European journal of clinical investigation
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Eur. J. Clin. Invest. · Aug 2011
Review2011 ESCI Award for Excellence in Basic / Translational Research: innate regulation of adaptive immunity by dendritic cells.
Dendritic cells (DC) play a key role in the initiation of adaptive immunity, and the manipulation and/or targeting of DC has great potential for immune intervention. However, clinical applications are hampered by the fact that we still know relatively little about how DC become 'activated' to stimulate and direct T-cell responses. Over the last decade, much emphasis has been placed on dissecting innate signalling pathways that can trigger DC activation and promote T-cell priming. ⋯ Finally, a distinct pathway involves cell surface and phagosomal recognition of fungi by C-type lectins, which signal via Syk kinase. Notably, some of these pathways are involved not only in direct sensing of pathogens but also in the recognition of self-alterations that might accompany infection, such as induction of cell death. These studies help build a global picture of the receptors and signalling pathways that regulate DC activation and have applications in immunotherapy of cancer and infectious diseases.
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Eur. J. Clin. Invest. · Aug 2011
Remission of diabetic nephropathy in type 2 diabetic Asian population: role of tight glucose and blood pressure control.
Asian has higher prevalence of diabetic nephropathy (DN) and end-stage renal disease when compared to Caucasian. No study to date has evaluated whether multifactorial intervention was associated with remission of microalbuminuria in type 2 diabetic Asian population. We evaluated the effect of tightly controlling multiple factors on the remission of DN in type 2 diabetic Chinese with microalbuminuria. ⋯ The remission of DN could be achieved under multifactorial intervention. Therapeutic focus on remission by tight glycemic and blood pressure control should be considered in Asian population with diabetes and microalbuminuria.
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Eur. J. Clin. Invest. · Aug 2011
Carotid intima media thickness is associated with plasma lipoprotein-associated phospholipase A2 mass in nondiabetic subjects but not in patients with type 2 diabetes.
A recent meta-analysis showed that both plasma lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ) mass and activity independently predict cardiovascular events. Notably, Lp-PLA(2) activity but not mass was found to be a determinant of cardiovascular outcome in type 2 diabetes mellitus. We questioned whether relationships of carotid intima media thickness (IMT), a measure of subclinical atherosclerosis, with Lp-PLA(2) mass differ between diabetic and nondiabetic subjects. ⋯ Plasma Lp-PLA(2) may relate to early stages of atherosclerosis development. In diabetes mellitus, in contrast, the association of IMT with plasma Lp-PLA(2) mass is abolished, which could be partly ascribed to redistribution of Lp-PLA(2) mass from apolipoprotein B-containing lipoproteins towards HDL. These findings raise questions about the usefulness of plasma Lp-PLA(2) mass measurement as a marker of subclinical atherosclerosis in type 2 diabetes mellitus.
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Eur. J. Clin. Invest. · Jul 2011
Oxidative stress and autonomic nervous system functions in restless legs syndrome.
Oxidative stress has been implicated in over 100 disorders in recent years; however, the situation in restless legs syndrome (RLS) has not been studied yet. ⋯ Increased AChE and decreased LOOHs, which were influenced by increased PON1, were considered as indicators of efforts towards the protection of dopaminergic activity in central nervous system in RLS group. Increased ESR, MPV and low HRVi indicate elevated sympathetic activity in RLS group. Elevated sympathetic activity might be beneficial in relieving RLS symptoms, also causing increases in TOS. The evidence we found regarding oxidative stress and autonomic nervous system might be seminal in RLS treatment.
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Eur. J. Clin. Invest. · Jun 2011
Angiotensin blockade in diabetic patients decreases insulin resistance-associated low-grade inflammation.
Insulin-resistant states, such as metabolic syndrome and diabetes mellitus type 2 (DM2), have been associated with chronic low-grade systemic inflammation. Elevated levels of interleukin-6 (IL-6), monocyte chemoattractant protein (MCP-1) and C-reactive protein (hs-CRP), are found in patients with type 2 diabetes with and without complications. Angiotensin II (Ang II), a potent vasopressor, seems to regulate also the expression of the above inflammatory mediators acting as proinflammatory cytokine. In this study, we examined the effects of candesartan, an angiotensin receptror blocker, in the chronic low-grade inflammation observed in DM 2. ⋯ Candesartan could decrease the low-grade inflammation of type 2 DM as shown by the decrease of inflammatory mediators. Thus, angiotensin receptor blockers could be useful for treating patients with DM2 not only for their antihypertensive capacity but also for their anti-inflammatory actions.