Treatment with metformin is associated with a high incidence of gastrointestinal side effects of unknown mechanism. Metformin is a biguanide derivative, which resembles 5-HT3-receptor agonists in its structure. Activation of 5-HT3 receptors is known to induce nausea, vomiting, and diarrhea. In this study, we investigated if the gastrointestinal side effects produced by metformin were antagonized by ondansetron, a selective antagonist of 5-HT3 receptors. Patients experiencing gastrointestinal side effects were randomized to ondansetron (4 mg bid p.o.) or placebo while maintained on metformin (double-blind, parallel-group design). If side effects persisted or worsened, metformin was discontinued and the patient considered a therapeutic failure. Of the 98 subjects treated with metformin, 22 developed side effects to match the study entry criteria. Diarrhea was the most frequent side effect. Subjects were randomized to ondansetron (10/2 F/M, 42.8 +/- 2.3 years, 28.6 +/- 1.1 kg/m2, 2585 +/- 35 mg/d metformin) or placebo (9/1 F/M, 43 +/- 4.3 years, 29.7 +/- 1.8 kg/m2, 2715 +/- 71 mg/d metformin). Ondansetron showed no efficacy against metformin-induced side effects. A comparable number of therapeutic failures were observed in ondansetron (8/12; 66%) and placebo-treated subjects (5/10; 50%) (P<0.1). Mean nausea scores (numeric analog scale) before and during treatment with ondansetron were 6.3 +/- 1 and 6.9 +/- 1 cm, respectively. Nausea scores averaged 7.3 +/- 1.5 and 5.9 +/- 1.5 cm, before and during treatment with placebo (P>0.1). In conclusion, 5-HT3 receptors do not seem to play a role in metformin-induced gastrointestinal side effects.
RESUMO: "Efeito hipoglicêmico de Croton cuneatus em ratos diabéticos induzido por estreptozotocina". A ação hipoglicemiante do extrato aquoso das cascas do caule de Croton cuneatus Klotz (Euphorbiaceae) foi investigada em ratos com diabetes induzida pela estreptozotocina (STZ). Doses crescentes do extrato aquoso (6,5, 13, 26 e 52 mg/kg i.p.) foram administradas separadamente a grupos de animais normais e diabéticos em jejum. Foram avaliadas as concentrações plasmáticas de glicose e colesterol, assim como mudanças no peso corporal. A administração crônica intraperitoneal (i.p.) do extrato durante 22 dias induziu uma redução signifi cativa nos níveis de glicose sanguínea. Foi feita uma comparação entre o extrato aquoso de C. cuneatus e a droga de referência glibenclamida. Os resultados desse experimento indicam que esta planta possui atividade antidiabética em modelo com animais hiperglicêmicos. Unitermos:Croton cuneatus, estreptozotocina, açúcar no sangue, efeito antihiperglicémico.ABSTRACT: Aqueous extract of the stem barks of Croton cuneatus Klotz (Euphorbiaceae) was investigated for hypoglycaemic activity in streptozotocin(STZ)-induced diabetic rats. Increasing doses of aqueous extract (6.5, 13, 26 and 52 mg/kg i.p.) were separately administered to groups of fasted normal and diabetic rats. Plasma glucose concentration, cholesterol and changes in body weight were evaluated. The chronic intraperitoneal (i.p.) administration of the extract for 22 days was found to induce signifi cant reduction in blood glucose level. A comparison was made between the action of the aqueous extract of C. cuneatus and the reference standard drug glibenclamide. The results of this experimental animal study indicate that this plant has an antidiabetic activity in hiperglycaemic rat models.
1. The existence of functional interrelationships between dorsal and ventral regions of the rat striatum was investigated. Kainic acid (KA) was employed to induce neuronal lesions in the more dorsal striatum, the caudate-putamen (CP). Only one CP (one side) received KA. KA-induced neurotoxicity at the site of injection (CP) was evidenced by reductions in choline-acetyltransferase activity and in GABA levels, and by increases in the ratios metabolite/monoamine for dopamine (DA) and serotonin (5-HT). 2. In addition to the well-known local effects, direct stereotaxic injection of KA into the CP produced distant effects in the ipsilateral olfactory tubercle (OT). A dose-dependent increase in the levels of 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5-HIAA) and decreases in DA and 5-HT concentrations were observed in the OT ipsilateral to the CP injected with KA. With 1, 2, 3, and 4 microg of KA, the ratio DOPAC+HVA/DA in the OT was 30, 79, 140, and 173% higher, respectively, than control levels. With 2, 3, and 4 microg of KA, the levels of 5-HIAA were approximately 30, 60, and 120% higher than control values, and the changes in 5-HIAA were associated with significant reductions in 5-HT concentrations. 3. Our results suggest that the dorsal part of the striatum exerts important regulatory functions over the most ventral striatal region, the OT. Destruction of CP interneurons by KA leads to disinhibition of DA and 5-HT activities to the OT. The functional interactions between dorsal and ventral striatal regions may play a role in the integration of fundamental life-preserving, motivational, and goal-directed olfactory motor behaviors of rodents.
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