ml/kg), bromobenzene (0.25 ml/kg), and thioacetamide (50 mg/kg). In this respect, cysteine (200 mg/kg i.p.) was active against CCl₄ and bromobenzene, cysteamine (100 mg/kg i.p.) against CCl₄ and allyl alcohol, penicillamine (100 mg/kg i.p.) against allyl alcohol, thiazolidine carbonic acid (100 mg/kg i.p.) against bromobenzene, and thioctic acid (100 mg/kg i.p.) against allyl alcohol and thioacetamide. Dimercaprol (100 mg/kg i.p.) had a weak antidotal effect only against allyl alcohol poisoning. None of the tested antidotes inhibited serum enzyme elevations evoked by dimethyl nitrosamine (100 mg/kg p.o.). These findings prove the antihepatotoxic activity of diethyldithiocarbamate to be superior to that of all other thio compounds under observation.The lowest dose of dithiocarb active against carbon tetrachloride was 25 mg/kg i.p. The dose-response curves for serum-enzyme elevations induced by carbon tetrachloride (0.1–4 ml/kg p.o.) were shifted to the right under the influence of dithiocarb indicating a competitive antagonism. Dithiocarb (100 mg/kg i.p.) depressed the p-hydroxylation of aniline in the 9000 x g liver homogenate supernatant of mice by about 55%. Thus, the antihepatotoxic activity of dithiocarb seems to be the consequence of a decreased oxidase activity.     

Synthesis, structure and structure–activity relationship analysis of 3-tert-butoxycarbonyl-2-arylthiazolidine-4-carboxylic acid derivatives as potential antibacterial agents

Nine 2-arylthiazolidine-4-carboxylic acid derivatives and nine 3-tert-butoxycarbonyl-2-arylthiazolidine-4-carboxylic acid derivatives were synthesized to screen for their antibacterial activities. Compounds 5, 14–18 were first reported. Their chemical structures were clearly determined by ¹H NMR, ¹³C NMR, ESI mass spectra and elemental analyses, coupled with one selected single-crystal structure. All the compounds were assayed for antibacterial activities against two Gram-positive bacterial strains (Bacillus subtilis ATCC 6633 and Staphylococcus aureus ATCC 6538) and two Gram-negative bacterial strains (Escherichia coli ATCC 35218 and Pseudomonas aeruginosa ATCC 13525) by MTT method. Most of the 3-tert-butoxycarbonyl-2-arylthiazolidine-4-carboxylic acid derivatives exhibited better antibacterial activities against the four bacterial strains than relative 2-arylthiazolidine-4-carboxylic acid derivatives. Compound (2RS,4R)-3-(tert-butoxycarbonyl)-2-(5-fluoro-2-hydroxyphenyl)thiazolidine-4-carboxylic acid (14) showed powerful antibacterial activities against P. aeruginosa with IC₅₀ value of 0.195 μg/mL, which was superior to the positive controls Penicillin G and Kanamycin B, respectively. On the basis of the biological results, structure–activity relationships were discussed.     

Hemmung der aeroben Glykolyse von Ascites-Tumor-Zellen durch Thiazolidine desl-Glycerinaldehyds

Summary Thiazolidines formed froml-glyceraldehyde andl-cysteine ord-penieillamine inhibit glycolysis in ascites tumour cells in the presence, but not in the absence of air. The respiration is not inhibited at all.These findings are discussed and compared with those of O. Warburg [20] in regard to the effect of freel-glyceraldehyde on the metabolism of tumour cells.

Wir danken der Fa. Heyl u. Co., Berlin, für die Überlassung vond-Penicillamin zur Herstellung des entsprechenden Thiazolidins.     

含硫亚硝基脲衍生物

本文报道一系列含硫亚硝基脲衍生物的合成、光谱学特征及对小鼠白血病L1210的作用。这些化合物都是CNC-半胱胺的衍生物,包括二硫化合物、2-氯乙基氨甲酸酯衍生物以及与羰基化合物环合而成的2,2-二取代的CNC-四氢噻唑。CNC-半胱胺及其二硫化合物、CNC-胱胺甲酰叠氮均有良好的抗L1210的作用;相应的氨甲酸酯衍生物和四氢噻唑衍生物的作用不明显。值得注意的是,2-甲基-2-乙氧羰甲基-3-CNC-四氢噻唑(15b)是一个例外,它对L1210有显著的抑制作用。