Dyslipidaemia of diabetes and the intestine

Atherosclerosis is the major complication of diabetes and has become a major issue in the provision of medical care.In particular the economic burden is growing at an alarming rate in parallel with the increasing worldwide prevalence of diabetes.The major disturbance of lipid metabolism in diabetes relates to the effect of insulin on fat metabolism.Raised triglycerides being the hallmark of uncontrolled diabetes,i.e.,in the presence of hyperglycaemia.The explosion of type 2 diabetes has generated increasing interest on the aetiology ofatherosclerosis in diabetic patients.The importance of the atherogenic properties of triglyceride rich lipoproteins has only recently been recognised by the majority of diabetologists and cardiologists even though experimental evidence has been strong for many years.In the post-prandial phase 50% of triglyceride rich lipoproteins come from chylomicrons produced in the intestine.Recent evidence has secured the chylomicron as a major player in the atherogenic process.In diabetes chylomicron production is increased through disturbance in cholesterol absorption,in particular Neimann Pick C1-like1 activity is increased as is intestinal synthesis of cholesterol through 3-hydroxy-3-methyl glutaryl co enzyme A reductase.ATP binding cassette proteins G5 and G8 which regulate cholesterol in the intestine is reduced leading to chylomicronaemia.The chylomicron particle itself is atherogenic but the increase in the triglyceride-rich lipoproteins lead to an atherogenic low density lipoprotein and low high density lipoprotein.The various steps in the absorption process and the disturbance in chylomicron synthesis are discussed.

Purifying chylous plasma by precluding triglyceride via carboxylated polyethersulfone microfiltration membrane

Precluding the excessive lipoproteins from plasma rapidly and effectively is highly needed for biomedical detection and reducing plasma product scrap in blood donation stations.The current centrifugation procedure is high-cost and time-consuming.Herein,we fabricated an anionic microfiltration polyethersulfone(PES)membrane modified by interface swelling and implanting of acrylic acid(AA)for screening out large particle lipoprotein chylomicron(CM)and adsorbing cationic very low-density lipoproteins(VLDL).To improve the separation efficiency,a two-stage filtration through carboxylated polyethersulfone microfiltration membranes with the mean pore size of 0.45 and 0.22μm respectively were conducted.Attenuated total reflection Fourier transform infrared technique(ATR-FTIR),water contact angle(WCA),Zeta potential and scanning electron microscope(SEM)were employed to characterize the modified membrane.To test the effectiveness of this membrane,plasma flux and concentration variation of plasma components were examined to study the purification effectiveness.Furthermore,the hemocompatibility of modified membranes was tested to confirm its practicability on bloodcontacting materials.The carboxylated polyethersulfone microfiltration membrane shows its promising potential application to purify chylous plasma.

An update on oral drug delivery via intestinal lymphatic transport

Orally administered drug entities have to survive the harsh gastrointestinal environment,penetrate the enteric epithelia and circumvent hepatic metabolism before reaching the systemic circulation.Whereas the gastrointestinal stability can be well maintained by taking proper measures,hepatic metabolism presents as a formidable barrier to drugs suffering from first-pass metabolism.The pharmaceutical academia and industries are seeking alternative pathways for drug transport to circumvent problems associated with the portal pathway.Intestinal lymphatic transport is emerging as a promising pathway to this end.In this review,we intend to provide an updated overview on the rationale,strategies,factors and applications involved in intestinal lymphatic transport.There are mainly two pathways for peroral lymphatic transportdthe chylomicron and the microfold cell pathways.The underlying mechanisms are being unraveled gradually and nowadays witness increasing research input and applications.