Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anticopper drugs that have been developed to treat Wilson's disease, a disease of copper toxicity, include tetrathiomolybdate, zinc, penicillamine, and trientine. Lowering copper levels by a modest amount in non-Wilson's patients with tetrathiomolybdate inhibits angiogenesis, fibrosis and inflammation while avoiding clinical copper deficiency. Through this mechanism tetrathiomolybdate has proven effective in numerous animal models of cancer, retinopathy, fibrosis, and inflammation. Penicillamine has efficacy in rheumatoid arthritis and trientine has efficacy in diabetic neuropathy and diabetic heart disease. If clinical studies support the animal work, anticopper therapy holds promise for therapy of cancer, fibrotic disease and inflammatory and autoimmune diseases.
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PMID:Anticopper therapy against cancer and diseases of inflammation and fibrosis. 1618 95

Anaemia is a frequent complication of diabetic nephropathy. It has only recently been recognised that in diabetic patients anaemia is seen not only in preterminal renal failure, but also frequently in patients with only minor derangement of renal function. At any level of glomerular filtration rate (GFR) anaemia is more frequent and severe in diabetic compared to nondiabetic patients. A major cause of anaemia is an inappropriate response of erythropoietin to anaemia. Additional factors are iron deficiency and iatrogenic factors, e.g. ACE inhibitor treatment. When serum creatinine is still normal, the erythropoietin concentration is predictive of more rapid loss of glomerular function. When serum creatinine is elevated, the haemoglobin values are predictive of the rate of progression. It is currently under investigation whether reversal of anaemia attenuates the rate of progression. Because most of the late complications of diabetes (retinopathy, neuropathy, heart disease, peripheral arterial disease) involve ischaemic tissue damage, it would be intuitively plausible that treatment with human recombinant erythropoietin should be beneficial, but definite evidence for this hypothesis is currently not available.
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PMID:Diabetic nephropathy and anaemia. 1628 61

The function of the retina is sensitive to oxygen tension. Any change in the perfusion pressure of the eye affects the retina although the eye is able to autoregulate its hemodynamics. Systemic hypoxemia (lung or heart disease) or a vascular disease in the retina can cause retinal hypoxia. All the hypoxia-dependent events in cells appear to share a common denominator: hypoxia-inducible factor (HIF), which is a heterodimeric transcription factor, a protein. HIF comprises a labile alpha subunit (1-3), which is regulated, and a stable beta subunit, which is constitutively expressed. Both are helix-loop-helix factors and belong to the PAS-domain family of transcription factors. Oxygen plays the key role in stabilizing HIF-1alpha and its function. When the oxygen tension is normal, HIF-1alpha is rapidly oxidized by hydroxylase enzymes, but when cells become hypoxic, HIF-1alpha escapes the degradation and starts to accumulate, triggering the activation of a large number of genes, like vascular endothelial growth factor (VEGF) and erythropoietin. HIF-1alpha has been shown to have, either clinically or experimentally, a mediating or contributing role in several oxygen-dependent retinal diseases such as von Hippel-Lindau, proliferative diabetic retinopathy, retinopathy of prematurity and glaucoma. In retinitis pigmentosa and high-altitude retinopathy, however, the evidence is still indirect. There are three different strategies available for treating retinal diseases, which have all shown promising results: retinal cell transplantation or replacement, gene replacement, and pharmacological intervention. Specifically, recent results show that the HIF pathway can be used as a therapeutic target, although there is still a long way to go from bench to clinic. HIF can be stabilized by inhibiting prolyl hydroxylase or by blocking the VHL:HIF-alpha complex if angiogenesis is the goal, as in retinitis pigmentosa. On the other hand, the downregulation of HIF has a pivotal role if we are to inhibit neovascularization, as in proliferative diabetic retinopathy. To date, several small-molecule inhibitors of HIF have been developed and are entering clinical trials. HIF is a remarkable example of a single transcription factor that can be regarded as a "master switch" regulating all the oxygen-dependent retinal diseases.
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PMID:Oxygen-dependent diseases in the retina: role of hypoxia-inducible factors. 1675 May 26

We evaluated the incidence of significant coronary artery stenoses (CAS), angina pectoris (AP), revascularization and associated risk factors in 155 consecutive diabetic nephropathy transplant candidates. Kidney and kidney-pancreas transplant candidates with diabetes for more than 10 years and/or retinopathy and/or biopsy verified diabetic nephropathy were included. The inclusion period was 1999-2004. Seventy-two percent of patients were male. Sixty-one percent had type 1 diabetes and 39% had type 2 diabetes and mean age was 46 years (+/-10) and 58 years (+/-11), respectively. History of heart disease was present in 34% of patients, 34% had cerebro-vascular and/or peripheral atherosclerotic disease, and 51% had neither. Fifty-five percent had a smoking history and 46% were on dialysis. Significant CAS was found in 45% of patients, of whom 17% had AP. No patients below 35 years of age had significant CAS (n = 11, p = 0.001). Revascularization was performed in 57% of patients with significant CAS. The only risk factor for significant CAS in multiple logistic regression was age (p = 0.046). Approximately half of the patients had significant CAS, and half of these underwent revascularization. Most patients with CAS did not have symptoms of myocardial ischemia. The data justify screening diabetic nephropathy transplant candidates with coronary angiography before transplantation.
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PMID:Routine coronary angiography in diabetic nephropathy patients before transplantation. 1729 Feb 38

Type 1 diabetes mellitus subjects millions to a daily burden of disease management, life threatening hypoglycemia and long-term complications such as retinopathy, nephropathy, heart disease, and stroke. Cell transplantation therapies providing a glucose-regulated supply of insulin have been implemented clinically, but are limited by safety, efficacy and supply considerations. Stem cells promise a plentiful and flexible source of cells for transplantation therapies. Here, we show that cells derived from human embryonic germ (EG) cells express markers of definitive endoderm, pancreatic and beta-cell development, glucose sensing, and production of mature insulin. These cells integrate functions necessary for glucose responsive regulation of preproinsulin mRNA and expression of insulin C-peptide in vitro. Following transplantation into mice, cells become insulin and C-peptide immunoreactive and produce plasma C-peptide in response to glucose. These findings suggest that EG cell derivatives may eventually serve as a source of insulin producing cells for the treatment of diabetes.
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PMID:Glucose responsive insulin production from human embryonic germ (EG) cell derivatives. 1738 13

In the last years the occurrence of type 2 diabetes mellitus has rapidly increased. The presence of cardiovascular complications, retinopathy, nephropathy and neuropathy are the results of delayed diagnosis. In the year 2004, in the Internal Diseases Depertment in Dabrowa Tarnowska, type 2 diabetes mellitus was diagnosed for the first time in 62 patients. In this group the majority of patient suffered from I-III degree hypertension, 27% had ishaemic heart disease, and 11% were hospitalized because of heart infarction. Heart failure was present in 20% and paroxysmal atrial fibrillation in 21% of them. The other diabetic complications diagnosed in this group were: microalbuminuria (43%), proteinuria (27%), simple retinopathy (64%), proliferative retinopathy (21%), and peripheral neuropathy in 40 of patients.
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PMID:[Organ complications in patients with diabetes mellitus type 2 diagnosed during hospitalization due to other diseases in the year 2004]. 1778 45

Successful treatment of hypertension in patients with type 2 diabetes mellitus increases life expectancy and reduces the risk of many of the complications associated with diabetes, such as heart disease, stroke, and retinopathy. Controlling blood pressure also protects against advancing renal disease, with several recent studies having clearly shown the advantage of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in slowing the progression of renal disease. Here, the authors review current guidelines for the management of hypertension in patients with type 2 diabetes mellitus and explore ways in which nurse practitioners can improve care for these patients.
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PMID:Taking the pressure off type 2 diabetes mellitus: implementing hypertension guidelines. 1778 92

Bardet-Biedl syndrome (BBS) is a ciliopathy causing multivisceral abnormalities. Its prevalence in Europe is from 1/125,000 to 1/175,000. This disorder is defined by a combination of clinical signs: obesity, pigmentary retinopathy, post-axial polydactyly, polycystic kidneys, hypogenitalism, and learning disabilities, many of which appearing after several years of evolution. Individual clinical phenotype is highly variable. Most signs are present in a majority of patients but only pigmentary retinopathy is constant after infancy. There are many other associated minor clinical signs including diabetes, blood hypertension, congenital cardiopathy or Hirschsprung disease. This broad clinical spectrum is associated to a great genetic heterogeneity, with mainly an autosomal recessive transmission and, sometimes cases of oligogenism. To date, mutations in 12 different genes (BBS1 to BBS12) are responsible for this phenotype. These genes code for proteins involved in the development and function of primary cilia. Absent or non functional BBS proteins affect cilia in certain organs such as kidney or eye. However, some symptoms are still not clearly related to cilia dysfunction. BB syndrome has to be recognized because a molecular diagnosis is possible and will lead to familial genetic counseling and possibly prenatal diagnosis. Patients with BBS will need a multidisciplinary medical care. The renal abnormalities are the main life-threatening features because they can lead to end-stage renal failure and renal transplantation. Retinal dystrophy leading to progressive vision loss, moderate mental retardation, and obesity will affect social life of these patients.
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PMID:[Bardet-Biedl syndrome]. 1901 43

Research shows a causal association between hyperglycemia and diabetic complications which include nephropathy, neuropathy, retinopathy and blood vessel and heart disease. Intensive control of blood glucose in children has been debated for years. The Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Interventions and Complications (EDIC) study followed more than 1,400 volunteers and intensely managed a portion of those patients over several years. Results from the DCCT study regarding the benefits of intensive diabetes management continue to be significant more than 15 years after they were published.
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PMID:A better future for children with type 1 diabetes: Review of the conclusions from the Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications study. 1981 99

In congenital cyanotic heart disease, oxygenated and deoxygenated blood mixes, and oxygen saturation of the arterial blood is not maintained. As a result, an ischemic environment prevails in the entire body. While various ocular findings have been described in patients with cyanotic heart disease, proliferative retinopathy has not been previously noted. We report a child with congenital cyanotic heart disease and multiple fibrovascular fronds over the fundus consistent with proliferative retinopathy.
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PMID:Proliferative retinopathy in a child with congenital cyanotic heart disease. 2103 76


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