Ever since its first appearance among the multiple forms of diabetes,latent autoimmune diabetes in adults(LADA),has been the focus of endless discussions concerning mainly its existence as a special type of diabetes.I...Ever since its first appearance among the multiple forms of diabetes,latent autoimmune diabetes in adults(LADA),has been the focus of endless discussions concerning mainly its existence as a special type of diabetes.In this mini-review,through browsing important peer-reviewed publications,(original articles and reviews),we will attempt to refresh our knowledge regarding LADA hoping to enhance our understanding of this controversial diabetes entity.A unique combination of immunological,clinical and metabolic characteristics has been identified in this group of patients,namely persistent islet cell antibodies,high frequency of thyroid and gastric autoimmunity,DR3 and DR4 human leukocyte antigen haplotypes,progressive loss of beta cells,adult disease onset,normal weight,defective glycaemic control,and without tendency to ketoacidosis.Although anthropomorphic measurements are useful as a first line screening,the detection of C-peptide levels and the presence of glutamic acid decarboxylase(GAD)autoantibodies is undoubtedly the sine qua non condi-tion for a confirmatory LADA diagnosis.In point of fact,GAD autoantibodies are far from being solely a biomarker and the specific role of these autoantibodies in disease pathogenesis is still to be thoroughly studied.Nevertheless,the lack of diagnostic criteria and guidelines still puzzle the physicians,who struggle between early diagnosis and correct timing for insulin treatment.展开更多
Tobacco smoking is considered to be one of the main risk factors in the development of chronic pain.Long-term chronic exposure to nicotine and other forms of tobacco have been shown to be associated with an increased ...Tobacco smoking is considered to be one of the main risk factors in the development of chronic pain.Long-term chronic exposure to nicotine and other forms of tobacco have been shown to be associated with an increased incidence of pain.Studies have shown that acupuncture can help smokers to reduce their desire to smoke,reduce their withdrawal symptoms,and avoid a relapse after treatment.However,little has been reported about the effects of acupuncture on pain sensitivity caused by long-term smoking.Models of hyperalgesia were established in rats exposed to nicotine for 6 weeks.After 6 weeks of continuous nicotine exposure,electroacupuncture at bilateral acupoints Zusanli(ST36)and Taichong(LR3)was performed 20 minutes per day for 6 days at a continuous wave with a frequency of 2 Hz and a stimulus intensity of 1 m A.The results revealed that electroacupuncture treatment increased the mechanical response threshold of hind paw of nicotine-dependent rats with hyperalgesia and up-regulated the protein expression of pain-related factorsμ-opioid receptor,β-endorphin and glutamic acid decarboxylase 65 in the spinal cord and midbrain periaqueductal gray and the protein expression of glutamic acid decarboxylase 67 in the spinal cord.These findings suggest that electroacupuncture treatment has positive analgesic effects on pain sensitivity caused by long-term chronic nicotine exposure.One possible mechanism for the improved analgesia is that electroacupuncture increases the expression of painrelated factors in the spinal cord and midbrain periaqueductal gray.This study was approved by Institutional Animal Care and Use Committee(IACUC)of the University of Miami(#18-167)on December 12,2018.展开更多
文摘目的观察视网膜变性过程中γ-氨基丁酸(γ-amino butyric acid,GABA)及合成酶谷氨酸脱羧酶65(glutamicacid decarboxylase 65,GAD65)的表达变化。方法选择出生后15、30、60、90 d的RCS-P+和同年龄的RCS-rdy+-P+大鼠,采用免疫荧光(IF)和免疫印迹法(Western blot)观察两种大鼠出生后15、30、60、90 d GABA和GAD65的表达差异。结果视网膜中GABA和GAD65主要表达于内核层、内从状层和节细胞层。随着天龄的增加,RCS-rdy+-P+大鼠中GABA阳性细胞逐渐减少。RCS-P+变性鼠在出生后15～60 d GABA阳性细胞随天龄增加逐渐减少,在出生后60～90 d(即视网膜变性中晚期)GABA阳性细胞大量增加,GABA表达明显高于RCS-rdy+-P+大鼠(P<0.05)。不同年龄RCS-rdy+-P+大鼠其GAD65表达恒定,发育对GAD65表达无明显影响;与同年龄RCS-rdy+-P+大鼠相比,30 d RCS-P+大鼠GAD65表达略有增加(P<0.05),90 d时大量增加(P<0.01),其表达随病变发展明显升高。结论在视网膜色素变性过程中,GABA、GAD65在视网膜内层的表达均有显著的升高,提示输入剥夺后GABA能无长突细胞未见损伤,其活性甚至略有增高。
文摘Ever since its first appearance among the multiple forms of diabetes,latent autoimmune diabetes in adults(LADA),has been the focus of endless discussions concerning mainly its existence as a special type of diabetes.In this mini-review,through browsing important peer-reviewed publications,(original articles and reviews),we will attempt to refresh our knowledge regarding LADA hoping to enhance our understanding of this controversial diabetes entity.A unique combination of immunological,clinical and metabolic characteristics has been identified in this group of patients,namely persistent islet cell antibodies,high frequency of thyroid and gastric autoimmunity,DR3 and DR4 human leukocyte antigen haplotypes,progressive loss of beta cells,adult disease onset,normal weight,defective glycaemic control,and without tendency to ketoacidosis.Although anthropomorphic measurements are useful as a first line screening,the detection of C-peptide levels and the presence of glutamic acid decarboxylase(GAD)autoantibodies is undoubtedly the sine qua non condi-tion for a confirmatory LADA diagnosis.In point of fact,GAD autoantibodies are far from being solely a biomarker and the specific role of these autoantibodies in disease pathogenesis is still to be thoroughly studied.Nevertheless,the lack of diagnostic criteria and guidelines still puzzle the physicians,who struggle between early diagnosis and correct timing for insulin treatment.
基金supported by a grant from Department of Anesthesiology,Perioperative Medicine and Pain Management,University of Miami Miller School of Medicine,USA。
文摘Tobacco smoking is considered to be one of the main risk factors in the development of chronic pain.Long-term chronic exposure to nicotine and other forms of tobacco have been shown to be associated with an increased incidence of pain.Studies have shown that acupuncture can help smokers to reduce their desire to smoke,reduce their withdrawal symptoms,and avoid a relapse after treatment.However,little has been reported about the effects of acupuncture on pain sensitivity caused by long-term smoking.Models of hyperalgesia were established in rats exposed to nicotine for 6 weeks.After 6 weeks of continuous nicotine exposure,electroacupuncture at bilateral acupoints Zusanli(ST36)and Taichong(LR3)was performed 20 minutes per day for 6 days at a continuous wave with a frequency of 2 Hz and a stimulus intensity of 1 m A.The results revealed that electroacupuncture treatment increased the mechanical response threshold of hind paw of nicotine-dependent rats with hyperalgesia and up-regulated the protein expression of pain-related factorsμ-opioid receptor,β-endorphin and glutamic acid decarboxylase 65 in the spinal cord and midbrain periaqueductal gray and the protein expression of glutamic acid decarboxylase 67 in the spinal cord.These findings suggest that electroacupuncture treatment has positive analgesic effects on pain sensitivity caused by long-term chronic nicotine exposure.One possible mechanism for the improved analgesia is that electroacupuncture increases the expression of painrelated factors in the spinal cord and midbrain periaqueductal gray.This study was approved by Institutional Animal Care and Use Committee(IACUC)of the University of Miami(#18-167)on December 12,2018.
