Ming-Yuh Shiau has completed his PhD from Chung Shan Medical University. He is an Associate Professor and Chairman of Division of Basic Medical Sciences at Department of Nursing, College of Medicine & Nursing, Hungkuang University, Taiwan. He has published more than 34 papers in reputed journals and has been serving as an Editorial Board Member of Case Reports in Immunology.
Enhanced production of collagen, mediated by matrix metalloproteinases (MMPs), is a key event in the development of diabetic glomerular extracellular matrix (ECM) abnormalities. The MMP- mediated ECM alterations are also required for the processes of adipose tissue expansion which requires the differentiation and transformation of pre-adipocytes into mature adipocytes. Nevertheless, the pre-adipocytes behaviors, and their possible roles in energy homeostasis have long been overlooked. The present study aimed at examining the cross talk among glucose, insulin and interleukin-4 (IL-4) on regulating MMP-2 expression and activity in 3T3-L1 pre-adipocytes. Our results revealed that glucose level is a pre-requisite for pre-adipocytes responding to insulin and/or IL-4 treatment. In high glucose-containing environment, short-term acute insulin treatment (AI) and long-term chronic insulin exposure (CI) showed opposite regulation to MMP-2 expression and activity. Interestingly, the dominant MMP-2 regulatory role of CI under euglycemic condition was attenuated in cells exposed to high glucose concentration. It indicates that chronic insulin exposure has dominant effects on modulating MMP-2 and possibly the ECM remodeling under hyperglycemic state. This finding raises the possibility that continuous insulin injection, required for patients suffering from T1DM and T2DM with long duration, is likely to potentiate the onset of diabetic complications by causing ECM remodeling through MMP-2 alterations once their insulin treatment is not properly monitored. The present study uncovers novel observations regarding pre- adipocytes behaviors and suggests their roles in the process of increased adiposity and diabetic complications.
Edwin Rodríguez-Cruz has completed Doctorate degree from the San Juan Bautista School of Medicine PR. he specializes in Internal Medicine & Pediatrics. He completed Pediatric Cardiology fellowship and sub-fellowship in Interventional Cardiology from the Children's Hospital of Michigan. Currently is the Director of Cardiology of the San Jorge Children's Hospital, and Associate Professor of Medicine and Pediatrics at the San Juan Bautista School of Medicine, PR, USA. Has published over 20 articles in peer review journals and many specialty opinions by editors' request. His interests are in the areas of heart failure, structural heart diseases, and difficult venous accesses. Special interest in chronic total venous occlusions (CTVO).
Renal arteries obstructions are not common in the pediatric population. That is the reason why they are a great challenge for their diagnosis and treatment for the clinician when they present. The case of an 8 y/o female who presented with severe arterial hypertension is discussed. Initially, the patient was evaluated and up to 5 antihypertensive medications were started. After complete evaluation, she was found to have severe right renal artery's ostial and proximal stenosis. For these, she underwent recurrent angioplasties and then a bare metal stent (BMS) implantation, due to recurrence of the stenosis. Later the BMS developed a circumferential fracture, so, another stent was implanted. But the second stent used was a drug eluting stent (DES). Since the last intervention she has been stable for 8 years, although, on 2 antihypertensive medications. Renal artery stenosis is rare in the pediatric population. Angioplasty and surgery have been used to treat it. Stent implantation has been used more often in adults for its treatment, too. The use of BMS and DES may add another tool in the armamentarium of the pediatric interventionist to treat these children with recurrent stenosis that fail to angioplasty.