1.
Effect of pioglitazone on insulin resistance, progression of atherosclerosis and clinical course of coronary heart disease.
Skochko, OV, Kaidashev, IP
Wiadomosci lekarskie (Warsaw, Poland : 1960). 2017;(5):881-890
Abstract
INTRODUCTION Pioglitazone, a medication of thiazolidinedione group, is capable of triggering the peroxisome proliferator-activated receptors (PPAR-γ). Activation of receptor PPAR-γ regulates carbohydrate and lipid metabolism, immune and inflammatory responses in heart tissues. THE AIM Our aim was to study the effect of pioglitazone on insulin resistance, the clinical course of atherosclerosis and coronary heart disease (CHD). MATERIALS AND METHODS The study included 43 patients with coronary artery disease. Patients were divided into the main group - 20 patients, in whom pioglitazone (Pioglar, Ranbaxy, India) was included in the combined therapy at a dose of 15 mg 1 time per day in the morning, and the comparison group - 23 patients receiving standard complex drug therapy over 6 months. Patients underwent clinical examination, ultrasound of neck vessels, study of carbohydrate and lipid metabolism. RESULTS Joining pioglitazone to standard therapy resulted in the reduction of systolic (p<0.05) and diastolic (p<0.05) blood pressure; decrease in the duration of pain attacks (p<0.05); reduction in the frequency of angina attacks (p<0.05); regression of atherosclerosis of the carotid vessels (p<0.05), decrease in the thickness of the intima-media complex (p<0.05). The decline in oral glucose tolerance test (p<0.05), hyperglycemic factor (p<0.05), total cholesterol (p<0.05), and low density lipoproteins (p<0.05) were observed, as well as increased high-density lipoprotein (p<0.05). CONCLUSION Long-term treatment with pioglitazone at low doses against the background of standard therapy contributes to functional and clinical condition of patients, promotes the prevention of atherosclerosis and reduction of insulin resistance, thereby improving the clinical manifestations of coronary heart disease.
2.
[Peroxysome proliferator-activated receptors at pathogenesis and treatment of atherosclerosis (achievements, paradoxes and perspectives)].
Rasin, MS
Likars'ka sprava. 2014;(5-6):26-38
Abstract
All three types of peroxisome proliferation activating rexeptiors (PPAR): α, β/δ and γ, are sensors of fat acids and their derivatives and carry out the transcription adjusting of genes of exchange of lipids, including circulation of cholesterol and sensitiveness of tissues to insulin. They possess antiinflammatory properties, control activity of cells of the immune system, endothelia and smooth musculature of vessels. Such combination of functions does PPAR an ideal target for a prophylaxis and treatment of atherosclerosis. Nevertheless, 20-years-old experience of the use of tiazolidinodiones--agonists of PPARγ, as antidiabetic facilities, did not bring to the decline of morbidity and death rate of patients with diabetes mellitus 2 types from cardiovascular complication. The only exception is pioglitazone, which significantly reduces the mortality rate of patients with T2DM remains effective in the prevention and treatment of atherosclerosis. Effective not enough in this plan and fibrates--agonists of PPARa. Possible reasons of it and nearest perspestives are examined in a review.
3.
Pioglitazone inhibits the expression of inflammatory cytokines from both monocytes and lymphocytes in patients with impaired glucose tolerance.
Zhang, WY, Schwartz, EA, Permana, PA, Reaven, PD
Arteriosclerosis, thrombosis, and vascular biology. 2008;(12):2312-8
Abstract
OBJECTIVE The current study determines whether pioglitazone (PIO) therapy reduces both monocyte and lymphocyte inflammatory activity and their ability to induce inflammation in other tissues. METHODS AND RESULTS Monocyte and lymphocyte cytokine gene and protein expression of interleukin (IL)-6 were first shown to be greater in subjects with impaired glucose tolerance (IGT) than in subjects with normal glucose tolerance. Sixty-six IGT subjects were then randomized to 4,5 months of placebo or PIO therapy. After receiving PIO, subjects had lower triglycerides and higher HDL cholesterol (P<0.05) than did subjects receiving placebo. Monocyte gene and protein expression of IL-1 beta, IL-6, and IL-8 (and IL-2, IL-6 and IL-8 from lymphocytes) was significantly lower after PIO therapy in the resting state, as well as after lipopolysaccharide (LPS) stimulation (P<0.05 for all). Moreover, IL-6, IL-8, and MCP-1 gene expression were decreased by nearly 50% in human adipocytes exposed to conditioned media from monocytes or lymphocytes from PIO treated subjects. CONCLUSIONS These results demonstrate that PIO therapy in IGT can reduce proinflammatory gene and protein expression from both monocytes and lymphocytes. This intervention also reduces the inflammatory cross-talk between these immune cells and adipose tissue, which could in turn contribute to the metabolic improvements resulting from PIO therapy.