Nuclear receptor regulation of lipid metabolism: potential therapeutics for dyslipidemia, diabetes, and chronic heart and liver diseases.
Humans; Animals; Chronic Disease; *Lipid Metabolism; Hypoglycemic Agents/therapeutic use; Diabetes Mellitus/drug therapy/metabolism; Dyslipidemias/drug therapy/metabolism; Heart Diseases/*drug therapy/metabolism; Hypolipidemic Agents/therapeutic use; Liver Diseases/*drug therapy/metabolism; Metabolic Diseases/*drug therapy/metabolism; Receptors; Cytoplasmic and Nuclear/*metabolism
Lipids are essential components of biological membranes, fuel molecules and metabolic regulators that control cellular functions, metabolism and homeostasis. The liver plays a central role in regulating lipid metabolism and whole body lipid homeostasis. Sterols, bile acids and fatty acids are the endogenous ligands of the liver orphan receptor, farnesoid X receptor, peroxisome proliferator-activated receptor, vitamin D receptor, constitutive androstane receptor and pregnane X receptor. These metabolic receptors coordinately regulate lipid, glucose, energy and drug metabolism. Alteration of lipid homeostasis causes dyslipidemia, which is a major risk factor contributing to atherosclerotic cardiovascular diseases, diabetes, obesity and liver diseases. Advances in the understanding of the mechanisms of nuclear receptor regulation of lipid homeostasis have provided an opportunity to investigate potential therapeutic drugs targeted to nuclear receptors. This could be useful for the treatment of diabetes, and cardiovascular and chronic liver diseases.
Chiang John Y L
Current opinion in investigational drugs (London, England : 2000)
2005
2005-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Common fungal infections of the feet in patients with diabetes mellitus.
Humans; Aged; Randomized Controlled Trials as Topic; Metabolic Clearance Rate; Biological Availability; Drug Interactions; *Diabetes Complications; *Onychomycosis/diagnosis/drug therapy/physiopathology; *Tinea Pedis/diagnosis/drug therapy/physiopathology; Antifungal Agents/adverse effects/pharmacokinetics/*therapeutic use; Arthrodermataceae/*pathogenicity; Diabetes Mellitus/drug therapy; Hypoglycemic Agents/therapeutic use
Superficial fungal infections of the foot (tinea pedis and onychomycosis) are common among elderly patients. Although most authorities believe that patients with diabetes mellitus have an increased predisposition to dermatophytic infections, some controversies still remain. Because these infections disrupt the skin integrity and provide an avenue for bacterial superinfection, elderly diabetic patients with dermatophytic infection should be promptly treated with an antifungal agent. For most dermatophytic infections of the foot, topical agents are usually effective and less expensive than oral agents. Laboratory diagnosis of fungal infection prior to institution of therapy is recommended. Proper technique for obtaining the specimen is important to ensure a higher chance of isolating the infecting fungus. Commonly used anti-dermatophytic agents that are also active against the yeasts include the imidazoles, the allylamines-benzylamines and the hydroxypyridones, which are also effective against most of the moulds. Oral therapy for tinea pedis, although not well studied, should be limited to patients with more extensive infections, such as vesicobullous and moccasin type, resistant infections or chronic infections. In addition, oral agents should also be considered in diabetic and immunosuppressed patients. On the other hand, treatment of onychomycosis of the foot usually requires systemic therapy. Griseofulvin is the least effective agent when compared with the newer agents. Terbinafine, itraconazole and fluconazole have been shown to have acceptable cure rates. More recently, topical treatment of the nail with 8% ciclopirox nail lacquer, bifonazole with urea and amorolfine have been reported to be successful. Over the past decade, fungal foot infections of the skin and nail are more effectively treated with the introduction of numerous topical and oral agents.
Tan James S; Joseph Warren S
Drugs & Aging
2004
1905-6
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2165/00002512-200421020-00003" target="_blank" rel="noreferrer noopener">10.2165/00002512-200421020-00003</a>