Background: Hyperglycemic dividing mesangial cells initiate intracellular hyaluronan synthesis, autophagy, and cyclin D3-mediated hyaluronan matrix formation. Results: Heparin prevents the intracellular responses but induces synthesis of a monocyte-adhesive extracellular hyaluronan matrix after cell division. Conclusion: Heparin inhibits inflammatory responses in diabetic glomeruli. Significance: Responses of dividing cells to hyperglycemia contribute to diabetic pathologies.

Background: Heparin prevents intracellular hyaluronan synthesis and subsequent autophagy in hyperglycemic dividing mesangial cells. Results: The non-reducing terminal trisaccharide of heparin is sufficient for this response. Conclusion: This heparin trisaccharide motif is exposed by the mammalian heparanase and is recognized by a receptor on dividing cells. Significance: The trisaccharide does not have the anti-coagulant properties of heparin.

Previous studies and ongoing research indicate the importance of an interaction between a putative receptor on dividing cells in hyperglycemia and the non-reducing end motifs of heparin stored in mast cell secretory granules and how this interaction prevents activation of hyaluronan synthesis in intracellular compartments and subsequent autophagy. This suggests a new role for endosomal heparanase in exposing this cryptic motif present in the initial large heparin chains on serglycin and in the highly sulfated (NS) domains of heparan sulfate.

Background: Inflammatory bowel disease (IBD) patients are known to benefit from care delivered in a specialized, interdisciplinary setting. We aimed to evaluate the impact of this model on health outcomes, quality metrics, and health care resource utilization (HRU) in IBD patients insured with Medicaid. Materials and Methods:In July 2017, IBD patients at our tertiary hospital were transitioned from a fellows' general gastroenterology (GI) clinic to a fellows' interdisciplinary IBD clinic. IBD patients were included if they were insured with Medicaid, had at least 1 visit in the general GI clinic between

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