Previous reports provided recommendations for familial renal glucosuria diagnosis without complex view on differential diagnosis of glucosuria. The aim of this review was to provide an overview of the causes of glucosuria and to create an evidence-based diagnostic approach for children with glucosuria. We searched the current literature with a focus to identify the possible etiology of glucosuria, gaining insight into the pathophysiology of glucosuria. Urinary glucose is completely reabsorbed in the proximal tubule of kidneys. It only appears in the urine if the plasma glucose concentration exceeds the renal threshold for glucose or in the case of insufficient renal glucose reabsorption. The proteins that provide glucose reabsorption are SGLT2 and SGLT1 - sodium-dependent co-transporters that transport glucose from the lumen into epithelial cells - and GLUT2 - a passive transporter providing facilitative glucose transport from epithelial cells to plasma. Renal glucose reabsorption is affected in case of acquired or inherited complex dysfunction of proximal tubule called Fanconi Syndrome or due to pathogenic variants of genes encoding glucose transporters. Prior to diagnosing any of these, diabetes mellitus must be excluded together with other conditions leading to hyperglycemia. In conclusion, glucosuria is always an abnormal finding. The review provides a simple evidence-based diagnostic approach to navigate the differential diagnosis of glucosuria.

• MeSH
• diferenciální diagnóza MeSH
• dítě MeSH
• Fanconiho syndrom diagnóza   komplikace   MeSH
• glukosa * metabolismus   MeSH
• glykosurie * diagnóza   etiologie   MeSH
• lidé MeSH
• přenašeč glukosy typ 2 metabolismus   MeSH
• proximální tubuly ledvin metabolismus   MeSH
• renální glykosurie * diagnóza   etiologie   patofyziologie   MeSH
• transportér 1 pro sodík a glukosu metabolismus   MeSH
• transportér 2 pro sodík a glukózu metabolismus   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Liver glycogen storage disorders (GSDs) are rare inherited disorders of carbohydrate metabolism that are clinically characterized by hepatomegaly and fasting intolerance. This group of disorders comprises GSD Ia and Ib as well as the so-called ketotic GSDs including GSD III, VI, IX, XI and 0a. Although clinical practice guidelines exist for most GSD subtypes, diagnostics, treatment and monitoring differ significantly among metabolic centres. The aim of this study was to gain insight into current clinical practice for liver GSDs. METHODS: An international web-based survey was performed among health care professionals involved in the care of individuals with liver GSDs. RESULTS: Sixty-seven respondents from 28 different countries caring for approximately 2650 liver GSD patients completed the survey. While the diagnostic approach was generally consistent, significant differences among metabolic centres are still observed with respect to monitoring parameters and treatment approaches. Reasons for these differences are local availability of management tools and treatment options, the rarity of the different GSD subtypes, the experiences of health care professionals, and the existence of extreme phenotypes. CONCLUSION: The development of a standard set of outcomes for patients with liver GSDs is warranted as a reference for both daily care and the evaluation of safety and efficacy of future therapies. For various parameters that serve as valuable outcome measures, tools and target values should be better defined.

• MeSH
• glykogenóza * terapie   diagnóza   MeSH
• játra metabolismus   patologie   MeSH
• lidé MeSH
• management nemoci MeSH
• nemoci jater * terapie   diagnóza   MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Investigation determines the beneficial effect of bergaptol against gestational diabetes (GD). Gestational diabetes was induced in female rats and treated them with bergaptol 20 and 40 mg/kg for eighteen days. Effect of bergaptol was assessed on blood glucose and insulin level in GD rat. Inflammatory mediators and oxidative stress parameters were also assessed in GD rats. Moreover, mRNA expression of INSR, NF-kappaB, Akt and GSK-3beta were assessed in the GD rats by qRT-PCR method. In silico network pharmacology study was performed, along with gene ontology and egg pathway to assessed the targets of bergaptol, molecular docking study was also performed for the confirmation of possible pathway involved in the management of GD. Blood glucose and insulin level was significantly reduces in the blood bergaptol treated group than GD group of rats. Treatment with bergaptol ameliorates the altered level of mediators of inflammation and oxidative stress parameters in GD rats. There was significant reduction in the mRNA expression of NF-kappaB and GSK-3beta and increase in expression of INSR and Akt in the tissue homogenate of bergaptol treated GD rats. Docking study shows effective binding strength of bergaptol individually with INSR, NF-kappaB, Akt and GSK-3beta-protein targets. In conclusion, data of investigation suggest that bergaptol improves the sensitivity of insulin receptor in GD, as it reduces parameters of oxidative stress and inflammatory mediators by regulating INSR/NF-kappaB/Akt/GSK-3beta pathway. Key words Gestational diabetes, Bergaptol, Insulin resistance, Inflammation, Oxidative stress.

• MeSH
• experimentální diabetes mellitus * farmakoterapie   metabolismus   MeSH
• gestační diabetes * farmakoterapie   metabolismus   MeSH
• inzulinová rezistence * fyziologie   MeSH
• kinasa glykogensynthasy 3beta metabolismus   MeSH
• krevní glukóza metabolismus   účinky léků   MeSH
• krysa rodu rattus MeSH
• oxidační stres účinky léků   MeSH
• potkani Wistar MeSH
• receptor inzulinu metabolismus   MeSH
• signální transdukce účinky léků   MeSH
• simulace molekulového dockingu * MeSH
• těhotenství MeSH
• zánět farmakoterapie   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Background: Hypertriglyceridemia has serious health risks such as cardiovascular disease, type 2 diabetes mellitus, nephropathy, and others. Fenofibrate is an effective hypolipidemic drug, but its benefits for ameliorating disorders associated with hypertriglyceridemia failed to be proven in clinical trials. Methods: To search for possible causes of this situation and possibilities of their favorable influence, we tested the effect of FF monotherapy and the combination of fenofibrate with silymarin on metabolic disorders in a unique model of hereditary hypertriglyceridemic rats (HHTg). Results: Fenofibrate treatment (100 mg/kg BW/day for four weeks) significantly decreased serum levels of triglyceride, (-77%) and free fatty acids (-29%), the hepatic accumulation of triglycerides, and the expression of genes encoding transcription factors involved in lipid metabolism (Srebf2, Nr1h4. Rxrα, and Slco1a1). In contrast, the hypertriglyceridemia-induced ectopic storage of lipids in muscles, the heart, and kidneys reduced glucose utilization in muscles and was not affected. In addition, fenofibrate reduced the activity of the antioxidant system, including Nrf2 expression (-35%) and increased lipoperoxidation in the liver and, to a lesser extent, in the kidneys and heart. Adding silymarin (micronized form, 600 mg/kg BW/day) to fenofibrate therapy increased the synthesis of glycogen in muscles, (+36%) and reduced hyperinsulinemia (-34%). In the liver, it increased the activity of the antioxidant system, including PON-1 activity and Nrf2 expression, and reduced the formation of lipoperoxides. The beneficial effect of combination therapy on the parameters of oxidative stress and lipoperoxidation was also observed, to a lesser extent, in the heart and kidneys. Conclusions: Our results suggest the potential beneficial use of the combination of FF with SLM in the treatment of hypertriglyceridemia-induced metabolic disorders.

• Publikační typ
• časopisecké články MeSH

Hypoglykémie sú symptómom pomerne širokej skupiny ochorení s rôznou epidemiológiou, etiológiou, klinickým obrazom, liečbou a prognózou. Deti sú náchylnejšie na rozvoj hypoglykémie ako dospelí, nakoľko ich regulačné procesy na udržiavanie stabilnej glykémie majú menšiu kapacitu. Etiologicky ide o rozmanitú skupinu ochorení, pričom viaceré sú typické pre detský vek. Medzi najčastejšie formy hypoglykémií u detí patria liečba inzulínom pri diabetes mellitus, idiopatické ketotické hypoglykémie, hyperinzulinizmus (v novorodeneckom období), k menej častým, avšak závažným príčinám patria deficity kontra egulačných hormónov, niektoré dedičné poruchy metabolizmu, prípadne intoxikácie. Ich diagnostika je často komplexná, pričom na odlíšenie jednotlivých foriem hypoglykémií je kľúčové stanovenie ketolátok. Liečba a prognóza závisí najmä od typu hypoglykémie. Článok sa venuje nediabetickým hypoglykémiám u detí.

Hypoglycemia is a symptom of a relatively broad group of diseases with different epidemiology, etiology, clinical picture, treatment and prognosis. Children are more susceptible to developing hypoglycemia than adults, as their regulatory processes to maintain stable glycaemia have less capacity. Etiologically, hypoglycemia is a diverse group of diseases, with several being typical of childhood. The most common forms of hypoglycemia in children include insulin treatment in diabetes mellitus, idiopathic ketotic hypoglycemia, hyperinsulinism (in neonatal period), less common but serious causes include deficits of counterregulatory hormones, some inherited metabolic disorders, or intoxication. Their diagnosis is often complex. Determination of ketone bodies is crucial to differentiate the various forms of hypoglycemia. Treatment and prognosis depend mainly on the type of hypoglycemia. This article is dedicated to Non-diabetic hypoglycemias in children.

• MeSH
• diferenciální diagnóza MeSH
• glykogenóza diagnóza   genetika   metabolismus   MeSH
• hladovění komplikace   metabolismus   patofyziologie   MeSH
• hyperinzulinismus diagnóza   komplikace   MeSH
• hypoglykemie * diagnóza   etiologie   komplikace   terapie   MeSH
• ketolátky krev   MeSH
• ketóza diagnóza   metabolismus   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH

Pseudomonas mandelii SW-3, isolated from the Napahai plateau wetland, can survive in cold environments. The mechanisms underlying the survival of bacteria in low temperatures and high altitudes are not yet fully understood. In this study, the whole genome of SW-3 was sequenced to identify the genomic features that may contribute to survival in cold environments. The results showed that the genome size of strain SW-3 was 6,538,059 bp with a GC content of 59%. A total of 67 tRNAs, a 34,110 bp prophage sequence, and a large number of metabolic genes were found. Based on 16S rRNA gene phylogeny and average nucleotide identity analysis among P. mandelii, SW-3 was identified as a strain belonging to P. mandelii. In addition, we clarified the mechanisms by which SW-3 survived in a cold environment, providing a basis for further investigation of host-phage interaction. P. mandelii SW-3 showed stress resistance mechanisms, including glycogen and trehalose metabolic pathways, and antisense transcriptional silencing. Furthermore, cold shock proteins and glucose 6-phosphate dehydrogenase may play pivotal roles in facilitating adaptation to cold environmental conditions. The genome-wide analysis provided us with a deeper understanding of the cold-adapted bacterium.

• MeSH
• DNA bakterií genetika   MeSH
• fylogeneze * MeSH
• fyziologická adaptace * genetika   MeSH
• genom bakteriální * MeSH
• nízká teplota * MeSH
• profágy genetika   MeSH
• Pseudomonas * genetika   klasifikace   MeSH
• RNA ribozomální 16S * genetika   MeSH
• sekvenování celého genomu MeSH
• zastoupení bazí MeSH
• Publikační typ
• časopisecké články MeSH

Ifosfamid je protinádorový lék ze skupiny alkylačních cytostatik, jenž zabudováním alkylové skupiny do řetězce DNA naruší replikaci nukleotidových řetězců. Jedná se sice již o historický medikament, jehož vznik se datuje do 70. let minulého století, ale stále se s ním běžně setkáváme v onkologické praxi, např. u nádorů kostí, sarkomů měkkých tkání, ale i recidivujících nonhodgkinských lymfomů či lymfomů CNS. Tato terapie je zatížena řadou nežádoucích účinků, z nichž ke klasickým akutním nežádoucím účinkům patří reverzibilní encefalopatie a hemoragická cystitida. V této kazuistice z německé kliniky bych se rád zaměřil na renální toxicitu ifosfamidu, respektive poškození proximálního tubulu, v jehož důsledku se může rozvinout až tzv. Fanconiho synrom.

Ifosfamide is an anticancer drug from the group of alkylating cytostatics that disrupts the replication of nucleotide chains by incorporating an alkyl group into the DNA chain. Although it is a historical drug dating back to the 1970s, it is still commonly encountered in cancer treatment, e. g. in bone tumours, sarcomas and recurrent non-Hodgkin's lymphomas or CNS lymphomas. This therapy is burdened with a number of adverse effects, of the classic acute side effects include reversible encephalopathy and hemorrhagic cystitis. In this case report, I would like to focus on the renal toxicity of ifosfamide or damage to the proximal tubule, which may result in the development of Fanconi syndrome.

• MeSH
• acidóza chemicky indukované   etiologie   MeSH
• dospělí MeSH
• etoposid aplikace a dávkování   škodlivé účinky   MeSH
• Ewingův sarkom * diagnostické zobrazování   farmakoterapie   komplikace   patofyziologie   MeSH
• Fanconiho syndrom * chemicky indukované   patologie   MeSH
• ifosfamid aplikace a dávkování   škodlivé účinky   MeSH
• kombinovaná farmakoterapie metody   MeSH
• lidé MeSH
• metastázy nádorů MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

BACKGROUND AND AIMS: Prolonged fasting, which leads to the mobilization of fat from adipose tissue, can result in the development of hepatosteatosis. However, it is not yet known whether the accumulation of fat in the liver after fasting can be affected by concurrent obesity. Therefore, this study aimed to assess how excessive adiposity influences changes in liver fat content induced by fasting and subsequent refeeding. METHODS AND RESULTS: Ten lean women and eleven women with obesity (age: 36.4 ± 7.9 and 34.5 ± 7.9 years, BMI: 21.4 ± 1.7 and 34.5 ± 4.8 kg/m2) underwent a 60-h fasting period followed by 2 days of isocaloric high-carbohydrate refeeding. Magnetic resonance spectroscopy (MRS) examinations of liver were conducted at baseline, after 48 h of fasting, and at the end of refeeding period. Hepatic fat content (HFC) increased in lean women after fasting, whereas no statistically significant change in HFC was observed in women with obesity. Additionally, fasting led to significant reductions in liver volume in both groups, likely attributable to glycogen depletion, with subsequent restoration upon refeeding. Notably, changes in hepatic fat volume (HFV) rather than HFC inversely correlated with baseline liver fat content and HOMA-IR. CONCLUSION: We demonstrated that prolonged fasting results in accumulation of fat in the liver in lean subjects only and that this accumulation is inversely related to baseline fat content and insulin resistance. Moreover, the study underscored the importance of evaluating hepatic fat volume rather than hepatic fat content in studies that involve considerable changes in hepatic lean volume.

• MeSH
• adipozita * MeSH
• časové faktory MeSH
• dietní sacharidy aplikace a dávkování   MeSH
• dospělí MeSH
• játra * metabolismus   diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita * patofyziologie   terapie   metabolismus   MeSH
• omezení příjmu potravy * MeSH
• sacharidová dieta škodlivé účinky   MeSH
• studie případů a kontrol MeSH
• ztučnělá játra diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Members of the casein kinase 1 (CK1) family are important regulators of multiple signaling pathways. CK1α is a well-known negative regulator of the Wnt/β-catenin pathway, which promotes the degradation of β-catenin via its phosphorylation of Ser45. In contrast, the closest paralog of CK1α, CK1α-like, is a poorly characterized kinase of unknown function. In this study, we show that the deletion of CK1α, but not CK1α-like, resulted in a strong activation of the Wnt/β-catenin pathway. Wnt-3a treatment further enhanced the activation, which suggests there are at least two modes, a CK1α-dependent and Wnt-dependent, of β-catenin regulation. Rescue experiments showed that only two out of ten naturally occurring splice CK1α/α-like variants were able to rescue the augmented Wnt/β-catenin signaling caused by CK1α deficiency in cells. Importantly, the ability to phosphorylate β-catenin on Ser45 in the in vitro kinase assay was required but not sufficient for such rescue. Our compound CK1α and GSK3α/β KO models suggest that the additional nonredundant function of CK1α in the Wnt pathway beyond Ser45-β-catenin phosphorylation includes Axin phosphorylation. Finally, we established NanoBRET assays for the three most common CK1α splice variants as well as CK1α-like. Target engagement data revealed comparable potency of known CK1α inhibitors for all CK1α variants but not for CK1α-like. In summary, our work brings important novel insights into the biology of CK1α, including evidence for the lack of redundancy with other CK1 kinases in the negative regulation of the Wnt/β-catenin pathway at the level of β-catenin and Axin.

• MeSH
• alternativní sestřih MeSH
• beta-katenin * metabolismus   genetika   MeSH
• fosforylace MeSH
• HEK293 buňky MeSH
• kaseinkinasa Ialfa * metabolismus   genetika   MeSH
• kinasa 3 glykogensynthasy metabolismus   genetika   MeSH
• kinasa glykogensynthasy 3beta metabolismus   genetika   MeSH
• lidé MeSH
• protein Wnt3A metabolismus   genetika   MeSH
• signální dráha Wnt * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Pompeho nemoc (PD, glykogenóza II. typu) je vzácné geneticky podmíněné metabolické onemocnění charakterizované deficitem alfa-1,4-glukosidázy (GAA, kyselé maltázy). Projevy onemocnění i délku života lze ovlivnit enzymovou substituční terapií (ERT). Neuromuskulární centrum 2. LF UK a FN Motol a Neuromuskulární centrum FN Brno realizují projekt, jehož cílem je odhalit dosud nepoznané případy Pompeho nemoci a nově diagnostikovaným pacientům poskytnout dispenzární péči a substituční terapii. Článek demonstruje typický průběh pozdní formy Pompeho nemoci na kazuistice pacienta zachyceného v rámci projektu.

Pompe disease (PD, glycogenosis type II) is a rare genetically determined metabolic disease characterized by alpha-1,4-glucosidase (GAA, acid maltase) deficiency. Disease manifestations and life expectancy can be influenced by enzyme replacement therapy (ERT). Neuromuscular centers in Prague and Brno are implementing a project aimed at detecting previously unknown cases of Pompe disease and providing dispensary care and substitution therapy to the newly diagnosed patients. The article demonstrates the typical course of the late form of Pompe disease by means of the case report of a patient found thanks to the project.

• MeSH
• dospělí MeSH
• dyspnoe etiologie   MeSH
• glykogenóza typu II * diagnóza   komplikace   terapie   MeSH
• lidé MeSH
• respirační insuficience etiologie   MeSH
• syndromy spánkové apnoe etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH