2 resultados para PATIENTS PERSPECTIVES

em Biblioteca Digital da Produção Intelectual da Universidade de São Paulo


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Patients with type 2 diabetes mellitus (T2DM) exhibit insulin resistance associated with obesity and inflammatory response, besides an increased level of oxidative DNA damage as a consequence of the hyperglycemic condition and the generation of reactive oxygen species (ROS). In order to provide information on the mechanisms involved in the pathophysiology of T2DM, we analyzed the transcriptional expression patterns exhibited by peripheral blood mononuclear cells (PBMCs) from patients with T2DM compared to non-diabetic subjects, by investigating several biological processes: inflammatory and immune responses, responses to oxidative stress and hypoxia, fatty acid processing, and DNA repair. PBMCs were obtained from 20 T2DM patients and eight non-diabetic subjects. Total RNA was hybridized to Agilent whole human genome 4x44K one-color oligo-microarray. Microarray data were analyzed using the GeneSpring GX 11.0 software (Agilent). We used BRB-ArrayTools software (gene set analysis - GSA) to investigate significant gene sets and the Genomica tool to study a possible influence of clinical features on gene expression profiles. We showed that PBMCs from T2DM patients presented significant changes in gene expression, exhibiting 1320 differentially expressed genes compared to the control group. A great number of genes were involved in biological processes implicated in the pathogenesis of T2DM. Among the genes with high fold-change values, the up-regulated ones were associated with fatty acid metabolism and protection against lipid-induced oxidative stress, while the down-regulated ones were implicated in the suppression of pro-inflammatory cytokines production and DNA repair. Moreover, we identified two significant signaling pathways: adipocytokine, related to insulin resistance; and ceramide, related to oxidative stress and induction of apoptosis. In addition, expression profiles were not influenced by patient features, such as age, gender, obesity, pre/post-menopause age, neuropathy, glycemia, and HbA(1c) percentage. Hence, by studying expression profiles of PBMCs, we provided quantitative and qualitative differences and similarities between T2DM patients and non-diabetic individuals, contributing with new perspectives for a better understanding of the disease. (C) 2012 Elsevier B.V. All rights reserved.

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Neurogenic neuroprotection elicited by deep brain stimulation is emerging as a promising approach for treating patients with ischemic brain lesions. In rats, stimulation of the fastigial nucleus, but not dentate nucleus, has been shown to reduce the volume of focal infarction. Protection of neural tissue is a rapid intervention that has a relatively long-lasting effect, rendering fastigial nucleus stimulation (FNS) a potentially valuable method for clinical application. We review some of the main findings of animal experimental research from a clinical perspective. Results: Although the complete mechanisms of neuroprotection induced by FNS remain unclear, important data has been presented in the last two decades. The acute effect of electrical stimulation of the fastigial nucleus is likely mediated by a prolonged opening of potassium channels, and the sustained effect appears to be linked to inhibition of the apoptotic cascade. A better understanding of the cellular and molecular mechanisms underlying neurogenic neuroprotection by stimulation of deep brain nuclei, with special attention to the fastigial nucleus, can contribute toward improving neurological outcomes in ischemic brain insults.