ABSTRACT
@#Background & Objective: Peripheral neuropathy is one of the most common complications of diabetes and leads to sensory symptoms, including diabetic neuropathic pain (DNP). Emodin has potential analgesic effect for the treatment of pain-related diseases. However, the analgesic effect of emodin on DNP and its possible mechanism remains unknown. The aim of the present study is to investigate the effect of emodin on STZ-induced DNP in rats and its potential molecular mechanism. Methods: To determine the analgesic effect of emodin on DNP, a mouse model of STZ-induced DNP was established. The pain-related behaviors were evaluated by von Frey test, and hot plate test. The mRNA and protein expression of several TRP channels was detected by qRT-PCR and western blot methods, and the level of inflammatory cytokines was determined by ELISA. Results: The mechanical and thermal pain thresholds were significantly decreased in DNP rats. A single injection of emodin treatment significantly reduced DNP. Further results demonstrated that emodin inhibited the up-regulation of Trpv1 mRNA in the DRG of DNP rats. Our data also indicated that emodin significantly reduced the levels of TNF-α, IL-1β and IL-6 in the DRG of DNP rats. Conclusions: Emodin ameliorates mechanical allodynia and thermal hyperalgesia in DNP rats by down-regulating the expression of TRPV1 in DRG and the expression of TNF-α, IL-1β and IL-6. Emodin serves as a potent analgesic reagent for treatment and prevention of DNP.
ABSTRACT
<p><b>BACKGROUND</b>Thrombolysis with recombinant tissue plasminogen activator (rt-PA) has gained international recognition, clinical outcomes following this thrombolytic therapy varied from patient to patient. Factors affecting clinical outcomes have not been well understood yet, so this retrospective case-control study aimed to investigate factors that may influence clinical outcomes of acute ischemic stroke treated with intravenous rt-PA.</p><p><b>METHODS</b>One hundred and one patients with acute ischemic stroke who received intravenous rt-PA thrombolysis within 4.5 hours from disease onset were included. Patients were divided into good or poor outcome group according to modified Rankin Scale (mRS) score, good outcome group: mRS score of 0-1; poor outcome group: mRS of 2-6. Stroke characteristics were compared between the two groups. Factors for stroke outcomes were analyzed via univariate analysis and Logistic regression.</p><p><b>RESULTS</b>Of the 101 patients studied, patients in good outcome group (n = 55) were significantly younger than patients in poor outcome group (n = 46, (62.82 ± 14.25) vs. (68.81 ± 9.85) years, P = 0.029). Good outcome group had fewer patients with diabetic history (9.09% vs. 28.26%, P = 0.012), fewer patients with leukoaraiosis (7.27% vs. 28.26%, P = 0.005) and presented with lower blood glucose level ((5.72 ± 1.76) vs. (6.72 ± 1.32) mmol/L, P = 0.012), lower systolic blood pressure level ((135.45 ± 19.36) vs. (148.78 ± 19.39) mmHg, P = 0.003), lower baseline NIHSS score (12.02 ± 5.26 vs. 15.78 ± 4.98, P = 0.002) and shorter onset-to-treatment time (OTT) ((2.38 ± 1.21) vs. (2.57 ± 1.03) hours, P = 0.044) than poor outcome group. Logistic regression analysis showed that absence of diabetic history (odds ratio (OR) 0.968 (95% CI 0.941-0.996)), absence of leukoaraiosis (OR 0.835 (95% CI 0.712-0.980)), lower baseline NIHSS score (OR 0.885 (95% CI 0.793-0.989)), lower pre-thrombolysis systolic blood pressure (OR 0.962 (95% CI 0.929-0.997)), and lower blood glucose level (OR 0.699 (95% CI 0.491-0.994)) before thrombolysis were significantly associated with better outcome.</p><p><b>CONCLUSION</b>Patients with no history of diabetes, no leukoaraiosis, low blood glucose level, low systolic blood pressure level and low baseline NIHSS score before thrombolysis have a better outcome.</p>