The relationship between Nrf2/Keap1 system and endoplasmic reticulum stress and inflammatory markers in peripheral blood mononuclear cells of type 2 diabetic subjects

Background: Oxidative stress, endoplasmic reticulum stress (ER stress), and inflammation are the main leading factors in the pathogenesis of type 2 diabetes. Nuclear factor erythroid 2-related factor 2/ Kelch-like ECH-associated protein 1 (Nrf2/Keap1) is the chief regulator of the antioxidant defense system that protects the cells against reactive oxygen species (ROS). ER stress and inflammatory pathways are involved in the suppression or the activation of the Nrf2/Keap1 system. In this study, we aimed to explore the possible relationships of the main factors contributing to oxidative stress, endoplasmic reticulum stress, and inflammation in peripheral blood mononuclear cells (PBMCs) of diabetic patients. Methods: Levels of biological parameters, oxidative stress markers as well as the gene transcription of Nrf2, Keap1, p22phox, Chop1, Grp78, IL-6, and TNF- were analyzed in the PBMCs of 32 type 2 diabetic and 31 non-diabetic subjects. The correlation analysis was performed for the markers of oxidative stress with selected ER stress-related genes and pro-inflammatory cytokines. Results: Fasting blood sugar (

Mesenchymal Stem Cells: Rising Concerns over Their Application in Treatment of Type One Diabetes Mellitus

Type 1 diabetes mellitus (T1DM) is an autoimmune disorder that leads to beta cell destruction and lowered insulin production. In recent years, stem cell therapies have opened up new horizons to treatment of diabetes mellitus. Among all kinds of stem cells, mesenchymal stem cells (MSCs) have been shown to be an interesting therapeutic option based on their immunomodulatory properties and differentiation potentials confirmed in various experimental and clinical trial studies. In this review, we discuss MSCs differential potentials in differentiation into insulin-producing cells (IPCs) from various sources and also have an overview on currently understood mechanisms through which MSCs exhibit their immunomodulatory effects. Other important issues that are provided in this review, due to their importance in the field of cell therapy, are genetic manipulations (as a new biotechnological method), routes of transplantation, combination of MSCs with other cell types, frequency of transplantation, and special considerations regarding diabetic patients’ autologous MSCs transplantation. At the end, utilization of biomaterials either as encapsulation tools or as scaffolds to prevent immune rejection, preparation of tridimensional vascularized microenvironment, and completed or ongoing clinical trials using MSCs are discussed. Despite all unresolved concerns about clinical applications of MSCs, this group of stem cells still remains a promising therapeutic modality for treatment of diabetes

Role of Clinical Laboratory in Diagnosis and Management of Di-abe¬tes Mellitus- Review Article

The aim of the clinical laboratory in endocrine disease diagnosis and management is detecting either the hormones or their downstream reaction metabolites or some other related substances. In the case of hormone measurement almost all the routine methods are based on immunoassay with different labels (radioimmunoassay, enzyme linked immunosorbant assay, chemiluminescence assays …) and different sensitivity and specificity. But their related metabolites can be measured with different methods from simple biochemical to highly sophisticated methods. These tests are used either for diagnosis or monitoring. With respect to diabetes the tests are categorized to biochemical, immunological and genetic. In this paper we will describe the most common tests, but the genetic tests that are not used in routine investigations are out of the scope of this paper.   Keywords: Laboratory, Diagnosis, Diabete

Can Following Paleolithic and Mediterranean Diets Reduce the Risk of Stress, Anxiety, and Depression: A Cross-Sectional Study on Iranian Women

Background. Psychiatric disorders have been a challenge for public health and will bring economic problems to individuals and healthcare systems in the future. One of the important factors that could affect these disorders is diet. Objective. In the current study with a cross-sectional design, we investigated the association of Paleolithic and Mediterranean diets with psychological disorders in a sample of adult women. Methods. Participants were 435 adult women between 20 and 50 years old that refer to healthcare centers in the south of Tehran, Iran. The diet scores were created by the response to a valid and reliable semiquantitative food frequency questionnaire (FFQ), and the psychological profile was determined by response to the Depression, Anxiety, and Stress Scale (DASS-21). The multivariable-adjusted logistic regression was applied to compute the odds ratio (OR) and 95% confidence interval (CI). Results. After adjusted for potential confounders, it is evident that participants in the highest Paleolithic diet tertile had lower odds of depression (OR = 0.21; 95% CI: 0.12, 0.37: P<0.001), anxiety (OR = 0.27; 95% CI: 0.16, 0.45: P<0.001), and stress (OR = 0.19; 95% CI: 0.11, 0.32; P<0.001) in comparison to the lowest tertile. Furthermore, those in the third tertile of the Mediterranean diet score were at lower risk of depression (OR = 0.20; 95% CI: 0.11, 0.36; P<0.001), anxiety (OR = 0.22; 95% CI: 0.13, 0.38; P<0.001), and stress (OR = 0.23; 95% CI: 0.13, 0.39; P<0.001) compared with those in the first tertile. Conclusion. The result of the current study suggests that greater adherence to Paleolithic and Mediterranean dietary patterns may be related with a decreased risk of psychological disorders such as depression, anxiety, and stress

A systematic review and meta-analysis of the association of dietary diversity with undernutrition in school-aged children

Abstract Background Malnutrition in childhood has lasting consequences; its effects not only last a lifetime but are also passed down from generation to generation such as short stature, school-aged children are the most vulnerable section of the population and require special attention, including nutrition. Method We searched Medline through PubMed, Scopus, and Web of Science to identify all observational studies published before Jun 2022. Observational studies with a pediatric population aged 5–18 years that evaluated risk estimate with 95% confidence intervals the relationship between dietary diversity and undernutrition (wasting, stunting, and thinness) were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed. Results This is a first systematic review and meta-analysis with a total of 20 studies were eligible (n = 18 388). Fourteen data evaluated stunting resulting in a pooled effect size estimated odds ratio of 1.43 (95% CI: 1.08–1.89; p = 0.013). Ten data evaluated Thinness resulting in a pooled effect size estimated odds ratio of 1.10 (95% CI: 0.81–1.49; P = 0.542). Two studies were revealed wasting with a odds ratio of 2.18 (95% CI: 1.41–3.36; p-value < 0.001). Conclusion According to the conclusions of this meta-analysis of cross-sectional studies, inadequate dietary diversity increases the risk of undernutrition in growth linear but not in thinness in school-aged children. The findings of this analysis suggest that initiatives that support improvements to the diversity of children’s diets to reduce the risk of undernutrition may be warranted in LMICs

Developing a Clinical Diabetes Guideline in Diabetes Research Network in Iran.

Development of evidence-based clinical guidelines to raising standards of medical care in diabetes is a core element of coping with the global diabetes epidemic. The purpose of this study was to develop a systematic clinical diabetes guideline from the latest scientific evidences and also to localize its recommendations according to regional and cultural needs of our society. Searches were conducted using NICE, SIGN, WDPCP, IDF, JDC, ADA, AACE, ICSI, CDA, AMDA, IDC, NyDoH guidelines which were examined and criticized and scored using Agree method. Guidelines which got higher score in some important areas of Agree scale including: rigor of development, clarity and comprehensiveness of the recommendations and applicability, especially in the climatic conditions of our country were selected. The existing recommendations were extracted by committee members and supporting evidences of each recommendation were determined based on the sources listed in the clinical guideline. Recommendations grading were classified from grade A to D based on the quality of their supporting evidences (BEL1-5). This guideline covered all areas related to diabetes including screening and diagnosis, lifestyle modification and patient education, management, complications and hypoglycemia. Regarding capacities of this guideline and lack of comprehensive and updated guidelines in our country and region, it is suggested that designing a pilot study to implement this Learner-centered guideline and finding its weaknesses can lead to patient care improvement and also propel us towards our goal to design a comprehensive guideline in compliance with regional and national needs in Middle East

Stem Cell Transplantation in Iran: A Systematic Review Article

Background: Stem cell therapy is a new treatment option for different diseases. The aim of this systematic review is assessing the articles that focus on SCT in Iran and evaluate the amount of their success, failure and complication. Methods: Systematic search was conducted for finding English and Persian papers (controlled trials and cohort studies with follow up) published before March 2015. We searched PubMed, ISI, and SCOPUS as the main international electronic data sources, as well as Iranmedex, Irandoc, andSID as the main domestic databases. Quality assessment of clinical trial and cohort study was performed based on the Consolidated Standards of Reporting Trials (CONSORT) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) check lists respectively. Results: The 19 published articles in this systematic review included 2 cohort, 13 clinical trial, 3 open label clinical trial and 1 clinical trial pilot study. The stem cell types for transplantation were Mesenchymal (63.15%), mononuclear (31.6%), and fetal liver cell suspension (5.6%). The most SCT was performed at Tehran (68.42%), Shiraz (15.8%), Kerman & Isfahan hospitals (5.26%). The main diseases were decompensated cirrhosis and myocardial infarction (26.31%), MS (15.78%), DM (10.52%), Burger disease, neuroblastoma, sub-acute spinal cord injury and osteoarthritis (5.26%). Conclusion: The most of cells transplantation are performed successfully in Iran. Cell transplantation may be safely administered to treat patients with disabling disease.   Keywords: Clinical Trial, Cohort, Stem Cell Transplantation, Ira

Inequalities in the prevalence, diagnosis awareness, treatment coverage and effective control of diabetes: a small area estimation analysis in Iran

Abstract Objective This study aims to assess geographic inequalities in the prevalence, awareness of diagnosis, treatment coverage and effective control of diabetes in 429 districts of Iran. Methods A modelling study by the small area estimation method, based on a nationwide cross-sectional survey, Iran STEPwise approach to surveillance (STEPS) 2016, was performed. The modelling estimated the prevalence, awareness of diagnosis, treatment coverage, and effective control of diabetes in all 429 districts of Iran based on data from available districts. The modelling results were provided in different geographical and socio-economic scales to make the comparison possible across the country. Results In 2016, the prevalence of diabetes ranged from 3.2 to 19.8% for women and 2.4 to 19.1% for men. The awareness of diagnosis ranged from 51.9 to 95.7% for women and 35.7 to 100% for men. The rate of treatment coverage ranged from 37.2 to 85.6% for women and 24.4 to 80.5% for men. The rate of effective control ranged from 12.1 to 63.6% for women and 12 to 73% for men. The highest treatment coverage rates belonged to Ardebil for women and Shahr-e-kord for men. The highest effective control rates belonged to Sanandaj for women and Nehbandan for men. Across Iran districts, there were considerable differences between the highest and lowest rates of prevalence, diagnosis awareness, treatment coverage, and effective control of diabetes. The concentration indices of diabetes prevalence, awareness of diagnosis, and treatment coverage were positive and significant for both sexes. Conclusion Findings of this study highlight the existence of inequalities in diagnosis awareness, treatment coverage, and effective control of diabetes in all Iran regions. More suitable population-wide strategies and policies are warranted to handle these inequalities in Iran

Inhibition of Insulin Degrading Enzyme and Insulin Degradation by UV-Killed Lactobacillus acidophilus

Probiotics have beneficial effects on management of type 2 diabetes (T2D). The major hallmarks of T2D are insulin deficiency and insulin resistance which emphasize insulin therapy in onset of disease. Lactobacilli such as Lactobacillus acidophilus (L. acidophilus) have well known properties on prevention of T2D and insulin resistance but not on insulin degradation. Insulin-degrading enzyme (IDE) degrades insulin in the human body. We studied the effects of cell-free supernatant (CFS) and ultraviolet (UV)-killed L. acidophilus (ATCC 314) on IDE activity and insulin degradation in vitro. Cell growth inhibition by CFS and UV-killed L. acidophilus (ATCC 314) was studied and Western blotting and a fluoregenic assay was performed to determine IDE expression and its activity, respectively. Insulin degradation was evaluated by sandwich enzyme-linked immunosorbent assay(ELISA). IDE expression and activity was reduced by CFS and UV-killed L. acidophilus (ATCC 314). Although, decreased enzyme expression and activity was not significant for CFS in contrast to MRL (MRS with same pH as CFS). Also, reduction in IDE activity was not statistically considerable when compared to IDE expression. Insulin degradation was increased by CFS but decreased by UV-killed L. acidophilus (ATCC 314)