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Uzbekova D.G.,Ryazan State Medical University
Diabetes Mellitus | Year: 2015

This article describes the academic works of the N.P. Kravkov (1865-1924), a prominent Russian pharmacologist, on the study of the endocrine glands. In N.P. Kravkov's laboratory, via experiments on rabbits and dogs, a method of isolating the pancreas and extracting its perfusate was developed based on passing Ringer-Locke's solution through the vessels of the isolated gland. It was discovered that the perfusate contains a substance that reduces the level of glucose in the blood of healthy animals and, in large doses, causes hypoglycaemic coma. N.P. Kravkov called this substance pancreotoxin. The experiments of N.P. Kravkov's followers on the isolated hearts of animals showed that, for a heart in the normal condition, pancreotoxin decelerates the heartbeat and reduces the amplitude of contractions, whereas for the heart tired above a certain threshold, the opposite effect is observed. The study of the blood vessels in isolated ears of rabbits and the eyes of frogs revealed antagonism between pancreotoxin and adrenalin: pancreotoxin weakens the vasoconstrictive effect of adrenalin and reduces its influence on the size of the pupil in frogs. It was also shown that passing the perfusate containing pancreotoxin through the adrenal gland increases the secretion of adrenalin. Later, pancreotoxin was obtained in the dried form and used to prepare a drug prescribed to patients with diabetes in hospitals. From its properties, pancreotoxin turned out to be insulin. It should be noted that the news that insulin had been isolated from the pancreas by the Canadian researchers F. Banting and C. Best reached Russia only after the researchers in N.P. Kravkov's laboratory had extracted and studied pancreotoxin from isolated pancreases. Thus, N.P. Kravkov and foreign researchers discovered this hormone independently. In experiments on the isolated adrenal glands of cattle, N.P. Kravkov and his collaborators obtained the perfusate containing an adrenalin- like substance produced in the medulla of the adrenal gland and a muscarine-like substance produced by the suprarenal cortex. The research by N.P. Kravkov and his followers on the physiology, pathology and pharmacology of the glands of internal secretion at the beginning of the 20th century has proved to be of great importance for the development of endocrinology in Russia. Source

Asfandiyarova N.S.,Ryazan State Medical University
Medical Hypotheses | Year: 2012

Any classification is a step forward and it should help to determine the reason, the course, the prognosis, the treatment of a disease. The current classification of diabetes mellitus (DM) is really very convenient for work, but it has some drawbacks, and the absence of differentiation of type 2 diabetes is the main. The problem is the absence of an adequate criterion, based on pathogenesis for differentiation.We suppose that cell mediated immunity (CMI) to insulin plays the central role in the diabetes genesis. Autoimmune process may be triggered by viruses family Paramyxoviridae, in 10-20% of type 1 diabetes patients the disease is a consequence of direct cytotoxic effect of other viruses to the islet cells of pancreas. In acute phase of viral infection (measles, mumps, parainfluenza) CMI against viruses is developed, in some patients CMI to insulin appeared. We suppose that autoimmune reactions in these cases are the result of cross reaction between viral antigens and insulin. The majorities of patients suppress these reactions and recover from acute infection diseases with the antiviral immunity development and without any complications. Other patients are not able to suppress autoimmune reactions to insulin and pathological process is triggered. Type 1A diabetes is a result of direct CMI to insulin, and this process is responsible for beta-cells destruction; may be type 1B DM is due to the direct cytotoxic effect of other viruses or toxins to them.Some patients with acute viral infection cannot destroy the aggressive clone and they suppress autoimmune reaction to insulin by prostaglandin synthesizing cells (PGSC) or s{cyrillic}ells with histamine receptors (CHR). As a result of this process the insulin resistance is developed, because these cells or their cytokines form a block to the insulin receptors not only on immunocompetent cells, but in insulin sensitive tissues too.Patients with different reactions to insulin have different courses and outcomes of DM. We suppose that CMI to insulin is acceptable criterion for differentiation of DM, for identifying high risk group of patients in whom DM or its complications may develop. Moreover, prophylactic measures for decreasing of insulin resistance by nonsteroid anti-inflammatory drugs or histamine H 2 receptor antagonists in persons with high activity of PGSC or CHR respectively can give good results.Furthermore, our hypothesis explains the initial reason for insulin resistance development, accordingly, it explains the reason for metabolic syndrome and atherosclerosis. © 2011 Elsevier Ltd. Source

Asfandiyarova N.S.,Ryazan State Medical University
Terapevticheskii Arkhiv | Year: 2011

Aim. To characterize clinically subtypes of type 2 diabetes mellitus (DM2) depending on lymphocyte reaction to insulin. Material and methods. DM2 patients (n = 357) were divided into 4 groups: DM2a - direct response of lymphocytes to insulin (RLI) detected in lymphocyte blasttransformation reaction, ICA+; DM2b indirect RLI detected at inhibition of cells with receptors to histamine with Cimetidin, ICA+; DM2c indirect RLI detected at inhibition of cells synthetizing prostaglandin with indometacine, ICA -; DM2d - the absence of RLI, ICA Results. DM2a patients were characterized by 5-year need in insulin, development of microangiopathy. DM2b patients - by overweight, combination of micro- and macroangiopathy, high risk of stroke, myocardial infarction, diabetic foot, need in insulin. DM2c patients had classic DM2, they were not in need of insulin at early stages of the disease, with typical development of macroangiopathy. DM2d patients had pancreatogenic DM. Conclusion. Application of the immunological criterion (type of RLI) differentiates DM2 patients with different course, prognosis. They need different treatment. Source

Asfandiyarova N.S.,Ryazan State Medical University
Diabetes Mellitus | Year: 2015

The morbidity and mortality associated with type 2 diabetes have increased over recent years. The causes of death include cardiovascular disease, cancer, infection, kidney disease and diabetic coma. Risk factors for death are a sedentary lifestyle, obesity, smoking, sex, age, duration and severity of diabetes, macro- and microvascular complications and hyper- and hypoglycaemic states. Adequate glycemic control and moderate exercise along with the use of antiplatelet agents (e.g. aspirin), statins, antihypertensives and metformin can reduce mortality. Intensive glucose control was associated with an increased risk of severe hypoglycaemia and death, and surgical intervention increased the risk of death. Source

Solodun M.V.,Ryazan State Medical University
Russian Journal of Cardiology | Year: 2016

Recently, myocardial infarction is a significant medical and social problem. Mortality in one year after infarction remains high, regardless the therapy with all recommended for the prognosis improvement medications. As one of probable reasons for adverse prognosis could be considered drug tolerance, related to genes polymorphism, responsible for pharmacokinetics and pharmacodynamics of the drugs. Current review summarizes some available at the moment literature data in the genes SLCO1B1, LIPC, CYP2C19, ACE, ADRB1 polymorphism influence on the effectiveness of myocardial infarction therapy, that might be useful for further scientific investigation or improvement of long term treatment of this disease by personalization of drug therapy. © 2016, Silicea-Poligraf. All Rights Reserved. Source

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