Disease-drug-drug interactions (DDDIs) have been identified in some inflammatory diseases in which elevated proinflammatory cytokines can downregulate the expression of cytochrome P450 (CYP) enzymes, potentially increasing systemic exposure to drugs metabolized by CYPs. Following anti-inflammatory treatments, CYP expression may return to normal, resulting in reduced drug exposure and diminished clinical efficacy. Vedolizumab has a well-established positive benefit-risk profile in patients with ulcerative colitis (UC) or Crohn's disease (CD) and has no known systemic immunosuppressive activity.
View Article and Find Full Text PDFAims: Patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) have impaired endothelial function. Vitamin D and its analogs may play a role in regulation of endothelial function and inflammation. We studied effects of paricalcitol compared to placebo on endothelial function and markers of inflammation and oxidative stress in patients with T2DM and CKD.
View Article and Find Full Text PDFInsulin resistance is a complex metabolic defect that has several causes dependent on an individual's genetic substrate and the underlying pathophysiologic state. Atherogenic dyslipidemia, hyperinsulinemia, dysglycemia, inflammation associated with obesity, and ectopic steatosis in liver and skeletal muscle all collude to facilitate endothelial dysfunction and predispose to the initiation and propagation of atherosclerosis. As aggressive management of the various risk factors does not seem to abrogate the so-called residual risk, more research is needed to define ways by which intervention can fundamentally alter the metabolic and vascular milieu and slow the pace of atherosclerosis, thus favorably affecting outcomes.
View Article and Find Full Text PDFBoth glucose and fatty acids may have good/adaptive or toxic/maladaptive actions on the pancreatic beta cell, depending on their concentrations. Hyperglycemia, via metabolic intermediates, may result in multiple cellular effects that are toxic to the pancreatic beta cell and indeed other tissues. While free fatty acids may affect cellular processes beyond lipid metabolism by interacting with transcription factors, triglyceride rich lipoproteins are endothelial cell-toxic and facilitate atherogenesis.
View Article and Find Full Text PDFPerformance status, a measure of physical functioning, can be influenced by several undefined physician and patient-related factors, and is inherently subjective. Although disappointing results in phase 3 trials may reflect a lack of improved outcomes due to biological mechanisms, a confounding effect of imbalances of physical functioning cannot be excluded in the context of modest increments in antitumor activity. Therefore, performance status estimation may complicate drug development, and an objective measure of physical reserve is desirable and may complement or outperform performance status.
View Article and Find Full Text PDFThe ever-growing need to dissipate larger amounts of heat from components and structures requires the development of novel materials with superior thermal conductivity. Aligned carbon nanotube arrays that are integrated in composite materials and structures may prove useful in increasing heat transfer through their thickness. Theoretical studies have shown the potential of carbon nanotubes to reach a thermal conductivity of 6600 Wm(-1)K(-1).
View Article and Find Full Text PDFCurr Atheroscler Rep
November 2010
The United Kingdom Prospective Diabetes Study (UKPDS) and the Diabetes Chronic Complications Trial (DCCT) are two landmark trials that convincingly demonstrated that tight glycemic control has beneficial effects on microvascular end points. These studies also revealed a "legacy effect," which is a sustained benefit with respect to cardiovascular disease outcomes seen long after the conclusion of the trial. We discuss possible molecular mechanisms that could play a role in causing the legacy effect.
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