Health
Traditional Chinese herbal medicines hold promise for slowing the progression from prediabetes to an official diabetes diagnosis, according to new research accepted for publication in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Prediabetes is diagnosed an individual has developed elevated blood sugar levels, but glucose levels have not yet risen to the point of developing type 2 diabetes.
People who are prediabetic face a heightened risk of developing type 2 diabetes as well as heart disease and stroke.
According to the Centers for Disease Control and Prevention, about 79 million American adults age 20 years or older have prediabetes.
“With diabetes evolving into a serious public health burden worldwide, it is crucial to take steps to stem the flood of cases,” said one of the study's authors, Chun-Su Yuan, MD, PhD, of the University of Chicago. “Patients often struggle to make the necessary lifestyle changes to control blood sugar levels, and current medications have limitations and can have adverse gastrointestinal side effects. Traditional Chinese herbs may offer a new option for managing blood sugar levels, either alone or in combination with other treatments.”
During the double-blind, randomized, placebo-controlled trial, 389 participants at 11 research sites in China were randomly assigned to take either a capsule containing a mixture of 10 Chinese herbal medicines or a placebo.
For a year, subjects took capsules of either the Chinese herb mixture, called Tianqi, or the placebo three times a day before meals.
All participants received a month of lifestyle education at the outset of the trial and met with nutritionists several times during the course of the study. Subjects' glucose tolerance was measured on a quarterly basis.
At the end of the trial, 36 participants in the Tianqi group and 56 in the placebo group had developed diabetes. The analysis found taking Tianqi reduced the risk of diabetes by 32.1 percent compared with the placebo, after adjusting for age and gender.
The overall reduction in risk was comparable to that found in studies of diabetes medications acarbose and metformin, and study participants reported few side effects from the Tianqi herbs. Tianqi includes several herbs that have been shown to lower blood glucose levels and improve control of blood glucose levels after meals.
“Few controlled clinical trials have examined traditional Chinese medicine's impact on diabetes, and the findings from our study showed this approach can be very useful in slowing the disease's progression,” said one of the study's lead authors, Xiaolin Tong, MD, PhD, of Guang'anmen Hospital in Beijing, China, said. “More research is needed to evaluate the role Chinese herbal medicine can play in preventing and controlling diabetes.”
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Christopher Parsons, MD, Director of the HIV Malignancies Program at LSU Health Sciences Center New Orleans, is the senior author of a paper that is the first to report that specialized fat (lipid) molecules, called sphingolipids, play a key role in the survival of aggressive lymphomas caused by viruses.
The paper also reveals a new therapy for preventing production of sphingolipids by lymphoma cells, thereby killing these cells, which are often resistant to standard therapies.
The study is published in the January 2014 issue of Molecular Cancer Therapeutics, a journal of the American Association for Cancer Research.
The research team focuses on primary effusion lymphoma (PEL), an aggressive and deadly variant of diffuse large B-cell lymphoma that frequently occurs in people infected with HIV.
Though scientists have known that the Kaposi's sarcoma-associated herpesvirus (KSHV) causes PEL, development of effective therapies has proven difficult. PEL tumors arise within body cavities and progress rapidly with an average survival of around 6 months.
Combination chemotherapy represents the current standard of care for PEL, but side effects (including bone marrow suppression) and drug resistance (generated through virus-associated mechanisms) continue to limit the effectiveness of standard therapy.
After documenting the role of an enzyme called sphingosine kinase (SK), in the generation of biologically active sphingolipids in PEL tumors that keep the tumor cells alive, the researchers tested a novel clinical-grade small molecule that selectively targets SK.
The molecule, called ABC294640, was developed by Apogee Biotechnology Corporation. Previous studies found antitumor effects for ABC294640 with kidney, prostate, and breast cancer cell lines.
In the current study, ABC294640 not only inhibited SK function and induced PEL cell death, it worked selectively for virus-infected cells while sparing uninfected cells.
“It is still early in our understanding of how these special lipids contribute to viral cancers, but this is a major potential advance. There are no therapies available to fight viral tumors by selectively blocking these pathways, all while not harming normal, uninfected cells,” noted Dr. Parsons, who is also a member of the LSUHSC Stanley S. Scott Cancer Center.
Dr. Parsons' research group partnered with Apogee several years ago to develop and test new small molecules targeting lipid synthesis pathways, especially those in viral lymphomas, which have high rates of relapse or failure with standard therapies and higher mortality than non-viral lymphomas.
“Our research thus far indicates that this molecule is safe, with the potential to stand alone as a single, orally administered drug with no need to combine it with other toxic drugs now routinely used but which fail to work for many patients,” concluded Dr. Parsons.
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