Examining the clinical relevance of metformin as an antioxidant intervention

Abstract

In physiological concentrations, reactive oxygen species play a vital role in regulating cell signaling and gene expression. Nevertheless, oxidative stress is implicated in the pathogenesis of numerous diseases and can inflict damage on diverse cell types and tissues. Thus, understanding the factors that mitigate the deleterious effects of oxidative stress is imperative for identifying new therapeutic targets. In light of the absence of direct treatment recommendations for reducing oxidative stress, there is a continuing need for fundamental research that utilizes innovative therapeutic approaches. Metformin, known for its multifaceted beneficial properties, is acknowledged for its ability to counteract the adverse effects of increased oxidative stress at both molecular and cellular levels. In this review, we delve into recent insights regarding metformin’s antioxidant attributes, aiming to expand its clinical applicability. Our review proposes that metformin holds promise as a potential adjunctive therapy for various diseases, given its modulation of oxidative stress characteristics and regulation of diverse metabolic pathways. These pathways include lipid metabolism, hormone synthesis, and immunological responses, all of which may experience dysregulation in disease states, contributing to increased oxidative stress. Furthermore, our review introduces potential novel metformin-based interventions that may merit consideration in future research. Nevertheless, the necessity for clinical trials involving this drug remains imperative, as they are essential for establishing therapeutic dosages and addressing challenges associated with dose-dependent effects.

Transforming Diabetes Care: The Molecular Pathways through Which GLP1-RAs Impact the Kidneys in Diabetic Kidney Disease

“…Experimental studies highlight RAGE-mediated mitochondrial dysfunction, often via NAD(P)H oxidase activation, as an early indicator of DKD, preceding clinical manifestations such as albuminuria and histological changes. Despite these insights, clinical trials focusing on oxidative stress and inflammation have not yet confirmed the effectiveness of targeted therapies, underscoring the importance of strict glucose control [ 28 ].…”

“…In the early stages of diabetes, there is a notable increase in intraglomerular pressure coupled with hyperfiltration, which is pivotal in the genesis and exacerbation of DKD. This hyperfiltration phenomenon can be partly attributed to anomalies in tubuloglomerular feedback mechanisms [ 28 , 29 ]. Abnormalities in the feedback mechanisms between different kidney parts can partially explain this increased filtration.…”