The immunomodulatory effect 1,25 (OH)2 D3 on TLR 2 and TLR4 expression on monocytes of patients with type II diabetes mellitus

Background: Recent studies have shown the immunomodulatory effect of vitamin D3 through down-regulation of Toll-like receptor (TLR) expression in human monocytes. In this study, the effects of vitamin D treatment on TLR2 and TLR4 expression on monocytes derived from type 2 diabetes was investigated.Materials and Methods: To assess the influence of vitamin D3 on expression of TLR2 and TLR4 on monocytes from patients with type II diabetes, peripheral blood sample was taken of 30 patients. Peripheral blood mononuclear cells (PBMCs) were isolated by density gradient centrifuge and then monocytes were isolated from these cells with using the magnetic activated cell sorting (MACS). To investigate the effect of vitamin D3 on the expression of TLR2 and TLR4, monocytes were cultured in the presence of vitamin D3 (10-9 M) for 48 hours. Then the expression of TLR2 and TLR4 was determined by Real-time PCR.Results: We found that vitamin D3 suppresses the mRNA expression of TLR2 and TLR4 in patients with type II diabetes. TLR2 and TLR4 expression in the patients exposed to vitamin D3 were significantly decreased in comparison with patients who were not treated with vitamin D3.Conclusion: It can be concluded that vitamin D3 supplements may be further analyzed as a therapeutic option by reducing TLR2 and TLR4 expression in patients with type II diabetes

Lipid Profile as a Predictive Marker for Organ Dysfunction after Thoracoabdominal Surgery: A Cross-sectional Study

Background: Plasma total cholesterol is considered a negative acute phase reactant. In various pathological conditions, such as trauma, sepsis, burns, and liver dysfunction, as well as post-surgery, serum cholesterol level decreases. This study aimed to investigate the role of lipid profiles in determining the probability of organ dysfunction after surgery.Methods: This cross-sectional study included patients who underwent thoracoabdominal surgery and were admitted to the intensive care unit of Imam Reza Hospital in Tabriz, Iran, between October 2016 and September 2018. During the first two days of admission, blood samples were taken, and serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and albumin were measured. The relation between the changes in these laboratory markers and six organ functions including cardiovascular, respiratory, renal, central nervous system, hepatic, and hematologic, length of stay in the hospital and intensive care unit, mechanical ventilation duration, and vasopressor use were investigated. The independent t test was used to compare continuous variables. The association between different variables and organ dysfunction and mortality was evaluated by using logistic regression.Results: The serum TC increased the risk of mortality (OR=1.09, 95%CI=1.06-1.11, P<0.001), renal dysfunction (OR=1.09, 95%CI=1.06-1.12; P<0.001), liver dysfunction (OR=1.07, 95%CI=1.03-1.10; P<0.001), respiratory dysfunction (OR=1.08, 95%CI=1.05-1.13; P<0.001). Moreover, LDL, HDL, and TG were found to be inversely related to mortality, organ dysfunction, length of stay in the hospital and intensive care unit, mechanical ventilation duration, and vasopressor use. Conclusion: TC could be considered a risk factor for mortality, organ dysfunction, and clinical outcomes. On the other hand, LDL, HDL, and TG played a protective role in the patients’ mortality, organ dysfunction, and clinical outcomes

Effect of Delphinium denudatum Wall. (Jadwar) on Knee Osteoarthritis: A Randomized Double-Blinded Placebo-Controlled Clinical Trial

Background: Osteoarthritis (OA) is the most common disease of joints. The management of OA is challenging due to the efficacy and safety of treatments. In recent decades, traditional herbal medicines have been introduced for treatment of disease. Delphinium denudatum Wall. (Jadwar) is a medicinal herb with a long-lasting usage in traditional Persian medicine for joint diseases. The present study aimed to investigate the effect of Jadwar on pain and symptoms of knee OA. Methods: In this randomized double-blind placebo-controlled trial, 104 patients with knee OA were randomly assigned into two groups of intervention and control. While the intervention group received one Jadwar capsule (500 mg) twice a day for four weeks, the control group received placebo capsules. The primary outcomes, including pain, stiffness, and physical activity were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and the Visual Analogue Scale (VAS) at baseline two and four weeks after the intervention. Results: Ninety-four participants completed the study. Considering the time of interaction, after four weeks, data analysis revealed a significant decrease in the VAS score (37.23±12.58 vs. 57.87±13.21), total WOMAC score (24.83±9.70 vs. 49.17±12.89), WOMAC pain score (7.19±2.90 vs. 12.40±4.46), stiffness (2.06± 0.845 vs. 4.11±1.14), and physical function (15.57±7.25 vs. 32.66±9.78) in the intervention group compared to the control group (P<0.0001 for all outcomes). Additionally, no serious adverse effects were reported. Conclusion: Jadwar can be suggested as a safe medicinal plant for knee OA because it can relieve the pain and symptoms of OA

Sodium Bicarbonate versus Statins to Prevent Contrast-induced Acute Kidney Injury: A Comprehensive Review

Iodinated contrast agents are commonly used in diagnostic radiography techniques along with therapeutic interventions. Contrast-Induced Acute Kidney Injury (CI-AKI) is a significant problem of all angiographic procedures, triggered by the use of Iodinated Contrast Media (ICM). There are conflicting data concerning the prevention and treatment of CI-AKI. Numerous approaches have been studied to prevent CI-AKI, but the therapy of choice remains undetermined. The cornerstones of CI-AKI prevention include low-osmolar ICM and intravenous hydration. The recommended hydration must be achieved by means of an isotonic solution of saline. Statins were tested against AKI due to their anti-inflammatory action and antioxidant effect on endothelial function. Novel approaches are required to investigate the short-term effects of high dosage atorvastatin versus sodium bicarbonate on CI-AKI prevention. The objective of this review is to compare the findings of various studies that had applied different doses of statins, sodium bicarbonate, and other agents for preventing CI-AKI.</jats:p