Diabetes mellitus, a well-established risk factor for stroke, is related to higher mortality and poorer outcomes following the stroke event. Advanced glycation end products(AGEs), their receptors RAGEs, other ligands, and several other processes contribute to the cerebrovascular pathomechanism interaction in the diabetes–ischemic stroke combination. Critical reappraisal of molecular targets and therapeutic agents to mitigate them is required to identify key elements for therapeutic interventions that may improve patient outcomes. This scoping review maps evidence on the key roles of AGEs, RAGEs, other ligands such as Leukotriene B4 (LTB4), High-mobility group box 1 (HMGB1) nuclear protein, brain–kidney–muscle crosstalk, alternate pathomechanisms in neurodegeneration, and cognitive decline related to diabetic ischemic stroke. RAGE, HMGB1, nitricoxide, and polyamine mechanisms are important therapeutic targets, inflicting common consequences of neuroinflammation andoxidative stress. Experimental findings on a numberof existing–emerging therapeutic agents and natural compounds against key targets are promising. The lackof large clinical trials with adequate follow-up periods is a gap that requires addressing to validate the emerging therapeutic agents. Five therapeutic components, which include agents to mitigate the AGE–RAGE axis, improved biomarkers for risk stratification, better renal dysfunction management, adjunctive anti-inflammatory–antioxidant therapies, and innovative neuromuscular stimulation for rehabilitation, are identified. A comprehensive therapeutic strategy that features all the identified components is needed for outcome improvement in diabetic stroke patients.
Background: Boswellia serrata has been known for many decades and mentioned in the ancient Ayurvedic texts. Many previous studies have demonstrated its role in depression and anxiety in animal models.
Objectives: The present study is carried out to evaluate the effect of Boswellia serrata on neurotransmitter levels of Swiss albino mice by spectrophotometer.
Methods: Eighteen (n=18) Swiss albino male mice were procured for this study. All mice were divided into three groups of six mice in each. The first group of mice (control) received normal saline (10 mg/kg); the second group (standard) received imipramine (10 mg/kg), and the third group (test) received Boswellia serrata (100 mg/kg) orally for 21 days. On the 22nd day, all mice were sacrificed as per CPCSEA (Committee for the Purpose of Control and Supervision of Experiments on Animals) guidelines. The mice brains were dissected, and their brain tissue was collected and stored in a preservative. The mice brain tissue was centrifuged, and samples were used for the estimation of serotonin (5-HT), Acetylcholinesterase (AChE), dopamine, Gamma-Aminobutyric Acid (GABA), and glutamate levels by spectrophotometry.
Results: The levels of neurotransmitters are expressed in Mean±SE. Analysis of results was done by 1-way ANOVA and Tukey Kramer tests. The statistical tests revealed that imipramine- treated mice have significantly increased the levels of AChE, GABA, and glutamate when compared to control (P<0.05). However, imipramine treated group showed statistically significant lower levels of 5-HT and dopamine levels when compared to the control (P<0.05). Similarly, the test drug Boswellia serrata-treated group had significantly higher levels of 5-HT, AChE, GABA, and glutamate when compared to the control group (P<0.05) and lower levels of dopamine when compared to the control (P<0.05).
Conclusion: The present study establishes the role of Boswellia serrata in various psychiatric disorders like depression and anxiety in animal models by modulating multiple neurotransmitters in the brain.
Title of the article: Analysis and correlation of small dense low-density lipoprotein-cholesterol (sdLDL-C) with various lipoproteins and cardiac markers in acute coronary syndrome patients associated with normal Low-density lipoprotein-cholesterol (LDL-C) level: A cross-sectional study. Aim: To analyze the levels of sdLDL cholesterol in acute coronary syndrome patients (ACS) with normal LDL cholesterol (LDL-C) and correlate with various lipoproteins and cardiac markers. Methodology: The present study included 100 patients diagnosed with ACS with normal LDL-C. Demographic details and cardiac markers were correlated with sdLDL levels. A detailed history was elicited from the patients and the details of clinical examination and laboratory findings such as cardiac Troponin, C- reactive protein, and CK-MB were obtained from patient case files. Results: The results are expressed in mean±sd. The mean age of study participants was 39.5±10.5yrs. The majority of the participants were men (69%) between the age group of 31-40 years. Mean values of total cholesterol, VLDL, sdLDL, Trop-I, CRP, and CKMB are at higher levels in men when compared to women. Whereas, mean values of triglycerides, LDL, and HDL are higher in women when compared to men. The majority of participants were having unstable angina (42%) followed by STEMI (33%) and NSTEMI (25%). Correlation between sdLDL and other parameters was carried out using Mann–Whitney–Wilcoxon test. The result showed a statistically significant correlation between sdLDL and VLDL, Trop-I, and CRP with p <0.05. Patients with sdLDL of > 25mg/dl had a higher incidence of unstable angina and STEMI. Conclusion: Our study result suggests that ACS with normolipidemic patients has a positive correlation with sdLDL levels and sdLDL can be a new diagnostic marker along with cardiac troponins in ACS.
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