The prototypical xanthine oxidase (XO) inhibitor allopurinol, has been the cornerstone of the clinical management of gout and conditions associated with hyperuricemia for several decades. More recent data indicate that XO also plays an important role in various forms of ischemic and other types of tissue and vascular injuries, inflammatory diseases, and chronic heart failure. Allopurinol and its active metabolite oxypurinol showed considerable promise in the treatment of these conditions both in experimental animals and in small-scale human clinical trials. Although some of the beneficial effects of these compounds may be unrelated to the inhibition of the XO, the encouraging findings rekindled significant interest in the development of additional, novel series of XO inhibitors for various therapeutic indications. Here we present a critical overview of the effects of XO inhibitors in various pathophysiological conditions and also review the various emerging therapeutic strategies offered by this approach.

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Therapeutic Effects of Xanthine Oxidase Inhibitors: Renaissance Half a Century after the Discovery of Allopurinol

The cascade of Alzheimer's disease (AD) neurodegeneration is associated with persistent oxidative stress, mitochondrial dysfunction, impaired energy metabolism, and activation of pro-death signaling pathways. More recently, studies with human postmortem brain tissue linked many of the characteristic molecular and pathological features of AD to reduced expression of the insulin and insulin-like growth factor (IGF) genes and their corresponding receptors. We now demonstrate using an in vivo model of intracerebral Streptozotocin (ic-STZ), that chemical depletion of insulin and IGF signaling mechanisms combined with oxidative injury is sufficient to cause AD-type neurodegeneration. The ic-STZ-injected rats did not have elevated blood glucose levels, and pancreatic architecture and insulin immunoreactivity were similar to control, yet their brains were reduced in size and exhibited neurodegeneration associated with cell loss, gliosis, and increased immunoreactivity for p53, active glycogen synthase kinase 3beta, phospho-tau, ubiquitin, and amyloid-beta. Real time quantitative RT-PCR studies demonstrated that the ic-STZ-treated brains had significantly reduced expression of genes corresponding to neurons, oligodendroglia, and choline acetyltransferase, and increased expression of genes encoding glial fibrillary acidic protein, microglia-specific proteins, acetylcholinesterase, tau, and amyloid precursor protein. These abnormalities were associated reduced expression of genes encoding insulin, IGF-II, insulin receptor, IGF-I receptor, and insulin receptor substrate-1, and reduced ligand binding to the insulin and IGF-II receptors. These results demonstrate that many of the characteristic features of AD-type neurodegeneration can be produced experimentally by selectively impairing insulin/IGF functions together with increasing oxidative stress, and support our hypothesis that AD represents a neuro-endocrine disorder associated with brain-specific perturbations in insulin and IGF signaling mechanisms, i.e. Type 3 diabetes.

Intracerebral streptozotocin model of type 3 diabetes: Relevance to sporadic Alzheimer's disease

Emerging reports on the organization of the different hormone-secreting cell types (alpha, glucagon; beta, insulin; and delta, somatostatin) in human islets have emphasized the distinct differences between human and mouse islets, raising questions about the relevance of studies of mouse islets to human islet physiology. Here, we examine the differences and similarities between the architecture of human and mouse islets. We studied islets from various mouse models including ob/ob and db/db and pregnant mice. We also examined the islets of monkeys, pigs, rabbits and birds for further comparisons. Despite differences in overall body and pancreas size as well as total beta-cell mass among these species, the distribution of their islet sizes closely overlaps, except in the bird pancreas in which the delta-cell population predominates (both in singlets and clusters) along with a small number of islets. Markedly large islets (>10,000 mum(2)) were observed in human and monkey islets as well as in islets from ob/ob and pregnant mice. The fraction of alpha-, beta- and delta-cells within an islet varied between islets in all the species examined. Furthermore, there was variability in the distribution of alpha- and delta-cells within the same species. In summary, human and mouse islets share common architectural features that may reflect demand for insulin. Comparative studies of islet architecture may lead to a better understanding of islet development and function.

Islet architecture: A comparative study

Animal models to test drugs with potential antidiabetic activity.

Diabetes mellitus is one of the major health problems in the world, the incidence and associated mortality are increasing. Inadequate regulation of the blood sugar imposes serious consequences for health. Conventional antidiabetic drugs are effective, however, also with unavoidable side effects. On the other hand, medicinal plants may act as an alternative source of antidiabetic agents. Examples of medicinal plants with antidiabetic potential are described, with focuses on preclinical and clinical studies. The beneficial potential of each plant matrix is given by the combined and concerted action of their profile of biologically active compounds.

https://www.mdpi.com/2218-273X/9/10/551/pdf

Antidiabetic Potential of Medicinal Plants and Their Active Components.

An attempt was made to study the beneficial effects of Aloe vera (L.) Burm. fil. in streptozotocin-induced diabetic rats. In diabetic induced rats fed with A. vera (300 mg/kg body wt), the fasting plasma glucose levels were reduced to normal and body weight was found to be increased. In the pancreatic sections of diabetic rats fed with A. vera, the islets were comparable to normal rats. In liver, the changes caused after induction of diabetes are granular cytoplasm, dilated sinusoids, shrunken nuclei and inflammation, which was reduced after feeding with A. vera. Excess proliferation of epithelium in the small intestine was observed in diabetic rats, which was reduced after A. vera feeding. In diabetic rats and diabetic rats fed with A. vera, no change was noticed in the kidney and stomach.

Antidiabetic activity of Aloe vera and histology of organs in streptozotocin-induced diabetic rats

Our objective was to study the effects of three (30, 40, and 50 mg/kg) doses of Streptozotocin (STZ) on fasting plasma glucose level (FPG) and observe its effects at the cellular level in rat pancreas by electron microscopy. FPG was measured in rats before induction of diabetes and then on 3, 7, and 14 days after induction of diabetes with STZ. Keto diastix urine strips were used to check urine glucose and ketone bodies. Two weeks after the induction of diabetes, the rat pancreas was removed and fixed for light and electron microscopic studies. Three days after induction, the mean FPG level was 112 mg/dl in Group I (30 mg/kg STZ), 217 mg/dl in Group II (40 mg/kg STZ), and 376 mg/dl in Group III (50 mg/kg STZ). Histology was normal in Group I but revealed altered islet structure in Groups II and III. Ultrastructure revealed intact D cells in all three groups. The focal mitochondria and Golgi complex swelling found in A and B cells was occasional in Group I and frequent in Groups II and III. Swelling of other organelles and reduction in the size and number of granules was further observed in Group III. It is our conclusion that the 30-mg/kg body weight STZ produces mild changes while 50 mg/kg proves to be fatal. STZ at 40 mg/kg has a moderate effect on plasma glucose as well as on the islets of Langerhans at a cellular level.

Effect of streptozotocin on the ultrastructure of rat pancreatic islets

Background: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia. Plant extracts and their products are being used as an alternative system of medicine for the treatment of diabetes. Aloe vera has been traditionally used to treat several diseases and it exhibits antioxidant, anti-inflammatory, and wound-healing effects. Streptozotocin (STZ)-induced Wistar diabetic rats were used in this study to understand the potential protective effect of A. vera extract on the pancreatic islets. Objective: The aim of the present study was to evaluate the A. vera extract on improvement of insulin secretion and pancreatic β-cell function by morphometric analysis of pancreatic islets in STZ-induced diabetic Wistar rats. Materials and Methods: After acclimatization, male Wistar rats, maintained as per the Committee for the Purpose of Control and Supervision of Experiments on Animals guidelines, were randomly divided into four groups of six rats each. Fasting plasma glucose and insulin levels were assessed. The effect of A. vera extract in STZ-induced diabetic rats on the pancreatic islets by morphometric analysis was evaluated. Results: Oral administration of A. vera extract (300 mg/kg) daily to diabetic rats for 3 weeks showed restoration of blood glucose levels to normal levels with a concomitant increase in insulin levels upon feeding with A. vera extract in STZ-induced diabetic rats. Morphometric analysis of pancreatic sections revealed quantitative and qualitative gain in terms of number, diameter, volume, and area of the pancreatic islets of diabetic rats treated with A. vera extract when compared to the untreated diabetic rats. Conclusion: A. vera extract exerts antidiabetic effects by improving insulin secretion and pancreatic β-cell function by restoring pancreatic islet mass in STZ-induced diabetic Wistar rats.

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Improvement of Insulin Secretion and Pancreatic β-cell Function in Streptozotocin-induced Diabetic Rats Treated with Aloe vera Extract

Costus pictus D. Don, commonly known as ‘insulin plant’ is a member of Zingiberacea family and is used as a munching dietary supplement for the treatment of diabetes in Southern India. The present study was carried out to evaluate the antidiabetic effect of Costus pictus leaves in normal and streptozotocin-induced diabetic rats. The oral feeding of aqueous leaf solution of this plant in diabetic rats for 28 days at a dosage of 2gm/kg body weight exhibited a significant (p<0.001) reduction in fasting blood glucose level and a remarkable increase in serum insulin level. There was a significant reduction (p<0.001) in serum parameters like SGOT, SGPT, lipids, triglycerides, total cholesterol, urea, TBARS, and albumin in diabetic rats treated with leaf solution. The body weight of diabetic rats was restored to normal state when treated with the C. pictus. Morphometric analysis of C. pictus-treated rat pancreatic islets showed a significant (p<0.001) increase in the number and area of islets when compared with normal and diabetic control rats. Histopathology studies in liver and kidney of diabetic rats treated with aqueous solution did not show any marked difference from normal which revealed the non-toxic effect of this plant. Estimation of trace elements using particle induced X-ray emission analysis in the leaf was also determined to find the antidiabetic potential elements in this plant. Based on the above results it is evident that the leaves of C. pictus have antidiabetic effect and must be considered as a potential candidate for future studies on diabetes mellitus.

Anti-diabetic effect of Costus pictus leaves in normal and streptozotocin-induced diabetic rats

The aim of this study was to assess recovery, cell death, and cell composition of post-thaw cultured human islets. Cryopreserved islets were provided by the Clinical Islet Transplant Program, Edmonton, Canada. Islets were processed using media prepared in accordance with Pre-Edmonton and Edmonton protocols. Cryopreserved islets were rapidly thawed and cultured for 24 h, 3 d, 5 d, and 7 d, following which they were processed for histology. Islet quantification, integrity, morphology and tissue turnover were studied via hematoxylin and eosin stained sections. Ultrastructure was studied by electron microscopy and endocrine cell composition by immunohistochemistry. Using the Pre-Edmonton protocol, islet recovery was 50.1% and islet survival was 50% at 24 h while for the Edmonton protocol, the islet recovery was 69.4% (p<0.001) and islet survival, 50% at ≈2.5 d. With an increasing culture duration although the physical integrity was retained there was an increasing loss of cohesivity both at light microscopic and at ultrastructure level regardless of the protocols used. Percentage islet survival and tissue turnover correlated negatively with culture duration in both protocols. The Edmonton protocol appears to preserve the islets better. However, culture duration adversely affects islet survival and quality, indicating the need for more optimal cryopreservation and culture techniques.

https://www.tandfonline.com/doi/pdf/10.4161/isl.26304

S Gunasekaran

Papers

Antidiabetic activity of Aloe vera and histology of organs in streptozotocin-induced diabetic rats

Effect of streptozotocin on the ultrastructure of rat pancreatic islets

Improvement of Insulin Secretion and Pancreatic β-cell Function in Streptozotocin-induced Diabetic Rats Treated with Aloe vera Extract

Anti-diabetic effect of Costus pictus leaves in normal and streptozotocin-induced diabetic rats

Human islet mass, morphology, and survival after cryopreservation using the Edmonton protocol