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Research Roundup

Posted by on Wednesday, July 19, 2023 in Around the Medical Center, Summer 2023 .

Diabetes drug may improve asthma

Type 2 diabetes mellitus and obesity are associated with many comorbidities, including asthma. Glucagon-like peptide-1 receptor agonist (GLP-1RA) drugs, which have been approved for the treatment of Type 2 diabetes, also may reduce asthma risk, although the mechanisms remain undefined.

New research conducted by Katherine Cahill, MD, and colleagues at VUMC and Brigham and Women’s Hospital in Boston found significantly lower levels of periostin in the serum of patients with Type 2 diabetes who were treated with GLP-1RA drugs, a finding that was independent of weight loss.

Periostin is a known clinical biomarker of treatment response in asthma clinical trials. These findings suggest that GLP-1RA use may reduce the risk for poor asthma outcomes in patients with Type 2 diabetes and obesity by impacting pathways relevant to airway inflammation.

This work, published in the journal Clinical & Experimental Allergy, strengthens the case for using GLP-1RA drugs to treat Type 2 diabetes patients who also suffer from asthma.

How arterial “stiffness” may impair cognition

Small vessel disease (SVD) is associated with cognitive decline and development of dementia. Enlargement of the perivascular spaces (ePVS) surrounding blood vessels in the brain may be a marker of SVD.

Angela Jefferson, PhD, and colleagues developed a novel machine-learning technique that enabled them to quantify ePVS volume from magnetic resonance imaging (MRI) of the basal ganglia, the part of the brain which plays a crucial role in information processing and executive function.

In a longitudinal study of 327 older adults in the Vanderbilt Memory & Aging Project, about half of whom had mild cognitive impairment, the researchers correlated increased ePVS burden in the basal ganglia with impaired executive function and cognition. Using cardiac MRI, they also found that a rise in aortic pulse wave velocity, a measure of arterial stiffness, was associated with increased ePVS count and volume.

Their paper, published in the journal Neurobiology of Aging, suggests that cardiovascular disease, by increasing ePVS volume, may lead to cognitive decline.

A marker for mortality

Prostaglandins are inflammatory mediators that can contribute to many chronic diseases. PGE-M, a prostaglandin metabolite that can be measured in urine, is reflective of prostaglandin production in the body.

Wanqing Wen, MD, MPH, and colleagues conducted a study to determine associations of urinary PGE-M levels with mortality in 2,927 noncancerous adults in the Shanghai Women’s Health Study and Shanghai Men’s Health Study, two ongoing prospective cohort studies conducted in Shanghai, China.

The researchers discovered that higher urinary PGE-M levels were significantly associated with a higher risk of mortality as well as cardiometabolic disease-related deaths. Of note, PGE-M levels were also increased in adults with a low education level, heavy smoking, obesity as measured by a waist-hip ratio, and old age.

This study, published in Scientific Reports, highlights the association of increased inflammatory responses, as measured by a urinary metabolite, with increased mortality and with multiple modifiable lifestyle factors.