Diabetes mellitus type 2 and cancer share many risk factors.The pleiotropic insulin-dependent and insulin-independent effects of metformin might inhibit pathways that are frequently amplified in neoplastic tissue.Part...Diabetes mellitus type 2 and cancer share many risk factors.The pleiotropic insulin-dependent and insulin-independent effects of metformin might inhibit pathways that are frequently amplified in neoplastic tissue.Particularly,modulation of inflammation,metabolism,and cell cycle arrest are potential therapeutic cancer targets utilized by metformin to boost the anti-cancer effects of chemotherapy.Studies in vitro and in vivo models have demonstrated the potential of metformin as a chemo-and radiosensitizer,besides its chemopreventive and direct therapeutic activity in digestive system(DS)tumors.Hence,these aspects have been considered in many cancer clinical trials.Case-control and cohort studies and associated meta-analyses have evaluated DS cancer risk and metformin usage,especially in colorectal cancer,pancreatic cancer,and hepatocellular carcinoma.Most clinical studies have demonstrated the protective role of metformin in the risk for DS cancers and survival rates.On the other hand,the ability of metformin to enhance the actions of chemotherapy for gastric and biliary cancers is yet to be investigated.This article reviews the current findings on the anti-cancer mechanisms of metformin and its apparatus from pre-clinical and ongoing studies in DS malignancies.展开更多
Solid organ transplantation offers life-saving treatment for patients with endorgan dysfunction.Patient survival and quality of life have improved over the past few decades as a result of pharmacological development,e...Solid organ transplantation offers life-saving treatment for patients with endorgan dysfunction.Patient survival and quality of life have improved over the past few decades as a result of pharmacological development,expansion of the donor pool,technological advances and standardization of practices related to transplantation.Still,transplantation is associated with cardiovascular complications,of which post-transplant diabetes mellitus(PTDM)is one of the most important.PTDM increases mortality,which is best documented in patients who have received kidney and heart transplants.PTDM results from traditional risk factors seen in patients with type 2 diabetes mellitus,but also from specific posttransplant risk factors such as metabolic side effects of immunosuppressive drugs,post-transplant viral infections and hypomagnesemia.Oral hypoglycaemic agents are the first choice for the treatment of type 2 diabetes mellitus in non-transplanted patients.However,the evidence on the safety and efficacy of oral hypoglycaemic agents in transplant recipients is limited.The favourable risk/benefit ratio,which is suggested by large-scale and long-term studies on new glucoselowering drug classes such as glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors,makes studies warranted to assess the potential role of these agents in the management of PTDM.展开更多
文摘Diabetes mellitus type 2 and cancer share many risk factors.The pleiotropic insulin-dependent and insulin-independent effects of metformin might inhibit pathways that are frequently amplified in neoplastic tissue.Particularly,modulation of inflammation,metabolism,and cell cycle arrest are potential therapeutic cancer targets utilized by metformin to boost the anti-cancer effects of chemotherapy.Studies in vitro and in vivo models have demonstrated the potential of metformin as a chemo-and radiosensitizer,besides its chemopreventive and direct therapeutic activity in digestive system(DS)tumors.Hence,these aspects have been considered in many cancer clinical trials.Case-control and cohort studies and associated meta-analyses have evaluated DS cancer risk and metformin usage,especially in colorectal cancer,pancreatic cancer,and hepatocellular carcinoma.Most clinical studies have demonstrated the protective role of metformin in the risk for DS cancers and survival rates.On the other hand,the ability of metformin to enhance the actions of chemotherapy for gastric and biliary cancers is yet to be investigated.This article reviews the current findings on the anti-cancer mechanisms of metformin and its apparatus from pre-clinical and ongoing studies in DS malignancies.
文摘Solid organ transplantation offers life-saving treatment for patients with endorgan dysfunction.Patient survival and quality of life have improved over the past few decades as a result of pharmacological development,expansion of the donor pool,technological advances and standardization of practices related to transplantation.Still,transplantation is associated with cardiovascular complications,of which post-transplant diabetes mellitus(PTDM)is one of the most important.PTDM increases mortality,which is best documented in patients who have received kidney and heart transplants.PTDM results from traditional risk factors seen in patients with type 2 diabetes mellitus,but also from specific posttransplant risk factors such as metabolic side effects of immunosuppressive drugs,post-transplant viral infections and hypomagnesemia.Oral hypoglycaemic agents are the first choice for the treatment of type 2 diabetes mellitus in non-transplanted patients.However,the evidence on the safety and efficacy of oral hypoglycaemic agents in transplant recipients is limited.The favourable risk/benefit ratio,which is suggested by large-scale and long-term studies on new glucoselowering drug classes such as glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors,makes studies warranted to assess the potential role of these agents in the management of PTDM.
