Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The renin-angiotensin system (RAS) has been implicated in haemodynamic maladaptations of diabetic kidney. Its effects may be modulated by endogenous substances like noradrenaline. Our aim was to study renal vascular response to angiotensin II and the interaction between intrarenal RAS and noradrenergic system at an early diabetic stage. Seven days after alloxan induction of diabetes, concentration-response curves to noradrenaline and angiotensin were generated in isolated, perfused rat kidneys. Percent changes in renal vascular resistance were considered as contractile responses. Diabetic kidneys showed enhanced noradrenaline sensitivity compared to controls. Enalapril and losartan elicited increments in ED(50) of noradrenaline in diabetics (diabetic, 3.4+/-0.2 nmol; diabetic + enalapril, 5.1+/-0.5 nmol, p<0.01 vs. diabetic; diabetic + losartan, 5.5+/-0.7 nmol, p<0.05 vs. diabetic). Maximum response (MR) and sensitivity to angiotensin were augmented in diabetics compared to controls. Prazosin decreased MR and sensitivity in diabetics (MR: control, 156.4%+/-5.1%; diabetic, 262.2%+/-21.1%, p<0.001 vs. control; diabetic + prazosin, 178.8%+/-11.2%, p<0.01 vs. diabetic). Enalapril, losartan and prazosin did not change control responses. At this diabetic stage, renal vasculature presented increased response to angiotensin, and an interaction between renal RAS and noradrenergic system was evidenced. Vascular response to noradrenaline requires the integrity of intrarenal RAS and the participation of AT(1) receptors; alpha(1)-adrenoceptors contribute to vascular response to angiotensin.
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PMID:Renal vascular responsiveness to angiotensin II at an early stage of diabetes: interaction between intrarenal noradrenergic and renin-angiotensin systems. 1460 69

Recent evidence points to the renin-angiotensin system (RAS) as one of the systems involved in the etiology of micro- and macrovascular disease in diabetic patients. To help elucidate this possibility, the effect of daily treatment with enalapril (25 mg/kg/d) was evaluated in streptozotocin (STZ)-diabetic rats at 2 weeks following the induction of diabetes. Untreated diabetic rats and non-diabetic rats that were age-matched were used for comparison. Vascular studies included the determination of aortic ring responses to norepinephrine (NE), angiotensin II (Ang II) and acetylcholine (Ach). Systolic blood pressure (SBP), cardiac output (CO) indices, plasmatic and vascular angiotensin-converting enzyme (ACE) activity and thickness of the aortic wall were also assessed. Enalapril improved Ach-induced relaxation by increasing the maximal relaxation from 54.3 +/- 4.3% in untreated diabetic rats to 89.8 +/- 6.2% (n=9, p<0.05) and by decreasing the EC50 value from 32.6 +/- 9.9 nmol/l in untreated diabetic animals to 17.9 +/- 5.1 nmol/l (n=8, p<0.05). In addition, enalapril normalized the high responses to NE found in diabetic rats without inducing changes in the EC50 value. A significant reduction in SBP (from 158 +/- 4 mm Hg to 123 +/- 1 mm Hg, p<0.05), combined with an improved CO index (from 40 +/- 2 ml/min x 100 g BW to 50 +/- 1 ml/min x 100 g BW), was observed in the enalapril-treated diabetic group. A significant regression of the media thickness was also observed in the aorta of diabetic rats after treatment. ACE activity in the aorta of diabetic rats, that was doubled compared to controls (p<0.05), decreased after enalapril treatment. These results point to the vascular RAS as one of the key systems in the etiology of vascular alterations at early stages of diabetes. Therefore, ACE inhibitors, as well as other pharmacological approaches targeting the vascular RAS, should be considered in the treatment of diabetic patients from the very early stages of the condition.
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PMID:Enalapril improves vascular and cardiac function in streptozotocin-diabetic rats. 1498 3

Previous studies have shown that the renin-angiotensin system (RAS) is activated in diabetes and this may contribute to the subcellular remodelling and heart dysfunction in this disease. Therefore, we examined the effects of RAS blockade by enalapril, an angiotensin-converting enzyme inhibitor, and losartan, an angiotensin receptor AT1 antagonist, on cardiac function, myofibrillar and myosin ATPase activity as well as myosin heavy chain (MHC) isozyme expression in diabetic hearts. Diabetes was induced in rats by a single injection of streptozotocin (65 mg/kg; i.v.) and these animals were treated with and without enalapril (10 mg/kg/day; oral) or losartan (20 mg/kg/day; oral) for 8 weeks. Enalapril or losartan prevented the depressions in left ventricular rate of pressure development, rate of pressure decay and ventricular weight seen in diabetic animals. Both drugs also attenuated the decrease in myofibrillar Ca2+-ATPase, Mg2+-ATPase and myosin ATPase activity seen in diabetic rats. The diabetes-induced increase in beta-MHC content and gene expression as well as the decrease in alpha-MHC content and mRNA levels were also prevented by enalapril and losartan. These results suggest the occurrence of myofibrillar remodelling in diabetic cardiomyopathy and provide evidence that the beneficial effects of RAS blockade in diabetes may be associated with attenuation of myofibrillar remodelling in the heart.
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PMID:Renin-angiotensin blockade attenuates cardiac myofibrillar remodelling in chronic diabetes. 1536 13

We have investigated the protective effect of YM598, a selective endothelin type A receptor antagonist, against an endothelin-1-induced proliferation of rat mesangial cells and renal function in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, an animal model of type II diabetes. YM598, but not K-8794, a selective endothelin type B receptor antagonist, inhibited the endothelin-1-induced proliferation of cultured mesangial cells derived from intact Wistar rats in a concentration-dependent manner. YM598 (0.1 or 1 mg/kg), enalapril (5 mg/kg), an angiotensin- converting enzyme inhibitor, or vehicle was administered once daily by gastric gavage to 22-week-old male OLETF rats for 32 weeks. YM598 blunted the development of albuminuria in a dose-dependent manner. A higher dose of YM598 reduced albuminuria comparable with enalapril. Urinary endothelin-1 excretion was greater in the diabetic rats than in the control rats, and was not substantially influenced by the agents. Enalapril, but not YM598, mildly lowered the blood pressure in the diabetic rats, indicating that blood pressure reduction is not involved in the major mechanism of the renoprotective effect of YM598 in OLETF rats. These data suggest that endothelin is involved in the progression of diabetic nephropathy in OLETF rats, and an endothelin type A antagonist is promising for the treatment of diabetic nephropathy.
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PMID:Renal protective effect of YM598, a selective endothelin type A receptor antagonist. 1583 46

In this study we examined diabetes- and hypertension-induced changes in cardiac structure and function in an animal model of type 2 diabetes, the Goto-Kakizaki (GK) rat. We hypothesized that treatment with omapatrilat, a vasopeptidase inhibitor, which causes simultaneous inhibition of angiotensin converting enzyme and neutral endopeptidase, provides additional cardioprotective effects, during normal- as well as high sodium intake, compared to treatment with enalapril, a selective inhibitor of angiotensin converting enzyme. Fifty-two GK rats were randomized into 6 groups to receive either normal-sodium (NaCl 0.8%) or high-sodium (NaCl 6%) diet and enalapril, omapatrilat or vehicle for 12 weeks. The GK rats developed hypertension, cardiac hypertrophy and overexpression of cardiac natriuretic peptides and profibrotic connective tissue growth factor compared to nondiabetic Wistar rats. The high dietary sodium further increased the systolic blood pressure, and changed the mitral inflow pattern measured by echocardiography towards diastolic dysfunction. Enalapril and omapatrilat equally decreased the systolic blood pressure compared to the control group during normal- as well as high-sodium diet. Both drugs had beneficial cardioprotective effects, which were blunted by the high dietary sodium. Compared to enalapril, omapatrilat reduced the echocardiographically measured left ventricular mass during normal-sodium diet and improved the diastolic function during high-sodium diet in GK rats. Furthermore, omapatrilat reduced relative cardiac weight more effectively than enalapril during high sodium intake. Our results suggest that both the renin-angiotensin and the neutral endopeptidase system are involved in the pathogenesis of diabetic cardiomyopathy since vasopeptidase inhibition was shown to provide additional benefits in comparison with selective angiotensin converting enzyme inhibition alone.
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PMID:Vasopeptidase inhibition has beneficial cardiac effects in spontaneously diabetic Goto-Kakizaki rats. 1613 72

1. The pathogenesis of diabetic neuropathy is a complex phenomenon, the mechanisms of which are not fully understood. Our previous studies have shown that the intracellular calcium signaling is impaired in primary and secondary nociceptive neurons in rats with streptozotocin (STZ)-induced diabetes. Here, we investigated the effect of prolonged treatment with the L-type calcium channel blocker nimodipine on diabetes-induced changes in neuronal calcium signaling and pain sensitivity. 2. Diabetes was induced in young rats (21 p.d.) by a streptozotocin injection. After 3 weeks of diabetes development, the rats were treated with nimodipine for another 3 weeks. The effect of nimodipine treatment on calcium homeostasis in nociceptive dorsal root ganglion neurons (DRG) and substantia gelatinosa (SG) neurons of the spinal cord slices was examined with fluorescent imaging technique. 3. Nimodipine treatment was not able to normalize elevated resting intracellular calcium ([Ca(2+)]( i )) levels in small DRG neurons. However, it was able to restore impaired Ca(2+) release from the ER, induced by either activation of ryanodine receptors or by receptor-independent mechanism in both DRG and SG neurons. 4. The beneficiary effects of nimodipine treatment on [Ca(2+)]( i ) signaling were paralleled with the reversal of diabetes-induced thermal hypoalgesia and normalization of the acute phase of the response to formalin injection. Nimodipine treatment was also able to shorten the duration of the tonic phase of formalin response to the control values. 5. To separate vasodilating effect of nimodipine Biessels et al., (Brain Res. 1035:86-93) from its effect on neuronal Ca(2+) channels, a group of STZ-diabetic rats was treated with vasodilator - enalapril. Enalapril treatment also have some beneficial effect on normalizing Ca(2+) release from the ER, however, it was far less explicit than the normalizing effect of nimodipine. Effect of enalapril treatment on nociceptive behavioral responses was also much less pronounced. It partially reversed diabetes-induced thermal hypoalgesia, but did not change the characteristics of the response to formalin injection. 6. The results of this study suggest that chronic nimodipine treatment may be effective in restoring diabetes-impaired neuronal calcium homeostasis as well as reduction of diabetes-induced thermal hypoalgesia and noxious stimuli responses. The nimodipine effect is mediated through a direct neuronal action combined with some vascular mechanism.
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PMID:The effect of nimodipine on calcium homeostasis and pain sensitivity in diabetic rats. 1683

We investigated the involvement of angiotensin II and vascular smooth muscle sarco/endoplasmic reticulum Ca(2+)-ATPase (SERCA) function in the impaired NO-induced relaxation seen in established streptozotocin-induced diabetes. Plasma angiotensin II levels, which were elevated in untreated diabetic rats (vs age-matched controls), were improved by treatment with the angiotensin-converting enzyme inhibitor enalapril. Systolic blood pressure was significantly decreased in chronic enalapril-treated diabetics (vs the other two groups). Intact aortae from diabetic rats and chronic angiotensin II-infused control rats, but not those from diabetic rats treated with enalapril, showed impaired endothelium-dependent relaxations to acetylcholine (vs controls). The relaxation induced by Angeli's Salt (a NO donor) was significantly impaired in endothelium-denuded aortae from diabetic rats (vs controls) but it was normalised by enalapril treatment. After preincubation with the irreversible SERCA inhibitor, thapsigargin, the relaxation induced by Angeli's Salt was significantly impaired in endothelium-denuded aortae from the controls, but not from the diabetics, and there was no significant difference between the thapsigargin-treated groups. Nitrotyrosine, an indirect marker of peroxynitrite, was markedly increased in aortic smooth muscle from diabetic rats, while chronic enalapril administration reduced this increase. These results suggest that in streptozotocin-induced diabetic rats, excessive angiotensin II production may lead to the generation of peroxynitrite and that this may in turn trigger a dysfunction of vascular smooth muscle SERCA. Enalapril improved the diabetes-related impairments.
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PMID:Enalapril improves impairment of SERCA-derived relaxation and enhancement of tyrosine nitration in diabetic rat aorta. 1719 60

Considering the growing importance of the interaction between components of kallikrein-kinin and renin-angiotensin systems in physiological and pathological processes, particularly in diabetes mellitus, the aim of the present study was to investigate the effect of enalapril on the reduced response of bradykinin and on the interaction between angiotensin-(1-7) (Ang-(1-7)) and bradykinin (BK), important components of these systems, in an insulin-resistance model of diabetes. For the above purpose, the response of mesenteric arterioles of anesthetized neonatal streptozotocin-induced (n-STZ) diabetic and control rats was evaluated using intravital microscopy. In n-STZ diabetic rats, enalapril treatment restored the reduced response to BK but not the potentiation of BK by Ang-(1-7) present in non-diabetic rats. The restorative effect of enalapril was observed at a dose that did not correct the altered parameters induced by diabetes such as hyperglycemia, glicosuria, insulin resistance but did reduce the high blood pressure levels of n-SZT diabetic rats. There was no difference in mRNA and protein expressions of B1 and B2 kinin receptor subtypes between n-STZ diabetic and control rats. Enalapril treatment increased the B2 kinin receptor expression. From our data, we conclude that in diabetes enalapril corrects the impaired BK response probably by increasing the expression of B2 receptors. The lack of potentiation of BK by Ang-(1-7) is not corrected by this agent.
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PMID:Enalapril treatment corrects the reduced response to bradykinin in diabetes increasing the B2 protein expression. 1819 Sep 98

The renin-angiotensin system (RAS) plays an important role in the regulation of blood pressure, fluid and electrolyte homeostasis. The RAS is activated and renal interstitial hydrostatic pressure (RIHP) is decreased in diabetic rats. The objective of this study was to evaluate the roles of proximal tubule reabsorption and RAS in the decreased RIHP and blunted natriuretic and diuretic responses to acute saline volume expansion (VE) in diabetic rats. Enalapril was utilized to inhibit angiotensin II (AII) formation. Diabetes mellitus (DM) was induced by a single intraperitoneal (i.p.) injection of streptozotocin (STZ, 65 mg/kg). RIHP was measured by a polyethylene (PE) matrix that was chronically implanted in the left kidney. Fractional excretion of phosphate (FE(Pi)) and fractional excretion of lithium (FE(Li)) were used as indexes for proximal tubule reabsorption. VE significantly increased both FE(Li) and FE(Pi) in all groups of rats studied. However, the increase in FE(Li) (DeltaFE(Li)=17.26+/-3.83%) and FE(Pi) (DeltaFE(Pi)=7.38+/-2.37%) in diabetic rats (DC, n=12) were significantly lower as compared with those in nondiabetic control rats (NC, n=8; DeltaFE(Li)=32.15+/-4.71% and DeltaFE(Pi)=20.62+/-3.27%). The blunted increases in FE(Li) and FE(Pi) were associated with an attenuated increase in RIHP (DeltaRIHP) in DC (1.8+/-0.4 mm Hg) compared with NC rats (4.3+/-0.3 mm Hg). Enalapril treatment (25 mg/kg/day in drinking water) had no effect on nondiabetic rats (NE, n=8) as compared with untreated NC rats, but significantly improved RIHP response (DeltaRIHP) to VE in diabetic rats (DE, n=9; 2.8+/-0.5 mm Hg). Both DeltaFE(Li) and DeltaFE(Pi) were restored by enalapril treatment in diabetic rats and no significant differences were found in DeltaFE(Li) and DeltaFE(Pi) between DE (DeltaFE(Li)=26.81+/-4.94% and DeltaFE(Pi)=10.45+/-4.67%) and NC groups of rats in response to VE. These data suggest that the activated RAS and the decrease in RIHP may play an important role in the increased proximal tubule reabsorption, and the attenuated natriuretic and diuretic responses to acute volume expansion in diabetic rats.
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PMID:Enalapril treatment restores the decreased proximal tubule reabsorption in response to acute volume expansion in diabetic rats. 1867 86

A 57 yr old man presented to endocrinology clinic with a six year history of poorly controlled hypertension which was treated with Metoprolol 200 mg/day and Enalapril 20 mg/day. He was asymptomatic but incidentally hypokalaemia was detected while having cholecystectomy, two years prior to his clinic appointment. He had never been on diuretics or laxatives. He was started on potassium supplements (120 mmol/d) and advised to increase dietary potassium by the surgical team. A detailed personal history revealed ingestion of 300-500 g licorice per day. Physical examination was unremarkable apart from increased blood pressure of 180/105 mmHg. Following the initial visit, his serum electrolyes (K+3.7 mmol/l) were normal with potassium supplementation and as were morning cortisol, ACTH, 11-deoxycortisol and plasma metanephrines. 17 OH-P, DHEAS and androstenedione were normal but testosterone was low. Morning ambulant aldosterone was slightly increased at 801 pmol/L and renin activity was undetectable. Urinary 24 h aldosterone excretion was significantly increased at 162 ng/24 h with normal cortisol and catecholamine excretion. Four weeks following advice to stop licorice, serum potassium decreased to 3.4 mmol/L despite continuous supplementation. Morning plasma aldosterone increased to 1 449 pmol/ml, renin activity remained undetectable but 24 h urine aldosterone excretion increased to 434 ng/24 h with a reduction in urinary cortisol excretion. Interestingly 17 OH-P and androstenedione levels, although within the reference range, were slightly higher compared to the levels whilst on licorice. Testosterone level had significantly increased to be within normal range. Abdominal imaging with US and MRI showed a 2.7 cmx2.2 cmx1.7 cm left adrenal mass. He underwent laparoscopic left adrenalectomy and histology confirmed aldosterone producing adrenal adenoma. Post-operatively his aldosterone and serum potassium levels normalized and he became normotensive without any antihypertensive medication.
Exp Clin Endocrinol Diabetes 2010 Apr
PMID:Licorice - or more? 2021 99


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