BACKGROUND: Type 1 diabetes mellitus (T1DM) is a chronic disease in children which is usually caused by autoimmunity that damages pancreatic a and b cells which have functions as blood glucose regulators. Some studies stated that Renalase (RNLS) gene deletion will protect these b cells from autoimmune reactions and Endoplasmic Reticulum (ER) stress. RNLS deletion by genome editing Clustered Regular interspersed Short Palindromic Repeats-CRISPR-related (CRISPR/Cas9) is believed to have the potential to be a therapy for T1DM Patients. AIM: This research was conducted to know the potential of RNLS deletion using the CRISPR/Cas9 as an effective therapy and whether it has a permanent effect on T1DM patients. METHODS: The method applied in this research summarized articles by analyzing the titles and abstracts of various predetermined keywords. In this case, the author chose a full-text article published within the past 10 years by prioritizing searches in the last 5 years through PubMed, Google Scholar, Science Direct, Cochrane, American Diabetes Association, and official guidelines from IDAI. RESULTS: RNLS deletion using CRISPR/Cas9 in mice weakened the response of polyclonal -cell-reactive CD8+ T cells and disrupted the immune recognition to cells so that autoimmune killing did occur. In addition, such deletion prevents RNLS ER stress by increasing the threshold, triggering the unfolded protein response so that ER stress is difficult to occur. RNLS mutations in b cells also increase b cell survivability to oxidative stress. CONCLUSION: b cells RNLS deletion by genome editing CRISPR/Cas9 is effective in protecting b cells from autoimmune reactions and RE stress. However, further research is needed to determine the side effects and safety of its use.
Introduction: The Sodium-Glucose Cotransporter-2 Inhibitor (SGLT-2 inhibitor) is a diabetic medication. Recently, there has been enough evidence of SGLT-2 inhibitors in type 2 diabetes mellitus, driving in an abatement in cardiovascular breakdown hospitalization. To explore SGLT-2 inhibitor in cardiovascular breakdown with lower discharge portion, we led an orderly survey and meta-examination. Strategies: We played out a methodical writing search from various electronic databases. We used keywords:” SGLT-2 inhibitor '' and “Heart Failure.” Inclusion criteria are randomized placebo-controlled trial, one-year follow-up and ejection fraction 40% or less. Composite endpoint is cardiovascular mortality with hospitalization of heart failure. Individual outcomes include all-cause mortality, cardiovascular passing, and cardiovascular breakdown hospitalization. For low heterogeneity scores, results are introduced utilizing a danger proportion (RR) with a 95 percent certainty stretch and statistical analysis using a fixed-effect model. Results: Total of two randomized control trial was selected (DAPA-HF [Dapagliflozin] and EMPEROR-Reduced [Empagliflozin]) with 8,474 patients pooled within our analysis. The results of the composite outcome compared SGLT-2 inhibitor with placebo had significant decrease in the composite of cardiovascular passing with hospitalization of cardiovascular breakdown (RR=0.78 [95% CI, 0.71–0.84], p<0.00001; I2=0%). Result of individual outcome showed significant reduction of all-cause mortality (RR=0.88 [95% CI, 0.79 – 0.98], p=0.03; I2=1%), cardiovascular mortality (RR=0.87 [95% CI, 0.77 – 0.99], p=0.03; I2=0%) and hospitalization of heart failure (RR=0.72 [95% CI, 0.65–0.81], p<0.00001; I2=0%). Conclusion: Within one year of treatment with an SGLT-2 inhibitor, the composite of cardiovascular passing with cardiovascular breakdown hospitalization, all-cause mortality, cardiovascular mortality, and cardiovascular breakdown hospitalization was significantly reduced.
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