Carbohydrate (CHO) intake in oral and enteral nutrition is regularly reduced in nutritional support of older patients due to the high prevalence of diabetes (usually type 2-T2DM) in this age group. However, CHO shortage can lead to the lack of building blocks necessary for tissue regeneration and other anabolic processes. Moreover, low CHO intake decreases CHO oxidation and can increase insulin resistance. The aim of our current study was to determine the extent to which an increased intake of a rapidly digestible carbohydrate-maltodextrin-affects blood glucose levels monitored continuously for one week in patients with and without T2DM. Twenty-one patients (14 T2DM and seven without diabetes) were studied for two weeks. During the first week, patients with T2DM received standard diabetic nutrition (250 g CHO per day) and patients without diabetes received a standard diet (350 g of CHO per day). During the second week, the daily CHO intake was increased to 400 in T2DM and 500 g in nondiabetic patients by addition of 150 g maltodextrin divided into three equal doses of 50 g and given immediately after the main meal. Plasma glucose level was monitored continually with the help of a subcutaneous sensor during both weeks. The increased CHO intake led to transient postprandial increase of glucose levels in T2DM patients. This rise was more manifest during the first three days of CHO intake, and then the postprandial peak hyperglycemia was blunted. During the night's fasting period, the glucose levels were not influenced by maltodextrin. Supplementation of additional CHO did not influence the percentual range of high glucose level and decreased a risk of hypoglycaemia. No change in T2DM treatment was indicated. The results confirm our assumption that increased CHO intake as an alternative to CHO restriction in type 2 diabetic patients during oral and enteral nutritional support is safe.
- MeSH
- diabetes mellitus 2. typu * MeSH
- dietní sacharidy MeSH
- enterální výživa škodlivé účinky MeSH
- hyperglykemie * MeSH
- inzulin MeSH
- krevní glukóza MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Inflammatory bowel disease (IBD) is a relapsing and remitting inflammatory disease affecting millions of people worldwide. The active phase of IBD is characterized by excessive formation of reactive oxygen species (ROS) in the intestinal mucosa, which further accelerates the inflammatory process. A feasible strategy for the IBD treatment is thus breaking the oxidation-inflammation vicious circle by scavenging excessive ROS with the use of a suitable antioxidant. Herein, we have developed a novel hydrogel system for oral administration utilizing sterically hindered amine-based redox polymer (SHARP) incorporating covalently bound antioxidant SHA groups. SHARP was prepared via free-radical polymerization by covalent crosslinking of 2-hydroxyethyl methacrylate (HEMA), poly(ethylene oxide) methyl ether methacrylate (PEGMA) and a SHA-based monomer, N-(2,2,6,6-tetramethyl-piperidin-4-yl)-methacrylamide. The SHARP hydrogel was resistant to hydrolysis and swelled considerably (∼90% water content) under the simulated gastrointestinal tract (GIT) conditions, and exhibited concentration-dependent antioxidant properties in vitro against different ROS. Further, the SHARP hydrogel was found to be non-genotoxic, non-cytotoxic, non-irritating, and non-absorbable from the gastrointestinal tract. Most importantly, SHARP hydrogel exhibited a statistically significant, dose-dependent therapeutic effect in the mice model of dextran sodium sulfate (DSS)-induced acute colitis. Altogether, the obtained results suggest that the SHARP hydrogel strategy holds a great promise with respect to IBD treatment.
- MeSH
- aminy MeSH
- hydrogely MeSH
- idiopatické střevní záněty * farmakoterapie MeSH
- kolitida * chemicky indukované farmakoterapie MeSH
- myši MeSH
- oxidace-redukce MeSH
- polymery MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Ztráta tělesné svaloviny je častá zejména u hospitalizovaných seniorů. Současně je u těchto nemocných častý výskyt diabetu 2. typu s doporučeným snížením příjmu sacharidů v dietě. Příjem sacharidů je však potřebný pro navození anabolické situace a následné zlepšení stavu pacienta během rekonvalescence; na druhé straně je u seniorů omezen vzhledem k obavě z dekompenzace. Cílem naší prospektivní studie bylo zjistit, do jaké míry ovlivní zvýšený příjem sacharidů 24hodinový glykemický profil u nemocných seniorů s diabetem 2. typu hospitalizovaných na lůžkách následní péče. Do prospektivní studie bylo zařazeno 14 diabetiků 2. typu. Během prvního týdne dostávali standardní nemocniční diabetickou dietu obsahující 250 g sacharidů. V následujícím týdnu bylo ke každému hlavnímu jídlu přidáno 50 g maltodextrinu – celková dávka sacharidů byla 400 g denně. Po oba týdny byla u nemocných monitorována glukózovým senzorem Enlite zavedeným do podkoží. Přidání 150 g maltodextrinu vedlo ke vzestupům glykemie po jeho podání. Tento vzestup byl nejvíce vyjádřen v první polovině týdne (den 1 až 3). V následném období došlo k poklesu glykemií. U žádného nemocného nebylo nutné měnit léčbu diabetu ani nedošlo k jeho dekompenzaci. Naše studie svědčí o tom, že restrikce sacharidů by měla být přehodnocena, zejména u seniorů, kteří potřebují nutriční podporu.
Loss of body muscle is especially common in hospitalized elderly people. At the same time, type 2 diabetes is common in these patients with a recommended reduction in dietary carbohydrate intake. However, carbohydrate intake is necessary to induce an anabolic situation and subsequent improvement of the patient‘s condition during recovery; on the other hand, it is limited in the elderly due to the fear of decompensation. The aim of our prospective study was to determine to what extent increased carbohydrate intake affects the 24-hour glycaemic profile in elderly patients with type 2 diabetes admitted to aftercare beds. Fourteen type 2 diabetic patients were enrolled in this prospective study. During the first week, they received a standard hospital diabetic diet containing 250 g of carbohydrate. In the following week, 50 g of maltodextrin was added to each main meal - the total carbohydrate intake was 400 g per day. For both weeks, patients‘ blood glucose was monitored using a subcutaneous sensor. The addition of 150 g of maltodextrin led to rises in glycaemia after its administration. This rise was most pronounced in the first half of the week (days 1 to 3). There was a decrease in glycaemia in the subsequent period. No patient required a change in diabetic treatment, nor was there any decompensation. Our study suggests that carbohydrate restriction should be re-evaluated, especially in the elderly who need nutritional support.
- MeSH
- diabetes mellitus 2. typu * MeSH
- diabetická dieta MeSH
- inzulinová rezistence MeSH
- lidé MeSH
- metabolismus sacharidů * MeSH
- metabolismus MeSH
- následná péče MeSH
- nutriční terapie MeSH
- prospektivní studie MeSH
- sacharidy terapeutické užití MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
Hemochromatosis (iron overload) encompasses a group of diseases that are characterized by a toxic hyperaccumulation of iron in parenchymal organs. Currently, only few treatments for this disease have been approved; however, all these treatments possess severe side effects. In this study, a paradigm for hemochromatosis maintenance/preventive therapy is investigated: polymers with negligible systemic biological availability form stable complexes with iron ions in the gastrointestinal tract, which reduces the biological availability of iron. Macroporous polymer beads are synthesized with three different iron-chelating moieties (benzene-1,2-diol, benzene-1,2,3-triol, and 1,10-phenanthroline). The polymers rapidly chelate iron ions from aqueous solutions in vitro in the course of minutes, and are noncytotoxic and nonprooxidant. Moreover, the in vivo biodistribution and pharmacokinetics show a negligible uptake from the gastrointestinal tract (using 125 I-labeled polymer and single photon emission computed tomography/computed tomography), which generally prevents them from having systemic side effects. The therapeutic efficacy of the prepared polymers is successfully tested in vivo, and exhibits a significant inhibition of iron uptake from the gastrointestinal tract without any noticeable signs of toxicity. Furthermore, an in silico method is developed for the prediction of chelator selectivity. Therefore, this paradigm can be applied to the next-generation maintenance/preventive treatment for hemochromatosis and/or other diseases of similar pathophysiology.
- MeSH
- benzen chemie farmakologie MeSH
- chelátory železa chemie farmakologie MeSH
- fenantroliny chemie farmakologie MeSH
- gastrointestinální trakt účinky léků MeSH
- hemochromatóza diagnostické zobrazování farmakoterapie patologie MeSH
- lidé MeSH
- polymery chemie farmakologie MeSH
- teoretické modely * MeSH
- tomografie emisní počítačová MeSH
- železo metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Currently, chemotherapy is the most common treatment for oncological diseases. Systemic administration of chemotherapeutics provides an easy and effective distribution of the active agents throughout the patient's body, however organs may be severely impaired by serious life-threatening side effects. In many oncological diseases, particularly solid tumors, the local application of chemotherapeutics would be advantageous. Recently, nanofibrous materials as local drug delivery systems have attracted much attention. They have considerable potential in the treatment of various cancers as they can provide a high concentration of the drug at the target site for a prolonged time, thereby lowering total exposure and adverse effects. The present review describes the specifics of drug delivery to the tumor microenvironment, basic characteristics of nanofibrous materials and their preparation, and comprehensively summarizes recent scientific reports concerning in vivo experiments with drug-loaded electrospun nanofibrous systems designed for local anticancer therapy.
Polymeric bile acid sequestrants (BAS) have recently attracted much attention as lipid-lowering agents. These non-absorbable materials specifically bind bile acids (BAs) in the intestine, preventing bile acid (BA) reabsorption into the blood through enterohepatic circulation. Therefore, it is important to understand the structure-property relationships between the polymer sequestrant and its ability to bind specific BAs molecules. In this review, we describe pleiotropic effects of bile acids, and we focus on BAS with various molecular architectures that result in different mechanisms of BA sequestration. Here, we present 1) amphiphilic polymers based on poly(meth)acrylates, poly(meth)acrylamides, polyalkylamines and polyallylamines containing quaternary ammonium groups, 2) cyclodextrins, and 3) BAS prepared via molecular imprinting methods. The synthetic approaches leading to individual BAS preparation, as well as results of their in vitro BA binding activities and in vivo lipid-lowering activities, are discussed.
- MeSH
- anticholesteremika chemická syntéza chemie farmakologie MeSH
- hypercholesterolemie farmakoterapie MeSH
- lidé MeSH
- molekulární struktura MeSH
- polymery chemická syntéza chemie farmakologie MeSH
- racionální návrh léčiv * MeSH
- vazebná místa účinky léků MeSH
- žlučové kyseliny a soli chemická syntéza chemie farmakologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
