Document Detail


PPARalpha: an emerging therapeutic target in diabetic microvascular damage.
MedLine Citation:
PMID:  20567246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The global pandemic of diabetes mellitus portends an alarming rise in the prevalence of microvascular complications, despite advanced therapies for hyperglycemia, hypertension and dyslipidemia. Peroxisome proliferator-activated receptor alpha (PPARalpha) is expressed in organs affected by diabetic microvascular disease (retina, kidney and nerves), and its expression is regulated specifically in these tissues. Experimental evidence suggests that PPARalpha activation attenuates or inhibits several mediators of vascular damage, including lipotoxicity, inflammation, reactive oxygen species generation, endothelial dysfunction, angiogenesis and thrombosis, and thus might influence intracellular signaling pathways that lead to microvascular complications. PPARalpha has emerged as a novel target to prevent microvascular disease, via both its lipid-related and lipid-unrelated actions. Despite strong experimental evidence of the potential benefits of PPARalpha agonists in the prevention of vascular damage, the evidence from clinical studies in patients with diabetes mellitus remains limited. Promising findings from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study on microvascular outcomes are countered by elevations in participants' homocysteine and creatinine levels that might potentially attenuate the benefits of PPARalpha activation. This Review focuses on the role of PPARalpha activation in diabetic microvascular disease and highlights the available experimental and clinical evidence from studies of PPARalpha agonists.
Authors:
Anne Hiukka; Marianna Maranghi; Niina Matikainen; Marja-Riitta Taskinen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-06-22
Journal Detail:
Title:  Nature reviews. Endocrinology     Volume:  6     ISSN:  1759-5037     ISO Abbreviation:  Nat Rev Endocrinol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-26     Completed Date:  2010-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101500078     Medline TA:  Nat Rev Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  454-63     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, Helsinki University Central Hospital and Biomedicum, Haartmaninkatu 8, 00029 Helsinki, Finland.
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MeSH Terms
Descriptor/Qualifier:
Clofibric Acid / therapeutic use
Diabetes Mellitus / drug therapy,  metabolism*
Dyslipidemias / drug therapy,  metabolism
Hemodynamics
Humans
Microvessels / metabolism*,  pathology*
PPAR alpha / metabolism*
Chemical
Reg. No./Substance:
0/PPAR alpha; 882-09-7/Clofibric Acid
Comments/Corrections
Erratum In:
Nat Rev Endocrinol. 2010 Sep;6(9):476

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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