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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Both metabolic and vascular factors have been invoked in the pathogenesis of diabetic neuropathy but their interrelationships are poorly understood. Both aldose reductase inhibitors and vasodilators improve nerve conduction velocity, nerve blood flow, and (Na+, K+)-ATPase activity in the streptozotocin diabetic rat, implying a metabolic-vascular interaction. Nitric oxide may be the 'bridge' linking these divergent hypotheses of diabetic neuropathy. We propose a model for the pathogenesis of neuropathy invoking metabolic defects both at a vascular and neurochemical level. Early after the induction of experimental diabetes, metabolic defects may lead to a decrease in synthesis of nitric oxide in either the vascular endothelium or the sympathetic ganglia leading to decreased nerve blood flow. In addition, nitric oxide may be involved in more distal defects of somatic nerve metabolism which impair the activity of the nerve Na/K-ATPase by a mechanism involving phosphoinositide signaling and diacyl glycerol and may therefore affect nerve conduction velocity independently of ischaemia. Improved understanding of the effects of hyperglycaemia on nitric oxide metabolism, may provide important clues elucidating the mechanisms underlying the pathogenesis of diabetic neuropathy.
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PMID:Nitric oxide as a potential bridge between the metabolic and vascular hypotheses of diabetic neuropathy. 760 Jul 40

1. There is growing evidence that an impairment in the function of nitric oxide synthase may play a role in the vascular complications of diabetes mellitus. The relaxation of resistance arteries from the mesenteric and hindlimb circulations of streptozotocin-induced diabetic rats and age-matched controls were investigated using two endothelium-dependent vasodilators, bradykinin and acetylcholine, and the endothelium-independent vasodilator sodium nitroprusside. The contractile responses to the alpha 1-adrenergic agonist phenylephrine were also studied. 2. Endothelium-dependent relaxation to acetylcholine was impaired in the diabetic rats in arteries from both mesenteric and hindlimb circulations (hindlimb pEC50, 7.93 +/- 0.08 in the control compared with 7.38 +/- 0.10 in the diabetic rat; mesenteric pEC50, 7.47 +/- 0.04 in the control compared with 6.65 +/- 0.06 in the diabetic rat; unpaired t-test P < 0.0001). Bradykinin elicited relaxation in only the mesenteric arteries, and this was not attenuated in the diabetic rats compared with controls. 3. Endothelium-independent relaxation to sodium nitroprusside was similar in the two circulations and was not abnormal in the diabetic rats. There was no significant difference in constrictor responses to phenylephrine between diabetic rats and controls in either the hindlimb or mesenteric arteries, in contrast to an earlier study in which we showed increased sensitivity to noradrenaline. 4. The diabetic rats therefore demonstrated a specific impairment of receptor-mediated endothelium-dependent relaxation to acetylcholine. These results suggest that, in this diabetic model, the ability of the endothelium to relax arteries via nitric oxide may involve a defect of a specific signal transduction pathway, leading to reduced production of nitric oxide.
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PMID:Selective impairment of acetylcholine-mediated endothelium-dependent relaxation in isolated resistance arteries of the streptozotocin-induced diabetic rat. 761 10

This review summarizes the envolving role of L-arginine, the metabolic precursor of nitric oxide (NO), in disease states that produce progressive loss of kidney function. Hypertension and hypertensive nephrosclerosis manifested in the Dahl/Rapp salt-sensitive rat are exquisitely sensitive to oral L-arginine, which can completely prevent hypertension and subsequent renal damage in these rats. L-Arginine also has been shown to decrease glomerular sclerosis in the remnant kidney model and improve renal hemodynamics and function in animal models of diabetes mellitus. Finally, accumulation of inhibitors of NO production occurs in renal failure and may contribute to hypertension in these patients. Understanding the role of L-arginine and the L-arginine:NO pathway in diseases that produce progressive renal failure may provide new approaches to management.
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PMID:L-arginine and arginine analogs in progressive renal failure. 761 93

This review discusses recent experimental findings in prostacyclin, nitric oxide and endothelin research. Prostacyclin formation by endothelial cells in atherosclerosis and diabetes is reviewed and the synthesis of prostacyclin by cyclooxygenase 1 and 2 (COX-1 and COX-2) is discussed. Further work on nitric oxide describes its involvement in septic and haemorrhagic shock and its interactions with the cyclooxygenase pathway. Recent studies in endothelin research include the development of both selective and orally active receptor antagonists, characterization of endothelin converting enzymes and the involvement of endothelin-1 in inflammation and wound repair.
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PMID:Regulatory mechanisms of the vascular endothelium: an update. 762 May 13

Nitric oxide (NO) may be a mediator of beta-cell damage in insulin-dependent diabetes mellitus. beta-Cells express the inducible form of NO synthase (iNOS) and produce large amounts of NO upon exposure to cytokines. iNOS requires the amino acid arginine for NO formation. It has been shown in other cell types that interferon-gamma (IFN gamma) and bacterial lipopolysaccharide induce the enzyme argininosuccinate synthetase (AS), enhancing the capacity of these cells to regenerate arginine from citrulline and maintain NO production in the presence of low arginine concentrations. To characterize the messenger RNA (mRNA) expression of AS in insulin-producing cells, RINm5F cells (RIN cells) were exposed to interleukin-1 beta (IL-1 beta) or to tumor necrosis factor-alpha plus IFN gamma. After 4-6 h, there was a significant and parallel induction of AS and iNOS mRNA. IL-1 beta-induced AS and iNOS mRNA expression was prevented by an inhibitor of the activation factor NF-kappa B pyrrolidine diaminoguanidine, an inhibitor of gene transcription (actinomycin D), and a blocker of protein synthesis (cycloheximide), suggesting coregulation of AS and iNOS by cytokines. RIN cells exposed to IL-1 beta in the presence of citrulline but the absence of arginine had increased AS enzyme activity and produced NO, demonstrating that cytokine-induced AS mRNA expression is accompanied by increased AS activity. Both adult rat islets exposed to IL-1 beta and human pancreatic islets cultured in the presence of IL-1 beta, tumor necrosis factor-alpha, and IFN gamma were able to use citrulline to regenerate arginine and produce NO. Taken as a whole, the present data suggest that regulation of AS activity may play a role in modulation of NO production in both rodent and human insulin-producing cells.
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PMID:Expression of the citrulline-nitric oxide cycle in rodent and human pancreatic beta-cells: induction of argininosuccinate synthetase by cytokines. 762 52

Cytokines, in particular interleukin 1 beta (IL-1 beta), have been implicated in pancreatic beta-cell destruction in insulin-dependent diabetes mellitus. In the rat prolonged exposure in vitro of islets of IL-1 beta leads to nitric oxide formation, impaired glucose metabolism and inhibition of insulin secretion. Interleukin 4 (IL-4) has been shown to be able to modulate nitric oxide formation in other cell systems. In the present study we have investigated the effect of IL-4 alone and in combination with IL-1 beta on islet cells. For this purpose isolated rat pancreatic islets were cultured for 42 h in medium supplemented with 0, 0.1, 1.0 or 10 ng/ml of human IL-4 in the absence or presence of 25 U/ml of IL-1 beta during the last 24 h of culture. IL-4 alone dose-dependently decreased the islet glucose oxidation rate and the glucose-stimulated insulin release. Furthermore, the cytokine potentiated IL-1 beta-induced reduction in the islet DNA content and (pro)insulin biosynthesis rate. The medium nitrite accumulation, as an index of nitric oxide formation, was not influenced by IL-4 (10 ng/ml) alone, whilst IL-1 beta stimulation of medium nitrite was partly reduced by IL-4. Compared to the action exerted by IL-1 beta the inhibitory action of IL-4 on rat islet function was moderate, and the latter action seems to be independent on nitric oxide production.
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PMID:Interleukin 4 impairs rat pancreatic islet function in vitro by an action different to that of interleukin 1. 764 Mar 49

Environmental toxins may be risk factors for some forms of diabetes mellitus and neurodegenerative diseases. The medicinal and food use of seed from the cycad plant (Cycas spp.), which contains the genotoxin cycasin, is a proposed etiological factor for amyotrophic lateral sclerosis/Parkinsonism-dementia complex (ALS/PDC), a prototypical neurodegenerative disease found in the western Pacific. Patients with ALS/PDC have a very high prevalence of glucose intolerance and diabetes mellitus (in the range of 50-80%). We investigated whether the cycad plant toxin cycasin (methylazoxymethanol (MAM) beta-D-glucoside) or the aglycone MAM are toxic in vitro to mouse or human pancreatic islets of Langerhans. Mouse pancreatic islets treated for 6 days with cycasin impaired the beta-cell insulin response to glucose, but this effect was reversible after a further 4 days in culture without the toxin. When mouse islets were exposed for 24 hr to MAM/MAM acetate (MAMOAc; 0.1-1.0 mM), there was a dose-dependent impairment in insulin release and glucose metabolism, and a significant decrease in islet insulin and DNA content. At higher MAM/MAMOAc concentrations (1.0 mM), widespread islet cell destruction was observed. Glucose-induced insulin release remained impaired even after removal of MAM and a further culturing for 4 days without the toxin. MAM damages islets by two possible mechanisms: (a) nitric oxide generation, as judged by increased medium nitrite accumulation; and (b) DNA alkylation, as judged by increased levels of O6-methyldeoxyguanosine in cellular DNA. Incubation of mouse islets with hemin (10 or 100 microM), a nitric oxide scavenger, or nicotinamide (5-20 mM) protected beta-cells from a decrease in glucose oxidation by MAM. In separate studies, a 24 hr treatment of human beta-islet cells with MAMOAc (1.0 mM) produced a significant decrease in both insulin content and release in response to glucose. In conclusion, the present data indicate that cycasin and its aglycone MAM impair both rodent and human beta-cell function which may lead to the death of pancreatic islet cells. These data suggest that a "slow toxin" may be a common aetiological factor for both diabetes mellitus and neurodegenerative disease.
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PMID:Cycad toxin-induced damage of rodent and human pancreatic beta-cells. 764 37

Previous studies from our laboratory showed that diabetes increases platelet aggregation in rats, but only in washed platelets. In the present study, we evaluated platelet aggregation coupled with adenosine triphosphate (ATP) release in normal and diabetic rats using a whole blood electrical aggregometer. Additionally, we investigated the role of endothelium-derived relaxing factor, or nitric oxide, in the platelet reactivity in diabetic rats. Rats were made diabetic using streptozocin, 55 mg/kg. After 1 month the rats were anesthetized, and arterial blood samples were collected directly into sodium citrate solution 3.8%. Platelet counts and mean platelet volumes were determined. Platelet aggregation, disaggregation, and ATP release in response to adenosine diphosphate (ADP), collagen, and arachidonic acid were measured. Platelet aggregation in response to ADP, collagen, and arachidonic acid was not different in diabetic rats when compared with that in controls. However, ATP release in response to ADP was significantly increased in diabetic rats. Platelets from diabetic animals were significantly larger than those of controls. Nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, decreased platelet aggregation in response to ADP in the normal animals, but not in the diabetic animals. However, arginine-induced nitric oxide production decreased platelet aggregation and enhanced the occurrence of disaggregation in platelets from both normal and diabetic rats. From these studies, we conclude that platelet aggregation in diabetic rats is not different using whole blood electrical aggregation, but platelet ATP secretion is significantly enhanced. Additionally, nitric oxide may modulate the platelet aggregation, disaggregation, and ATP secretory response. However, it does not appear to be a major factor in the altered aggregation responses in diabetic rats.
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PMID:The effect of streptozocin-induced diabetes on platelet aggregation as determined by impedance aggregometry and platelet secretion: a possible role for nitric oxide. 766 98

Overproduction of the free radical nitric oxide (NO) has been implicated in the pathogenesis of a variety of inflammatory and immunologically mediated diseases as well as complications of diabetes. In the present study we have demonstrated that aminoguanidine selectively inhibits the cytokine-inducible isoform of NO synthase which appears to be responsible for the excess production of NO linked to these disease states. By using organ, cell, and enzyme-based measurements we have shown that aminoguanidine is equipotent to NG-monomethyl-L-arginine (L-NMA) as an inhibitor of the cytokine-induced isoform of NO synthase but is 10 to 100-fold less potent as an inhibitor of the constitutive isoform. Thus, aminoguanidine may be useful as a selective inhibitor of the inducible NO synthase in the treatment of disease states characterized by the pathological overproduction of NO.
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PMID:Selective inhibition of the inducible nitric oxide synthase by aminoguanidine. 768 10

Nitric oxide (NO) generation may be a final common pathway for beta-cell damage in early insulin-dependent diabetes mellitus. Insulin-producing cells express an inducible form of NO synthase (iNOS), which is similar to that observed in activated macrophages. Induction of iNOS mRNA in these cells depends on protein synthesis. To further characterize the regulation of iNOS induction in insulin-producing cells, RINm5F cells (RIN cells) were exposed for 6 h to human recombinant interleukin-1 beta (rIL-1 beta; 1 ng/ml) alone or in combination with either nicotinamide (10, 20, or 50 mM) or dexamethasone (1 or 5 microM). These agents have been previously shown to prevent activation of iNOS in macrophages, fibroblasts, and hepatocytes. rIL-1 beta induced the expression of iNOS mRNA in RIN cells and a 12- to 13-fold increase in medium nitrite accumulation, the latter indicating NO production. Nicotinamide decreased nitrite production in a dose-dependent way. Thus, 10 mM nicotinamide decreased rIL-1 beta-induced nitrite formation by 30%, 20 mM by 60%, and 50 mM by 90%. The highest concentration of nicotinamide also prevented rIL-1 beta-induced iNOS mRNA, an effect associated with inhibition of total protein biosynthesis. However, 10 or 20 mM nicotinamide did not modify rIL-1 beta-induced iNOS mRNA expression or inhibit protein biosynthesis. Dexamethasone also decreased rIL-1 beta-induced nitrite production without affecting iNOS mRNA expression. As a whole, these data suggest that both nicotinamide and dexamethasone may prevent NO accumulation in insulin-producing cells by posttranscriptional mechanisms. It is also possible that these drugs induce direct inhibition of iNOS enzymatic activity and/or scavenge NO. Higher concentrations of nicotinamide might also inhibit iNOS mRNA expression, possibly by blocking protein biosynthesis.
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PMID:Nicotinamide and dexamethasone inhibit interleukin-1-induced nitric oxide production by RINm5F cells without decreasing messenger ribonucleic acid expression for nitric oxide synthase. 769 79


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