Beitrage zur Kenntnis der hypoglykamischen Wirkung der Gallensaure.

3-Oxy-7-ketocholansaure, Ursodesoxycholsaure und Chenodesoxycholsaure haben alle hypoglykamische Wirkung und zwar ist die erstere dem Wirkungsgrad nach am starksten. Dann folgt die mittlere und schlie&#946;lich die letzte Saure.</p

Uber den Einflu&#946; der Gallensaure auf die Gewebsoxydation und den Kohlehydratstoffwechsel. II.

Unter Anwendung der Thunbergschen Methylenblau-Reduktions-methode wurde folgendes im ganzen festgestellt. 1. Die Dehydrierungsvorgange im Frosch- u. Kaninchenmuskel sowie in der Kaninchenleber werden durch Zusatz von Dehydrocholsaure auch gehemmt, wenn auch ihre Hemmung relativ schwach ist. Weiter hemmt die Dehydrocholsaure die Gewebsoxydation in der Schleimhaut des Verdauungskanals. Diese hemmenden Wirkungen gehen parallel mit der Menge der zugesetzten Dehydrocholsaure. 2. Die Dehydrocholsaure zeigt eine Hemmung auf die Methylenblaureduktion des Muskelbreis des Frosches und des Gewebsextraktes des Kaninchens bei gleichzeitigem Zusatz von Traubenzucker oder Mannose und Dehydrocholsaure in das Rohrchen. Diese Hemmung verlauft mit der Menge der zugesetzten Dehydrocholsaure parallel. 3. Die Dehydrocholsaure hemmt die Fruktose-, Glykogen-, Glyzerinphosphorsaure-, Milchsaure- und Bernsteinsaureoxydation im Muskelbrei des Frosches sowie im Gewebsextrakt des Kaninchens. Dieser hemmende Einflu&#946; hat einen parallelen Verlauf mit der Menge der zugesetzten Dehydrocholsaure ausnahmlos in allen Oxydationsprozessen. 4. Die Desoxycholsaure ubt die starkste Hemmung auf die Gewebsoxydation und Kohlehydratverbrennung durch den Muskel sowie die Leber des Kaninchens aus und dieser folgen die Cholsaure und die Dehydrocholsaure. Die Hemmung durch Dehydrocholsaure ist am schwachsten. Aus den oben erwahnten Daten steht demnach fest, da&#946; die Gallensaure die Atmungsintensitat bzw. die Kohlehydratverbrennung durch ihre direkten Wirkungen herabsetzt. Die Verschiedenheit des Wirkungsgrades der Gallensauren scheint auch in diesen Dehydrasensystemen Shodas Anschauung zu entsprechen.</p

A Case of Lobulated and Pedunculated Duodenal Hyperplastic Polyp Treated with Snare Polypectomy

We report herein the case of a lobulated and pedunculated hyperplastic polyp in the third portion of the duodenum causing anemia and occult blood in stools, which was detected by capsule endoscopy (CE) and treated with snare polypectomy. A 71-year-old man was referred to our hospital because of anemia and occult blood in stools. Three months earlier, he had been admitted to another hospital because of hemorrhage from gastric antral vascular ectasia (GAVE). Despite being treated for GAVE, hemoglobin decreased gradually. Esophagogastroduodenoscopy (EGD) and colonoscopy revealed no source of bleeding. However, CE revealed a polyp at the distal duodenum. Barium meal and EGD revealed a lobulated and pedunculated polyp in the third portion of the duodenum. The polyp was treated with snare polypectomy. Histopathological examination of the polyp revealed hyperplasia. After treatment of the polyp, the anemia improved gradually. To our knowledge, there are only 6 reported cases of a duodenal hyperplastic polyp, including our case. The polyp was pedunculated in only 2 cases and lobulated only in our case. Moreover, our case was diagnosed by CE. When a patient presents with anemia or obscure gastrointestinal bleeding undiagnosed by EGD and colonoscopy, CE is useful for detecting the bleeding lesion

Involvement of Vascular Endothelial Cells in the Anti-atherogenic Effects of Liraglutide in Diabetic Apolipoprotein E-null Mice

Glucagon-like peptide 1 receptor agonists （GLP-1RAs） have been shown to exert anti-atherosclerotic effects via multiple mechanisms on different types of cells. However, it is unclear which of these mechanisms are crucial. We investigated the role of vascular endothelial cells （VECs） in the anti-atherogenic effects of the GLP-1RA liraglutide in a mouse model of atherosclerosis. Streptozotocin-induced diabetic apolipoprotein E-null mice were randomly assigned to treatment with either vehicle （saline） or liraglutide （107nmol/kg/day）, and were subjected to femoral artery wire injury to remove VECs. After 4 weeks, vessel samples were collected for analysis. Streptozotocin-injected mice had fasting plasma glucose levels of ＞300mg/dl and hemoglobin A1c levels of ＞9％, indicating that the injections had induced severe hyperglycemia. However, there were no differences in metabolic characteristics such as levels of hemoglobin A1c, fasting plasma glucose, total cholesterol, and triglycerides between the vehicle and liraglutide groups. Analysis of atherosclerotic plaque formation revealed that liraglutide treatment significantly suppressed plaque formation in the aorta. In addition, liraglutide treatment reduced plaque volume and intra-plaque macrophage accumulation at the aortic sinus. Furthermore, liraglutide treatment suppressed vascular expression of pro-inflammatory cytokines. In uninjured femoral arteries, no plaques were observed; however, severe plaque formation occurred in femoral arteries that had been injured by wire insertion to remove VECs. Unlike in the uninjured aorta, liraglutide treatment did not affect plaque volume or arterial remodeling （intimal and medial thinning, and arterial dilation） in wire-injured femoral arteries. Of the various cells that liraglutide affects, VECs play a central role in liraglutide’s anti-atherogenic effects in diabetic mice

Associations of Glucose and Blood Pressure Variability with Cardiac Diastolic Function in Patients with Type 2 Diabetes Mellitus and Hypertension: A Retrospective Observational Study

We evaluated the effects of glucose metabolism and blood pressure（BP） variability on cardiac diastolic function in patients with type 2 diabetes mellitus（T2DM） and hypertension. A total of 23 inpatients with T2DM underwent ambulatory BP monitoring（ABPM） and echocardiography. BP variability was assessed by measuring the mean BP and the standard deviation（SD） of systolic and diastolic BP over 24 hours, as well as daytime and nighttime ABPM. Cardiac diastolic function was assessed using the echocardiography E/e′ ratio. Participants had a mean age of 69.0±10.6 years, disease duration of 11.0±10.5 years, glycated hemoglobin（HbA1c） of 8.2％±1.3％, and glycated albumin（GA） of 22.0％±4.2％. Univariate analysis showed that the nighttime systolic BP, nighttime SDs of systolic and diastolic BP, urinary albumin, estimated glomerular filtration rate, and GA/HbA1c ratio were all significantly correlated with the E/e′ ratio. Moreover, stepwise multiple regression analysis identified nighttime SD of diastolic BP, urinary albumin, and GA/HbA1c ratio as independent contributors to the E/e′ ratio. In patients with T2DM and hypertension, cardiac diastolic function was associated with nighttime diastolic BP variability and the GA/HbA1c ratio

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target